Review of recent innovations in portable child growth measurement devices for use in low- and middle-income countries

AbstractObjectiveWe characterized post-infancy child growth patterns and determined the incidence of becoming stunted and of recovery from stunting.DesignData came from Young Lives, a longitudinal study of childhood poverty in four low- and middle-income countries.SettingWe analysed length/height measurements for children at ages 1, 5 and 8 years.SubjectsChildren (n 7171) in Ethiopia, India, Peru and Vietnam.ResultsMean height-for-age Z-score (HAZ) at age 1 year ranged from −1·51 (Ethiopia) to −1·08 (Vietnam). From age 1 to 5 years, mean HAZ increased by 0·27 in Ethiopia (P < 0·001) and decreased among the other cohorts (range: −0·19 (Peru) to −0·32 (India); all P < 0·001). From 5 to 8 years, mean HAZ increased in all cohorts (range: 0·19 (India) to 0·38 (Peru); all P < 0·001). Prevalence of stunting (HAZ<−2·0) at 1 year ranged from 21 % (Vietnam) to 46 % (Ethiopia). From age 1 to 5 years, stunting prevalence decreased by 15·1 percentage points in Ethiopia (P < 0·001) and increased in the other cohorts (range: 3·0 percentage points (Vietnam) to 5·3 percentage points (India); all P ≤ 0·001). From 5 to 8 years, stunting prevalence decreased in all cohorts (range: 5·0 percentage points (Vietnam) to 12·7 percentage points (Peru); all P < 0·001). The incidence of becoming stunted between ages 1 to 5 years ranged from 11 % (Vietnam) to 22 % (India); between ages 5 to 8 years, it ranged from 3 % (Peru) to 6 % (India and Ethiopia). The incidence of recovery from stunting between ages 1 and 5 years ranged from 27 % (Vietnam) to 53 % (Ethiopia); between ages 5 and 8 years, it ranged from 30 % (India) to 47 % (Ethiopia).ConclusionsWe found substantial recovery from early stunting among children in four low- and middle-income countries.

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Birth Status, Child Growth, and Adult Outcomes in Low- and Middle-Income Countries

The Journal of Pediatrics ◽

10.1016/j.jpeds.2013.08.012 ◽

2013 ◽

Vol 163 (6) ◽

pp. 1740-1746.e4 ◽

Cited By ~ 28

Author(s):

Aryeh D. Stein ◽

Fernando C. Barros ◽

Santosh K. Bhargava ◽

Wei Hao ◽

Bernardo L. Horta ◽

...

Keyword(s):

Child Growth ◽

Adult Outcomes ◽

Middle Income ◽

Middle Income Countries ◽

Low And Middle Income

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Secondhand Smoking and Obesity Among Nonsmoking Adolescents Aged 12–15 Years From 38 Low- and Middle-Income Countries

Nicotine & Tobacco Research ◽

10.1093/ntr/ntaa053 ◽

2020 ◽

Vol 22 (11) ◽

pp. 2014-2021

Author(s):

Ai Koyanagi ◽

Lee Smith ◽

Hans Oh ◽

Lin Yang ◽

Sarah E Jackson ◽

...

Keyword(s):

Secondhand Smoke ◽

Child Growth ◽

Cross Sectional ◽

Middle Income ◽

Daily Exposure ◽

Middle Income Countries ◽

Secondhand Smoking ◽

Country Study ◽

Meta Analyses ◽

Low And Middle Income

Abstract Introduction Secondhand smoking (SHS) may be a risk factor for obesity in adolescence, but data on the association between SHS and obesity are scarce, especially from low- and middle-income countries (LMICs). Therefore, the aim of this study was to assess the association between SHS and obesity among adolescents aged 12–15 years from 38 LMICs. Methods Cross-sectional data from 38 LMICs that participated in the Global School-based Student Health Survey (GSHS) were analyzed. Body mass index was calculated based on measured weight and height. The 2007 WHO Child Growth reference was used to define obesity. SHS was categorized as no exposure, non-daily exposure (ie, 1–6 days), and daily exposure (ie, 7 days) based on the number of days exposed to secondhand smoke in the past 7 days. Multivariable logistic regression and meta-analyses were conducted to assess the associations. Results The analyzed sample consisted of 88 209 adolescents aged 12–15 years who never smoked. The overall prevalence of non-daily and daily SHS was 34.2% and 15.7%, respectively. After adjustment for potential confounders, compared with no SHS, there was no significant association between non-daily SHS and obesity (odds ratio [OR] = 0.94; 95% confidence interval [CI] = 0.86–1.02), but adolescents who reported daily SHS were significantly more likely to have obesity (OR = 1.19; 95% CI = 1.06–1.34). Conclusions The prevalence of SHS was high among adolescents in LMICs, and daily SHS was associated with a significant increase in odds of obesity. Future studies with longitudinal designs are warranted to assess causality and whether prevention of SHS can reduce the risk of obesity in adolescence. Implications In the present large multi-country study on adolescents aged 12–15 years from LMICs, nearly half of the students were exposed to non-daily or daily secondhand smoke. Overall, while non-daily SHS was not significantly associated with obesity, adolescents who reported daily SHS had a significant 1.19 (95% CI = 1.06–1.34) times higher odds of obesity than those who reported no exposure to secondhand smoke. To the best of our knowledge, this is the first multi-country study on SHS and obesity from LMICs, and also the largest study on this topic to date.

