scholarly journals An uncertainty estimate of the prevalence of stunting in national surveys: the need for better precision

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Santu Ghosh ◽  
Nirupama Shivakumar ◽  
Sulagna Bandyopadhyay ◽  
Harshpal S. Sachdev ◽  
Anura V. Kurpad ◽  
...  
Keyword(s):  
Health Survey ◽  
Large Scale ◽  
Reference Value ◽  
Child Growth ◽  
Population Heterogeneity ◽  
World Health ◽  
National Surveys ◽  
Uncertainty Factor ◽  
Robust Statistical Method ◽  
Height For Age

Abstract Background Stunting is determined by using the World Health Organization (WHO) child growth standard which was developed using precise measurements. However, it is unlikely that large scale surveys maintain the same level of rigour and precision when measuring the height of children. The population measure of stunting in children is sensitive to over-dispersion, and the high prevalence of stunting observed in surveys in low and middle-income countries (LMIC) could partly be due to lower measurement precison. Objectives To quantify the incongruence in the dispersion of height-for-age in national surveys of < 5 y children, in relation to the standard WHO Multicenter Growth Reference Study (MGRS), and propose a measure of uncertainty in population measures of stunting. Methods An uncertainty factor was proposed and measured from the observed incongruence in dispersion of the height-for-age of < 5 y children in the MGRS against carefully matched populations from the Demographic Health Survey of 17 countries (‘test datasets’, based on the availability of data). This also allowed for the determination of uncertainty-corrected prevalence of stunting (height-for-age Z score < − 2) in < 5 y children. Results The uncertainty factor was estimated for 17 LMICs. This ranged from 0.9 to 2.1 for Peru and Egypt respectively (reference value 1). As an explicit country example, the dispersion of height-for-age in the Indian National Family Health Survey-4 test dataset was 39% higher than the MGRS study, with an uncertainty factor of 1.39. From this, the uncertainty-adjusted Indian national stunting prevalence estimate reduced to 18.7% from the unadjusted estimate of 36.2%. Conclusions This study proposes a robust statistical method to estimate uncertainty in stunting prevalence estimates due to incongruent dispersions of height measured in national surveys for children < 5 years in relation to the WHO height-for-age standard. The uncertainty is partly due to population heterogeneity, but also due to measurement precision, and calls for better quality in these measurements.

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

Nutrients ◽  
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.

scholarly journals National Narcissism predicts the Belief in and the Dissemination of Conspiracy Theories During the COVID-19 Pandemic: Evidence From 56 Countries

2021 ◽  
pp. 014616722110549
Author(s):  
Anni Sternisko ◽  
Aleksandra Cichocka ◽  
Aleksandra Cislak ◽  
Jay J. Van Bavel
Keyword(s):  
Large Scale ◽  
Secondary Analysis ◽  
The United States ◽  
Health Policies ◽  
World Health ◽  
Conspiracy Theories ◽  
Public Health Policies ◽  
National Surveys ◽  
The United Kingdom ◽  
Health Organization

Conspiracy theories related to coronavirus disease 2019 (COVID-19) have propagated around the globe, leading the World Health Organization to declare the spread of misinformation an “Infodemic.” We tested the hypothesis that national narcissism—a belief in the greatness of one’s nation that requires external recognition—is associated with the spread of conspiracy theories during the COVID-19 pandemic. In two large-scale national surveys ( NTotal = 950) conducted in the United States and the United Kingdom, and secondary analysis of data from 56 countries ( N = 50,757), we found a robust, positive relationship between national narcissism and proneness to believe and disseminate conspiracy theories related to COVID-19. Furthermore, belief in COVID-19 conspiracy theories was related to less engagement in health behaviors and less support for public-health policies to combat COVID-19. Our findings illustrate the importance of social identity factors in the spread of conspiracy theories and provide insights into the psychological processes underlying the COVID-19 pandemic.

scholarly journals Socioeconomic predictors of unconstrained child growth in Muscat, Oman

2004 ◽  
Vol 10 (3) ◽  
pp. 295-302
Author(s):  
A. J. Mohamed ◽  
A. W. Onyango ◽  
M. de Onis ◽  
N. Prakash ◽  
R. M. Mabry ◽  
...  
Keyword(s):  
Child Growth ◽  
World Health ◽  
Socioeconomic Indicators ◽  
Factors Associated ◽  
International Growth ◽  
Growth Reference ◽  
Sociodemographic Data ◽  
Health Organization ◽  
Health Registers ◽  
Height For Age

