scholarly journals Potential consequences of expanded MUAC-only programs on targeting of acutely malnourished children and ready-to-use-therapeutic-food allocation: lessons from cross-sectional surveys

BMC Nutrition ◽  
2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Benjamin Guesdon ◽  
Alexia Couture ◽  
Danka Pantchova ◽  
Oleg Bilukha
Keyword(s):  
Cross Sectional ◽  
Food Allocation ◽  
Malnourished Children ◽  
Therapeutic Food

scholarly journals Potential consequences of expanded MUAC-only programs on targeting of acutely malnourished children and ready-to-use-therapeutic-food allocation: lessons from cross-sectional surveys

2019 ◽  
Author(s):  
Benjamin Guesdon ◽  
Alexia Couture ◽  
Danka Pantchova ◽  
Oleg Bilukha
Keyword(s):  
A Priori ◽  
Acute Malnutrition ◽  
Case Definitions ◽  
Cross Sectional ◽  
Number Of Children ◽  
Malnourished Children ◽  
Arm Circumference ◽  
Mid Upper Arm Circumference ◽  
The Impact ◽  
Therapeutic Food

Abstract Background: Some of the recently piloted innovative approaches for the management of acute malnutrition in children use the “expanded MUAC-only” approach, with Mid Upper Arm Circumference (MUAC) <125mm as the sole anthropometric criterion for screening and admission, classification of cases as severe using the 115mm cut-off, and use Ready-to-Use-Therapeutic-Food (RUTF) for the management of both moderate (MAM) and severe (SAM) cases of acute malnutrition. Our study aimed at exploring the potential consequences of this “expanded MUAC-only” program scenario on the eligibility for treatment and RUTF allocation, as compared with the existing WHO normative guidance. Methods: We analyzed data from 550 population representative cross-sectional cluster surveys conducted since 2007. We retrieved all children classified as SAM and MAM according to currently used case definitions, and calculated the proportions of SAM children who would be excluded from treatment, misclassified as MAM, or whose specific risks (because of having both MUAC and weight-for height deficits) would be ignored. We also analyzed the expected changes in the number and demographics (sex, age) of children meant to receive RUTF according to the new approach. Results: We found that approximately one quarter of SAM children would not be detected and eligible for treatment under the “expanded MUAC-only” scenario, and another 20% would be classified as MAM. A further 17% of the total SAM children would be admitted and followed only according to their MUAC or oedema status, while they also present with a severe weight-for height deficit on admission. Considering MAM targeting, about half of the MAM children would be left undetected. This scenario also shows a 2.5 time increase in the number of children targeted with RUTF, with approximately 70% of MAM and 30% of SAM cases among this new RUTF target. Conclusions: This empirical evidence suggests that adoption of “expanded MUAC-only” programs would likely lead to a priori exclusion from treatment or misclassifying as MAM a large proportion of SAM cases, while redirecting programmatic costs in favor of those less in need. It underscores the need to explore other options for improving the impact of programs addressing the needs of acutely malnourished children.

scholarly journals Potential impact of expanded MUAC-only programs on targeting of acutely malnourished children and ready-to-use-therapeutic-food allocation: lessons from cross-sectional surveys

2019 ◽  
Author(s):  
Benjamin Guesdon ◽  
Alexia Couture ◽  
Danka Pantchova ◽  
Oleg Bilukha
Keyword(s):  
A Priori ◽  
Acute Malnutrition ◽  
Case Definitions ◽  
Cross Sectional ◽  
Number Of Children ◽  
Malnourished Children ◽  
Potential Impact ◽  
Mid Upper Arm Circumference ◽  
The Impact ◽  
Therapeutic Food

Abstract Background Some of the recently piloted innovative approaches for the management of acute malnutrition in children use the “expanded MUAC-only” approach, with Mid Upper Arm Circumference (MUAC) <125mm as the sole anthropometric criterion for screening and admission, classification of cases into moderate or severe using the 115mm cut-off, and use Ready-to-Use-Therapeutic-Food (RUTF) for the management of both moderate (MAM) and severe (SAM) cases of acute malnutrition. Our study aimed at exploring the potential impact of this “expanded MUAC-only” program scenario on the eligibility for treatment and RUTF allocation, as compared with the existing WHO normative guidance.Methods We analyzed data from 550 population representative cross-sectional cluster surveys conducted since 2007. We retrieved all children classified as SAM and MAM according to currently used case definitions, and calculated the proportions of SAM children who would be excluded from treatment, misclassified as MAM, or whose specific risks (because of having both MUAC and weight-for height deficits) would be ignored. We also analyzed the expected changes in the number and profile of children meant to receive RUTF according to the new approach.Results We found that approximately one quarter of SAM children would not be detected and eligible for treatment under the “expanded MUAC-only” scenario, and another 20% would be classified as MAM. A further 17% of the total SAM children would be admitted and followed only according to their MUAC or oedema status, while they also present with a severe weight-for height deficit on admission. Considering MAM targeting, about half of the MAM children would be left undetected. This scenario also shows a 2.5 time increase in the number of children targeted with RUTF, with approximately 70% of MAM and 30% of SAM cases among this new RUTF target.Conclusions This empirical evidence suggests that adoption of “expanded MUAC-only” programs would likely lead to a priori exclusion from treatment or misclassifying as MAM a large proportion of SAM cases, while redirecting programmatic costs in favor of those less in need. It underscores the need to explore other options for improving the impact of programs addressing the needs of acutely malnourished children.