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Associations between birth registration and early child growth and development: evidence from 31 low- and middle-income countries

BMC Public Health ◽

10.1186/s12889-018-5598-z ◽

2018 ◽

Vol 18 (1) ◽

Cited By ~ 3

Author(s):

Joshua Jeong ◽

Amiya Bhatia ◽

Günther Fink

Keyword(s):

Growth And Development ◽

Child Growth ◽

Birth Registration ◽

Middle Income ◽

Early Child ◽

Middle Income Countries ◽

Low And Middle Income

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Enablers and Barriers of Zinc Fortification; Experience from 10 Low- and Middle-Income Countries with Mandatory Large-Scale Food Fortification

Nutrients ◽

10.3390/nu13062051 ◽

2021 ◽

Vol 13 (6) ◽

pp. 2051

Author(s):

Ann Tarini ◽

Mari S. Manger ◽

Kenneth H. Brown ◽

Mduduzi N. N. Mbuya ◽

Laura A. Rowe ◽

...

Keyword(s):

Zinc Deficiency ◽

Large Scale ◽

Public Health Problem ◽

Child Growth ◽

World Health ◽

Food Fortification ◽

Middle Income ◽

Middle Income Countries ◽

Zinc Fortification ◽

Low And Middle Income

Adequate zinc nutrition is important for child growth, neurodevelopment, immune function, and normal pregnancy outcomes. Seventeen percent of the global population is estimated to be at risk for inadequate zinc intake. However, zinc is not included in the fortification standards of several low- and middle-income countries with mandatory fortification programs, despite data suggesting a zinc deficiency public health problem. To guide policy decisions, we investigated the factors enabling and impeding the inclusion of zinc as a fortificant by conducting in-depth interviews with 17 key informants from 10 countries. Findings revealed the decision to include zinc was influenced by guidance from international development partners and enabled by the assessment of zinc deficiency, mandatory regional food fortification standards which included zinc, the World Health Organization (WHO) guidelines for zinc fortification, and the low cost of zinc compound commonly used. Barriers included the absence of zinc from regional fortification standards, limited available data on the efficacy and effectiveness of zinc fortification, and the absence of national objectives related to the prevention of zinc deficiency. To promote zinc fortification there is a need to put the prevention of zinc deficiency higher on the international nutrition agenda and to promote large-scale food fortification as a key deficiency mitigation strategy.

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Mapping child growth failure across low- and middle-income countries

Nature ◽

10.1038/s41586-019-1878-8 ◽

2020 ◽

Vol 577 (7789) ◽

pp. 231-234 ◽

Cited By ~ 21

Author(s):

Keyword(s):

Growth Failure ◽

Child Growth ◽

Reference Standards ◽

World Health ◽

Middle Income ◽

Children Under Five ◽

Under Five ◽

Middle Income Countries ◽

Growth Reference ◽

Low And Middle Income

AbstractChildhood malnutrition is associated with high morbidity and mortality globally1. Undernourished children are more likely to experience cognitive, physical, and metabolic developmental impairments that can lead to later cardiovascular disease, reduced intellectual ability and school attainment, and reduced economic productivity in adulthood2. Child growth failure (CGF), expressed as stunting, wasting, and underweight in children under five years of age (0–59 months), is a specific subset of undernutrition characterized by insufficient height or weight against age-specific growth reference standards3–5. The prevalence of stunting, wasting, or underweight in children under five is the proportion of children with a height-for-age, weight-for-height, or weight-for-age z-score, respectively, that is more than two standard deviations below the World Health Organization’s median growth reference standards for a healthy population6. Subnational estimates of CGF report substantial heterogeneity within countries, but are available primarily at the first administrative level (for example, states or provinces)7; the uneven geographical distribution of CGF has motivated further calls for assessments that can match the local scale of many public health programmes8. Building from our previous work mapping CGF in Africa9, here we provide the first, to our knowledge, mapped high-spatial-resolution estimates of CGF indicators from 2000 to 2017 across 105 low- and middle-income countries (LMICs), where 99% of affected children live1, aggregated to policy-relevant first and second (for example, districts or counties) administrative-level units and national levels. Despite remarkable declines over the study period, many LMICs remain far from the ambitious World Health Organization Global Nutrition Targets to reduce stunting by 40% and wasting to less than 5% by 2025. Large disparities in prevalence and progress exist across and within countries; our maps identify high-prevalence areas even within nations otherwise succeeding in reducing overall CGF prevalence. By highlighting where the highest-need populations reside, these geospatial estimates can support policy-makers in planning interventions that are adapted locally and in efficiently directing resources towards reducing CGF and its health implications.

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