Weconducted a study to identify socioeconomic factors associated with unconstrained growth among preschoolers in Muscat, Oman. A sample of children born in 1995 and aged 28-43 months was drawn from the Child Health Registers of 2 health care centres. Sociodemographic data were collected by oral interview and maternal and child anthropometry measured. Regression analysis was used to identify socioeconomic indicators and cut-offs associated with unconstrained growth. Children from households with a monthly income > or = 800 Omani rials and mother’s education > or = 4 years attained height-for-age levels comparable to the current international growth reference. By screening using this criterion, we could obtain a suitable sample for the World Health Organization Multicentre Growth Reference Study in Muscat

scholarly journals A re-evaluation of the yield from national surveys of mental health

2008 ◽  
Vol 5 (1) ◽  
pp. 18-20 ◽  
Author(s):  
Ronald C. Kessler ◽  
T. Bedirhan Üstün
Keyword(s):  
Mental Health ◽  
Large Scale ◽  
World Health ◽  
List Type ◽  
Type Number ◽  
National Surveys ◽  
World Mental Health Survey ◽  
High Prevalence ◽  
The World ◽  
Political Value

Having spent a considerable amount of time thinking about the uses of large-scale descriptive psychiatric epidemiological needs assessment surveys in our capacity as co-directors of the World Health Organization's World Mental Health Survey Initiative, we agree with many of the conclusions of Henderson and Andrews. Most importantly, we agree: ∘that among the most important benefits of these surveys have been their political value in documenting high prevalence and high disability∘that the time has come to expand the focus to study causes.

scholarly journals The Relationship between Nutrient-Rich Foods (NRF) Index as A Measure of Diet Quality and Malnutrition in Children

2019 ◽  
Author(s):  
Jollanar Khankan ◽  
Shima Jazayeri ◽  
Farzad Shidfar ◽  
Zohreh Sajadi Hezaveh ◽  
Agha Fatemeh Hosseini ◽  
...  
Keyword(s):  
Diet Quality ◽  
Primary Schools ◽  
Weight Status ◽  
Child Growth ◽  
Index Score ◽  
World Health ◽  
Index Formula ◽  
Nutrient Density ◽  
Height For Age ◽  
Weight For Age

Background: The assessment of pediatric diet quality is of high interest because food habits that develop in childhood can predict adult diet-related disease. The aim of this study was to examine the association between the Nutrient-Rich Foods (NRF) index score and weight and height status. Methods: This cross-sectional study was conducted in primary schools of Tehran, and the NRF9.3 algorithms were used to estimate the nutrient density of the diet of 400 girls, aged 6.5-8.4 years. Dietary data were collected using a 168-item food frequency questionnaire of foods consumed over the past month. Height and weight were measured, and height for age, body mass index (BMI) for age, and weight for age were classified using the World Health Organization's child growth standard Z-scores. Linear regression was used to examine the association between the quintiles of NRF index score and weight for age, height for age, and BMI for age. Results: Liquid oil (P < 0.001), legume (P = 0.037), meat products (P = 0.005), and fruit (P < 0.001) were consumed in higher amounts significantly in the fifth quintile, while sugar & sweet sauce (P < 0.001), snacks (P = 0.002), fats, oil and savoury sauce (P = 0.002) were consumed in lower amounts significantly. A significant relationship between the NRF9.3 index and height for age (P = 0.039) was found, however, it did not follow a trend. The NRF9.3, NR9, and LIM3 scores were unrelated to weight status in childhood. Conclusion: There was no significant association between the NRF9.3 index score and malnutrition in girls, except for height for age. Bias in reporting the dietary intake or defects in the NRF index formula might be the reason for this insignificant result. Prospective studies can better detect the existence of such a relationship.

Nutritional Status of Pediatric Patients in Ramathibodi Hospital Using the WHO Child Growth Standard and the Thai Growth Reference

2020 ◽  
Vol 103 (10) ◽  
pp. 1099-1106
Keyword(s):  
Nutritional Status ◽  
Pediatric Patients ◽  
Chronically Ill ◽  
Child Growth ◽  
World Health ◽  
Healthy Children ◽  
Growth Standard ◽  
Growth Reference ◽  
Child Growth Standard

