scholarly journals Are Play Items and Interaction Activities at Home Associated with Developmental Outcomes in Children with Moderate Acute Malnutrition?

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1238-1238
Author(s):  
Meta Van den Heuvel ◽  
Harriet Babikako ◽  
Emmie Mbale ◽  
John Mukisa ◽  
Margaret Nampijja ◽  
...  
Keyword(s):  
Linear Regression ◽  
Developmental Outcomes ◽  
Acute Illness ◽  
Acute Malnutrition ◽  
Fine Motor ◽  
Z Score ◽  
Gross Motor ◽  
Point Increase ◽  
Moderate Acute Malnutrition

Abstract Objectives To assess the association between play and interaction, and developmental outcomes in children with moderate acute malnutrition (MAM) in a prospective cohort of hospitalized children in Malawi and Uganda (http://www.chainnetwork.org). Methods Children (age 2– 23 months) requiring hospitalization for acute illness were enrolled from January 2017 till December 2018. Children meeting WHO criteria for MAM by mean upper arm circumference (MUAC) were included in this sub-analysis. Child development was assessed using the Malawi Developmental Assessment Tool at discharge and 180-day follow-up. The Family Care Indicator (FCI) evaluated the number of play items and interactions in the home. Developmental outcomes at discharge and follow-up were assessed using paired t-test. Linear regression analysis examined associations between FCI score and developmental outcomes at follow-up, with adjustment for sex, prematurity, height-for-age z-score and HIV status, parental education, household assets, and maternal mental health. Results 128 children with MAM (52.3% male, mean age 11.3 months (±4.5) were included (mean MUAC 120 mm ± 3.2). Children were excluded for: pre-existing neurodisability (n = 5), death during follow-up (n = 4), and loss to follow-up (n = 22). At discharge 24.4% of the children had delays in the gross motor domain, 18.7% in the fine motor domain, 4.1% in the language domain and 7.3% in the social domain. Over the 6-month study period, significant improvements (P < 0.001) in the mean difference of gross motor (1.3), fine motor (0.83) and social domain (0.59) Z-scores were observed. No significant change was identified in the language domain Z-score. Adjusted linear regression revealed that a one-point increase in the number of play items was associated with an increase in gross motor z-score of 0.16 (95% CI 0.01–0.32, P = 0.04) and a one point increase in interaction activities was associated with an increase in language z-score of 0.27 (95% CI 0.03–0.51, P = 0.03) at follow-up. Conclusions Children with MAM admitted for an acute illness showed significant improvements in developmental outcomes at 180-day follow-up. The role of play and interaction activities at home should be further investigated for their potential to promote developmental outcomes in children with MAM. Funding Sources Bill and Melinda Gates Foundation.

scholarly journals Impact of food supplements on early child development in children with moderate acute malnutrition: A randomised 2 x 2 x 3 factorial trial in Burkina Faso

PLoS Medicine ◽  
2020 ◽  
Vol 17 (12) ◽  
pp. e1003442
Author(s):  
Mette F. Olsen ◽  
Ann-Sophie Iuel-Brockdorff ◽  
Charles W. Yaméogo ◽  
Bernardette Cichon ◽  
Christian Fabiansen ◽  
...  
Keyword(s):  
Child Development ◽  
Motor Development ◽  
Acute Malnutrition ◽  
Fine Motor ◽  
Gross Motor ◽  
Factorial Trial ◽  
Z Scores ◽  
Moderate Acute Malnutrition ◽  
Post Hoc

Background Lipid-based nutrient supplements (LNS) and corn–soy blends (CSBs) with varying soy and milk content are used in treatment of moderate acute malnutrition (MAM). We assessed the impact of these supplements on child development. Methods and findings We conducted a randomised 2 × 2 × 3 factorial trial to assess the effectiveness of 12 weeks’ supplementation with LNS or CSB, with either soy isolate or dehulled soy, and either 0%, 20%, or 50% of protein from milk, on child development among 6–23-month-old children with MAM. Recruitment took place at 5 health centres in Province du Passoré, Burkina Faso between September 2013 and August 2014. The study was fully blinded with respect to soy quality and milk content, while study participants were not blinded with respect to matrix. This analysis presents secondary trial outcomes: Gross motor, fine motor, and language development were assessed using the Malawi Development Assessment Tool (MDAT). Of 1,609 children enrolled, 54.7% were girls, and median age was 11.3 months (interquartile range [IQR] 8.2–16.0). Twelve weeks follow-up was completed by 1,548 (96.2%), and 24 weeks follow-up was completed by 1,503 (93.4%); follow-up was similar between randomised groups. During the study, 4 children died, and 102 children developed severe acute malnutrition (SAM). There was no difference in adverse events between randomised groups. At 12 weeks, the mean MDAT z-scores in the whole cohort had increased by 0.33 (95% CI: 0.28, 0.37), p < 0.001 for gross motor; 0.26 (0.20, 0.31), p < 0.001 for fine motor; and 0.14 (0.09, 0.20), p < 0.001 for language development. Children had larger improvement in language z-scores if receiving supplements with milk (20%: 0.09 [−0.01, 0.19], p = 0.08 and 50%: 0.11 [0.01, 0.21], p = 0.02), although the difference only reached statistical significance for 50% milk. Post hoc analyses suggested that this effect was specific to boys (interaction p = 0.02). The fine motor z-scores were also improved in children receiving milk, but only when 20% milk was added to CSB (0.18 [0.03, 0.33], p = 0.02). Soy isolate over dehulled soy increased language z-scores by 0.07 (−0.01, 0.15), p = 0.10, although not statistically significant. Post hoc analyses suggested that LNS benefited gross motor development among boys more than did CSB (interaction p = 0.04). Differences between supplement groups did not persist at 24 weeks, but MDAT z-scores continued to increase post-supplementation. The lack of an unsupplemented control group limits us from determining the overall effects of nutritional supplementation for children with MAM. Conclusions In this study, we found that child development improved during and after supplementation for treatment of MAM. Milk protein was beneficial for language and fine motor development, while suggested benefits related to soy quality and supplement matrix merit further investigation. Supplement-specific effects were not found post-intervention, but z-scores continued to improve, suggesting a sustained overall effect of supplementation. Trial registration ISRCTN42569496

scholarly journals Recovery rate of children with moderate acute malnutrition treated with ready-to-use supplementary food (RUSF) or improved corn–soya blend (CSB+): a randomized controlled trial

2015 ◽  
Vol 19 (2) ◽  
pp. 363-370 ◽  
Author(s):  
Gabriel Nama Medoua ◽  
Patricia M Ntsama ◽  
Anne Christine A Ndzana ◽  
Véronique J Essa’a ◽  
Julie Judith T Tsafack ◽  
...  
Keyword(s):  
Nutrition Education ◽  
Recovery Rate ◽  
Energy Requirement ◽  
Controlled Trial ◽  
Acute Malnutrition ◽  
Rank Test ◽  
Supplementary Food ◽  
Significant Difference ◽  
Moderate Acute Malnutrition