Background: The appropriate assessment of nutritional status in children is an essential aspect of health supervision. Currently, there are two references used for growth assessment in Thailand. The WHO child growth standard, which has been widely used since 2007, and the Thai growth reference developed by the Ministry of Public Health, which has been used since 1998. However, there were very few studies that made a direct comparison between both tools. Objective: To compare the nutritional status of healthy pediatric patients in Ramathibodi Hospital assessed by the World Health Organization (WHO) child growth standard and the Thai growth reference. Materials and Methods: The present study was a cross-sectional study. The data were collected from all pediatric patients registered in the outpatient department (OPD) of Faculty of Medicine, Ramathibodi Hospital between January 2013 and December 2018. All healthy children (aged 0 to 15 years) were included. Exclusion criteria of possibly chronically ill children were defined by those who were 1) visiting subspecialty clinics, 2) OPD and emergency room (ER) visits more than ten times per year, 3) having ICD-10 of chronic conditions, or 4) had been admitted in the hospital during the study. The weight and height or length data were extracted from the Electronic Medical Record system. All data were analyzed by the Stata Statistical Software focusing on age and sex-specific Z-scores, which references the WHO child growth standard and the Thai growth reference. Results: Sixty-two thousand one hundred four OPD visits were divided into 31,662 OPD visits for boys and 30,442 OPD visits for girls. Percent of weight for age and height or length for age more than +2 Z-score of both boys and girls when using the Thai growth reference was greater than that using the WHO child growth standard, especially for children aged 0 to 12 months. The Thai growth reference classified as overweight were approximately 10.26% to 31.12% more than using the WHO child growth standard. There was no difference in classification of height by both standards. Conclusion: There was a difference in classification of nutritional status between the Thai growth reference and the WHO child growth standard. Keywords: Nutritional status, Pediatric growth reference, Assessment tool, Overweight

scholarly journals Tuberculosis and Non-Communicable Disease Multimorbidity: An Analysis of the World Health Survey in 48 Low- and Middle-Income Countries

2021 ◽  
Vol 18 (5) ◽  
pp. 2439
Author(s):  
Brendon Stubbs ◽  
Kamran Siddiqi ◽  
Helen Elsey ◽  
Najma Siddiqi ◽  
Ruimin Ma ◽  
...  
Keyword(s):  
Health Survey ◽  
Low Income ◽  
World Health ◽  
Low Income Countries ◽  
Multivariable Logistic Regression Analysis ◽  
World Health Survey ◽  
Middle Income ◽  
Middle Income Countries ◽  
The World ◽  
Low And Middle Income

Tuberculosis (TB) is a leading cause of mortality in low- and middle-income countries (LMICs). TB multimorbidity [TB and ≥1 non-communicable diseases (NCDs)] is common, but studies are sparse. Cross-sectional, community-based data including adults from 21 low-income countries and 27 middle-income countries were utilized from the World Health Survey. Associations between 9 NCDs and TB were assessed with multivariable logistic regression analysis. Years lived with disability (YLDs) were calculated using disability weights provided by the 2017 Global Burden of Disease Study. Eight out of 9 NCDs (all except visual impairment) were associated with TB (odds ratio (OR) ranging from 1.38–4.0). Prevalence of self-reported TB increased linearly with increasing numbers of NCDs. Compared to those with no NCDs, those who had 1, 2, 3, 4, and ≥5 NCDs had 2.61 (95% confidence interval (CI) = 2.14–3.22), 4.71 (95%CI = 3.67–6.11), 6.96 (95%CI = 4.95–9.87), 10.59 (95%CI = 7.10–15.80), and 19.89 (95%CI = 11.13–35.52) times higher odds for TB. Among those with TB, the most prevalent combinations of NCDs were angina and depression, followed by angina and arthritis. For people with TB, the YLDs were three times higher than in people without multimorbidity or TB, and a third of the YLDs were attributable to NCDs. Urgent research to understand, prevent and manage NCDs in people with TB in LMICs is needed.

scholarly journals Maternal Tobacco and Alcohol Use in Relation to Child Malnutrition in Gauteng, South Africa: A Retrospective Analysis

Children ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 133
Author(s):  
Perpetua Modjadji ◽  
Mpinane Pitso
Keyword(s):  
South Africa ◽  
Alcohol Use ◽  
Tobacco Use ◽  
Child Growth ◽  
Growth Patterns ◽  
World Health ◽  
Poor Growth ◽  
Growth Standards ◽  
Validated Questionnaire ◽  
Current Tobacco

Tobacco and alcohol use among mothers is associated with numerous adverse consequences for affected offspring, including poor growth and development. This study determined the association between maternal tobacco and alcohol use, and malnutrition, among infants aged ≤ 12 months (n = 300), in selected health facilities situated in Gauteng, South Africa. Data on alcohol and tobacco use were collected using a validated questionnaire, in addition to mothers’ socio-demographic characteristics and obstetric history. Stunting (low height/length-for-age), underweight (low weight-for-age) and thinness (low body mass index-for-age) were calculated using z-scores based on the World Health Organization child growth standards. The association of tobacco and alcohol use with stunting, underweight and thinness was analysed using logistic regression analysis. The results showed a mean age of 29 years (24.0; 35.0) for mothers and 7.6 ± 3 months for infants, and over half of the mothers were unemployed (63%). Approximately 18.7% of mothers had used tobacco and 3% had used alcohol during pregnancy. The prevalence of current tobacco and alcohol use among mothers were estimated at 14.3% and 49.7%, respectively, and almost three-quarters (67.3%) of them were still breastfeeding during the study period. Stunting (55%) was the most prevalent malnutrition indicator among infants, while underweight was 41.7%, and thinness was 22%. Current tobacco use was associated with increased odds of being thin [OR = 2.40, 95% CI: 1.09–5.45), and after adjusting for confounders, current alcohol use was associated with the likelihood of being underweight [AOR = 1.96, 95% CI: 1.06–3.63] among infants. Future prospective cohort studies that examine growth patterns among infants who are exposed to maternal tobacco and alcohol use from the intrauterine life to infancy are necessary to inform, partly, the public health programmes, to reduce malnutrition among children.