AbstractObjectiveTo compare an improved corn–soya blend (CSB+) with a ready-to-use supplementary food (RUSF) to test the hypothesis that satisfactory recovery rate will be achieved with CSB+ or RUSF when these foods provide 50 % of the child’s energy requirement, the 50 % remaining coming from usual diet.DesignA comparative efficacy trial study was conducted with moderately wasted children, using a controlled randomized design, with parallel assignment for RUSF or CSB+. Every child received a daily ration of 167 kJ (40 kcal)/kg body weight during 56 d with a follow-up performed every 14 d. Every caregiver received nutrition counselling at enrolment and at each follow-up visit.SettingHealth districts of Mvog-Beti and Evodoula in the Centre region of Cameroon.SubjectsEight hundred and thirty-three children aged 6–59 months were screened and eighty-one malnourished children (weight-for-height Z-score between −3 and −2) aged 25–59 months were selected.ResultsOf children treated with CSB+ and RUSF, 73 % (95 % CI 59 %, 87 %) and 85 % (95 % CI 73 %, 97 %), respectively, recovered from moderate acute malnutrition, with no significant difference between groups. The mean duration of treatment required to achieve recovery was 44 d in the RUSF group and 51 d in the CSB+ group (log-rank test, P=0·0048).ConclusionsThere was no significant difference in recovery rate between the groups. Both CSB+ and RUSF were relatively successful for the treatment of moderate acute malnutrition in children. Despite the relatively low ration size provided, the recovery rates observed for both groups were comparable to or higher than those reported in previous studies, a probable effect of nutrition education.

scholarly journals Effect of play-based family-centered psychomotor/psychosocial stimulation on the development of severely acutely malnourished children under six in a low-income setting: a randomized controlled trial

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Teklu Gemechu Abessa ◽  
Berhanu Nigussie Worku ◽  
Mekitie Wondafrash ◽  
Tsinuel Girma ◽  
Johan Valy ◽  
...  
Keyword(s):  
Low Income ◽  
Effect Size ◽  
Linear Growth ◽  
Intervention Group ◽  
Fine Motor ◽  
Social Emotional ◽  
Gross Motor ◽  
Psychosocial Stimulation ◽  
Low Income Setting

Abstract Background The World Health Organization (WHO) recommends incorporating psychosocial stimulation into the management of severe acute malnutrition (SAM). However, there is little evidence about the effectiveness of these interventions for SAM children, particularly when serious food shortages and lack of a balanced diet prevail. The objective of this study was to examine whether family-based psychomotor/psychosocial stimulation in a low-income setting improves the development, linear growth, and nutritional outcomes in children with SAM. Method Children with SAM (N = 339) admitted for treatment to the Jimma University Specialized Hospital, Ethiopia, were randomized to a control (n = 170) or intervention (n = 169) group. Both groups received routine medical care and nutritional treatment at the hospital. The intervention group additionally received play-based psychomotor/psychosocial stimulation during their hospital stay, and at home for 6 months after being discharged from hospital. The fine motor (FM) and gross motor (GM) functions, language (LA) and personal-social (PS) skills of the children were assessed using adapted Denver II, the social-emotional (SE) behavior was assessed using adapted Ages and Stages Questionnaires: Social-Emotional, and the linear growth and nutritional status were determined through anthropometric assessments. All outcomes were assessed before the intervention, upon discharge from hospital, and 6 months after discharge (as end-line). The overtime changes of these outcomes measured in both groups were compared using Generalized Estimating Equations. Results The intervention group improved significantly on GM during hospital follow-up by 0.88 points (p < 0.001, effect size = 0.26 SD), and on FM functions during the home follow-up by 1.09 points (p = 0.001, effect size = 0.22 SD). Both young and older children benefited similarly from the treatment. The intervention did not contribute significantly to linear growth and nutritional outcomes. Conclusion Psychomotor/psychosocial stimulation of SAM children enhances improvement in gross motor functions when combined with standard nutrient-rich diets, but it can enhance the fine motor functions even when such standard dietary care is not available. Trial registration The trial was retrospectively registered on 30 January 2017 at the US National Institute of Health (ClinicalTrials.gov) # NCT03036176.

Diarrhea Prevalence and Child Growth Faltering Are Associated with Subsequent Adverse Child Developmental Outcomes in Bangladesh (CHoBI7 Program)

2021 ◽  
Author(s):  
Christine Marie George ◽  
Jamie Perin ◽  
Tahmina Parvin ◽  
Md Sazzadul Islam Bhuyian ◽  
Elizabeth D. Thomas ◽  
...  
Keyword(s):  
Developmental Outcomes ◽  
Child Growth ◽  
Social Problem Solving ◽  
Fine Motor ◽  
Linear Regression Models ◽  
Developmental Potential ◽  
Growth Faltering ◽  
Z Scores ◽  
Diarrhea Prevalence

Millions of young children annually are not meeting their developmental potential in low- and middle-income countries. Previous studies have shown that diarrheal diseases during early life are associated with subsequent malnutrition. This prospective cohort study of 576 children under 5 years was conducted in urban Dhaka, Bangladesh, to investigate the association between diarrhea prevalence, child growth, and child cognitive developmental outcomes. Height and weight were measured at baseline and a 12-month follow-up. Diarrhea prevalence was assessed through monthly surveillance visits. Developmental outcomes were assessed by communication, fine motor, gross motor, personal social, problem-solving, and combined developmental scores measured by the Extended Ages and Stages Questionnaire (EASQ) at the 12-month follow-up visit. To assess the association between diarrhea prevalence, child growth, and child developmental outcomes, linear regression models were fit using generalized estimating equations to account for clustering at the household level and to approximate 95% CIs. Diarrhea prevalence was negatively associated with change in height-for-age (HAZ) Z-scores from baseline to the 12-month follow-up (coefficient −0.85 [95% CI: −1.42, −0.28]). Diarrhea prevalence was a significant predictor of combined EASQ Z-scores with and without baseline stunting included in the model (−0.89 [95% CI: −1.67, −0.09] [baseline stunting included]) and (−0.88 [95% CI: −1.69, −0.07]). Change in HAZ from baseline to the 12-month follow-up was positively associated with follow-up combined EASQ Z-scores (0.28 [95% CI: 0.15, 0.42]). High diarrhea prevalence and linear growth faltering were associated with negative cognitive developmental outcomes among children residing in urban Dhaka, Bangladesh. Furthermore, high diarrhea prevalence was associated with negative child cognitive developmental outcomes with stunting included in the model, suggesting an effect of diarrhea on cognition independent of stunting.

Accuracy of parent-reported ages and stages questionnaire in assessing the motor and language skills of preterm infants

2020 ◽  
pp. 1-10
Author(s):  
G. Y. H. Hwarng ◽  
I. L Ereno ◽  
S. K. Ho ◽  
J. C. Allen ◽  
R. B. Moorakonda ◽  
...  
Keyword(s):  
Standardized Tests ◽  
Preterm Infants ◽  
Language Skills ◽  
Fine Motor ◽  
Gross Motor ◽  
Preschool Language ◽  
Singapore General Hospital ◽  
High Negative Predictive Value ◽  
Ages And Stages Questionnaire

BACKGROUND: Parent-completed tools like the Ages and Stages Questionnaire Third Edition (ASQ-3) are important in developmental screening. As a screening tool, a high negative predictive value (NPV) is critical to avoid missing the diagnosis of developmental delay. This study evaluated the NPV and accuracy of the ASQ-3 in assessing the development of preterm infants. METHODS: Infants born at <32 weeks and/or <1250 grams, presented to the Neonatal Neurodevelopmental Clinic at the Singapore General Hospital for follow-up from January 2014 –June 2017, at 6, 12, and 18 months corrected age, were included. The ASQ-3 and standardized tests –Peabody Developmental Motor Scale –Second Edition (PDMS-2) and Preschool Language Scale, Fourth Edition UK (PLS-4 UK) –were administered. ASQ-3 gross motor and fine motor scores were compared to PDMS-2 at 6 and 12 months, and ASQ-3 communication scores to PLS-4 UK at 18 months. RESULTS: At 6 months (n = 145), NPV for gross motor and fine motor were 96.4% (accuracy 80.0%) and 95.4% (accuracy 77.2%) respectively. At 12 months (n = 127), NPV for gross motor and fine motor were 88.9% (accuracy 79.8%) and 82.8% (accuracy 74.0%) respectively. At 18 months (n = 113), NPV for language was 56.9% (accuracy 63.7%). CONCLUSIONS: The ASQ-3 showed high NPV and accuracy in screening gross motor and fine motor skills at 6 and 12 months, but not in screening language skills at 18 months. Judicious use of the ASQ-3 may allow for more effective utilization of resources.

scholarly journals Time To Recovery From Moderate Acute Malnutrition And Its Predictors Among 6-59 Months Children Targeted For Supplementary Feeding In Shalla District, West Arsi Zone, Ethiopia, 2018.