scholarly journals Metals Exposures of Residents Living Near the Akaki River in Addis Ababa, Ethiopia: A Cross-Sectional Study

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Ellen Yard ◽  
Tesfaye Bayleyegn ◽  
Almaz Abebe ◽  
Andualem Mekonnen ◽  
Matthew Murphy ◽  
...  
Keyword(s):  
Drinking Water ◽  
Addis Ababa ◽  
Urinary Iodine ◽  
Reference Value ◽  
Cross Sectional Study ◽  
World Health ◽  
Sectional Study ◽  
Cross Sectional ◽  
Metal Levels ◽  
Akaki River

Background. The Akaki River in Ethiopia has been found to contain elevated levels of several metals. Our objectives were to characterize metals exposures of residents living near the Akaki River and to assess metal levels in their drinking water.Methods. In 2011, we conducted a cross-sectional study of 101 households in Akaki-Kality subcity (near the Akaki River) and 50 households in Yeka subcity (distant to the Akaki River). One willing adult in each household provided urine, blood, and drinking water sample.Results. Urinary molybdenum (p<0.001), tungsten (p<0.001), lead (p<0.001), uranium (p<0.001), and mercury (p=0.049) were higher in Akaki-Kality participants compared to Yeka participants. Participants in both subcities had low urinary iodine; 45% met the World Health Organization (WHO) classification for being at risk of moderate iodine deficiency. In Yeka, 47% of households exceeded the WHO aesthetic-based reference value for manganese; in Akaki-Kality, only 2% of households exceeded this value (p<0.001). There was no correlation between metals levels in water samples and clinical specimens.Conclusions. Most of the exposures found during this investigation seem unlikely to cause acute health effects based on known toxic thresholds. However, toxicity data for many of these metals are very limited.

scholarly journals Sustained Positive Deviant Child Care Practices and Their Effects on Child Growth in Viet Nam

2002 ◽  
Vol 23 (4_suppl2) ◽  
pp. 16-25 ◽  
Author(s):  
U. Agnes Trinh Mackintosh ◽  
David R. Marsh ◽  
Dirk G. Schroeder
Keyword(s):  
Child Growth ◽  
Program Completion ◽  
Viet Nam ◽  
Nutrition Program ◽  
Cross Sectional ◽  
Total N ◽  
Z Scores ◽  
Growth Promoting ◽  
Height For Age ◽  
Weight For Age

Save the Children's (SC) successful integrated nutrition program in Viet Nam, the poverty alleviation and nutrition program (PANP), uses the positive deviance (PD) approach to identify key growth promoting behaviors and provides participatory adult education allowing mothers to develop skills related to these behaviors. We investigated whether improvements seen during a PANP intervention (1993–1995) were sustained three and four years after SC's departure. Cross-sectional surveys were administered to 46 randomly selected households in four communes that had previously participated in the PANP and 25 households in a neighboring comparison community in 1998 and 1999. Two children per household, an older child who had participated in the PANP and a younger sibling who had not, were measured (total n = 142 children), and their mothers were interviewed. Older SC children tended to be better nourished than their counterparts. Their younger siblings were significantly better nourished than those in the comparison group, with adjusted mean weight-for-age Z scores of −1.82 versus −2.45 ( p = .007), weight-for-height Z scores of −0.71 versus −1.45 ( p < .001), and height-for-age Z scores of −2.11 and −2.37 (ns, p = .4), respectively. SC mothers reporting feeding the younger siblings more than their counterparts did (2.9 versus 2.2 main meals per day, p < .001, and 96.2% versus 52% offering snacks, p < .01]. SC mothers reported washing their hands “often” more than comparison mothers (100% vs. 76%, p < .001). Growth-promoting behaviors identified through PD studies and practiced through neighborhood-based rehabilitation sessions persisted years after program completion. These sustained behaviors contributed to better growth of younger siblings never exposed to the program.

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