2019 ◽  
Author(s):  
Kebede Kumsa Sadeta ◽  
Wondwosen Tekle silassie
Keyword(s):  
Supplementary Feeding ◽  
Childhood Mortality ◽  
Acute Malnutrition ◽  
National Standard ◽  
Multivariate Statistical ◽  
Mortality And Morbidity ◽  
Feeding Program ◽  
Moderate Acute Malnutrition ◽  
Food Share

Abstract Abstract Background-Globally, acute malnutrition accounts for >50% cases of childhood mortality in under 5 children each year. Moderate acute malnutrition treatment would be to reduce child mortality and morbidity. Study done in Ethiopia showed treatment food share, lack of water and other factor suggested to cause lower chance of recovery at end of 16 week as per Ethiopian acute malnutrition treatment guide line. Methods- Retrospective cohort study design was conducted among children aged 6–59 months which were treated in targeted supplementary feeding program. A total of 402 children were selected from eight health posts by systematic random sampling. Data were collected by reviewing registration records and interview from January 1-10/2018. Data were analyzed using SPSS version 20, bivariate and multivariate statistical methods were used to analyze and describe the data and p < 0.05 was considered as significant. Results-the overall average timely recovery was 15 week (SD,3.3). Children treated by super cereal were 2.44 times more likely to recover timely than children treated by corn soybean blend (AHR 2.44; 95% CI 1.85-3.21). Children that had regular follows up has 48% (AHR 1.48; 95% CI 1.09-2.00) more chance of recovery than intermittent treatment follow up, children’s from sever food in secured family had 51% lower chance to recover than moderate food insecured house hold (AHR 0.49; 95% CI 0.21-0.11) and, admission MUAC³11.6 cm had 1.18 times higher proportion of recovery than admission MUAC = 11.5 cm (AHR 1.18; 95% CI 1.13-1.12). Children who have no transport access has 2 times lower proportion of recovery than who have access (AHR 0.5; 95% CI 0.38-0.64). Conclusion- the mean time to recovery was 15 week which is consistent with the national standard 16 weeks. Type of treatment foods, treatment follow up status, and admission mid upper arm circumference had significant association with time recovery moderate acute malnutrition treatment.

Isolated CHDs and neurodevelopmental follow-up using the Bayley Scales of Infant and Toddler Development and the Ages and Stages Questionnaire at 18 and 36 months

2021 ◽  
pp. 1-8
Author(s):  
Mette Marie Baunsgaard ◽  
Tine B. Henriksen ◽  
Charlotte K. Gilberg ◽  
Dorthe B. Wibroe ◽  
Trine Haugsted ◽  
...  
Keyword(s):  
Fetal Brain ◽  
Fetal Mri ◽  
Z Score ◽  
Gross Motor ◽  
Score Difference ◽  
Increased Risk ◽  
Ages And Stages Questionnaire ◽  
Toddler Development ◽  
Bayley Scales

Abstract Objectives: To compare early neurocognitive development in children born with and without isolated CHD using the Bayley Scales of Infant and Toddler Development (3rd edition) and the Ages and Stages Questionnaire (3rd edition). Methods: Recruitment took place before birth. Women expecting fetuses with and without CHD causing disturbances in the flow of oxygenated blood to the fetal brain were included in a prospective cohort study comprising fetal MRI (previously published) and neurodevelopmental follow-up. We now present the 18- and 36-month neurodevelopmental follow-up using the Bayley Scales according to age and the 6-month-above-age Ages and Stages Questionnaire in 15 children with and 27 children without CHD. Results: Children with CHD had, compared with the children without CHD, an increased risk of scoring ≤ 100 in the Bayley Scales cognition category at 18 and 36 -months; relative risk 1.7 (95% confidence interval (CI): 1.0–2.8) and 3.1 (CI: 1.2–7.5), respectively. They also achieved lower scores in the 6-month-above-age Ages and Stages Questionnaires (24 and 42 months) communication; mean z-score difference −0.72 (CI: −1.4; −0.1) and −1.06 (CI: −1.8; −0.3) and gross motor; mean z-score difference: −0.87 (CI: −1.7; −0.1) and −1.22 (CI: −2.4; −0.02) categories. Conclusions: The children with CHD achieved lower scores in the Bayley Scales cognition category and the Ages and Stages Questionnaire communication and gross motor categories possibly indicative of early neurodevelopmental deficiencies. We recommend early screening and monitoring for neurodevelopmental delays in children with CHD in order to improve further neurodevelopment and educational achievements.

scholarly journals Low linoleic acid foods with added DHA given to Malawian children with severe acute malnutrition improves cognition: a randomized, triple blinded, controlled clinical trial

2021 ◽  
Author(s):  
Kevin Stephenson ◽  
Meghan Callaghan-Gillespie ◽  
Kenneth Maleta ◽  
Minyanga Nkhoma ◽  
Matthews George ◽  
...  
Keyword(s):  
Linoleic Acid ◽  
Assessment Tool ◽  
Severe Acute Malnutrition ◽  
Fatty Acid Content ◽  
Plasma Phospholipid ◽  
Acute Malnutrition ◽  
Fine Motor ◽  
Controlled Clinical Trial ◽  
Gross Motor ◽  
Z Scores

Background: There is concern that the PUFA composition of ready-to-use therapeutic food (RUTF) for treatment of severe acute malnutrition (SAM) is suboptimal for neurocognitive recovery. Objective: We tested the hypothesis that RUTF made with reduced amounts of linoleic acid, achieved using high oleic (HO) peanuts, with or without added DHA, improves cognition when compared to standard RUTF (S-RUTF). Methods: A triple-blind, randomized, controlled clinical feeding trial was conducted among children with uncomplicated SAM in Malawi with 3 types of RUTF; DHA-HO- RUTF, HO-RUTF and S-RUTF. The primary outcomes, measured in a subset of subjects, were the Malawi Developmental Assessment Tool (MDAT) global and 4 domain (gross motor, fine motor, language and social) z-scores and a modified Willatts problem solving assessment (PSA) intention score for 3 standardized problems, measured 6 months and immediately after completing RUTF therapy, respectively. Plasma fatty acid content, anthropometry and eye tracking were secondary outcomes. Comparisons were made between the novel PUFA RUTFs and S-RUTF. Results: Among the 2565 SAM children enrolled, global MDAT z-score was -0.69 ± 1.19 and -0.88 ± 1.27 for children receiving DHA-HO-RUTF and S-RUTF, respectively (difference 0.19, 95% CI 0.01 to 0.38). The gross motor and social domains had higher z-scores among children receiving either DHA-HO-RUTF than S-RUTF. The PSA problem 3 scores did not differ by dietary group (Odds ratio 0.92, 95% CI 0.67 to 1.26 for DHA-HO-RUTF). After 4 weeks of treatment, plasma phospholipid EPA and a- linolenic acid were greater in children consuming DHA-HO-RUTF or HO-RUTF when compared to S-RUTF (for all 4 comparisons P values < 0.001), but only plasma DHA was greater in DHA-HO-RUTF than S-RUTF ( P <0.001). Conclusions: Treatment of uncomplicated SAM with DHA-HO-RUTF resulted in an improved MDAT score, conferring a cognitive benefit six months after completing diet therapy. This treatment should be explored in operational settings.

Sign in / Sign up

Export Citation Format

Share Document