Dental Caries Severity and Nutritional Status of Nigerian Preschool Children

2021 ◽  
pp. 238008442110021
Author(s):  
O.O. Olatosi ◽  
A.A. Alade ◽  
T. Naicker ◽  
T. Busch ◽  
A. Oyapero ◽  
...  
Keyword(s):  
Early Childhood ◽  
Dental Caries ◽  
Nutritional Status ◽  
Early Childhood Caries ◽  
Z Score ◽  
Cross Sectional ◽  
Risk Of Death ◽  
Malnourished Children ◽  
Z Scores ◽  
Childhood Caries

Introduction: Malnutrition in children is one of the most prevalent global health challenges, and malnourished children have a higher risk of death from childhood diseases. Early childhood caries (ECC) is the most common chronic disease of childhood. Complications from ECC such as pain, loss of tooth/teeth, and infection can undermine a child’s nutrition and growth. Aim: This study aims to evaluate the severity of decay, missing, and filled tooth (dmft) by nutritional status using the z scores of the anthropometric measurements: height for age (HFA), weight for age (WFA), weight for height (WFH), and body mass index for age (BMIA) among children with ECC in Nigeria. Study Design: This is a cross-sectional study conducted in 5 local government areas (LGAs) in Lagos State, Nigeria. A multistage sampling technique was used. Results: A total of 273 cases of ECC were included in the analyses (mean age 4.19 ± 0.96 y). Overall, the mean dmft was 3.04 ± 2.28, and most (96%) were accounted for by untreated decay. The distribution of dmft within the different z score categories of BMIA (<–3 = severely wasted, –2 to –3 = wasted, –2 to +2 = normal, +2 to +3 = overweight and >+3 = obese) showed the highest dmft scores among the combined severely wasted and wasted groups, lowest among children with normal z scores, and intermediate in the overweight and obese groups. There was a significant negative correlation between BMIA z score, WFH z score, and dmft ( r = −0.181, P < 0.05 and r = −0.143, P < 0.05, respectively). However, the correlations between HFA z score, WFA z score, and dmft were positive but not significant ( r = 0.048, P = 0.44 and r = 0.022, P = 0.77, respectively). Conclusion: Our study showed an increased severity of dental caries among severely wasted or wasted children with ECC compared to those of normal or overweight. Knowledge Transfer Statement: The results from this study will raise awareness among clinicians and policy makers on the need for a primary prevention program for early childhood caries in countries with high burden of malnutrition and limited resources. Also, it will help draw the attention of clinicians to the caries status of malnourished children that can be managed to improve the nutritional outcomes.

scholarly journals Nutritional status of soil-transmitted helminthiasis-infected and uninfected children

2015 ◽  
Vol 55 (3) ◽  
pp. 136 ◽  
Author(s):  
Nelly Simarmata ◽  
Tiangsa Sembiring ◽  
Muhammad Ali
Keyword(s):  
Nutritional Status ◽  
Ascaris Lumbricoides ◽  
Rural Areas ◽  
Primary Schools ◽  
Infection Intensity ◽  
Public Health Problem ◽  
Trichuris Trichiura ◽  
Cross Sectional ◽  
Malnourished Children ◽  
Moderate Malnutrition

Background Soil-transmitted helminth (STH) infections remain a public health problem in developing countries. Their prevalence is particularly high in rural areas with people of low socioeconomic level. A single or mixed STH infection rarely causes death, but can affect nutritional status, growth, cognitive development and human health, especially in children.Objective To compare the nutritional status of STH-infected and uninfected children.Methods This cross-sectional study was conducted in June 2010 in children from 3 primary schools in the Simpang Empat and Kabanjahe Subdistricts, Karo District, North Sumatera Province. Fecal examinations were done by the Kato-Katz method to diagnose STH infections. Participants of this study consisted of 140 infected children and 141 uninfected children. Nutritional status classification was based on the 2000 Centers for Disease Control growth charts. All categorical data were analyzed by Chi-square test.Results Of 140 infected children, 8.6% were infected with Ascaris lumbricoides, 17.1% with Trichuris trichiura and 74.3% with mixed infections (Ascaris lumbricoides and Trichuris trichiura). We found significantly more STH infected children with mild to moderate malnutrition than the uninfected group. We also found significantly more mildly to moderately malnourished children with moderate infection intensity than mild infection intensity.Conclusion We find significantly more STH infected children with mild to moderate malnutrition than the uninfected group. We also find significantly more mildly to moderately malnourished children with moderate infection intensity than mild infection intensity. Higher severity of infection is associated with lower nutritional status.

scholarly journals ASSESSMENT OF NUTRITIONAL STATUS AND ITS DETERMINANTS AMONG CHILDREN IN AGE GROUP OF 1-5 YEARS IN A TRIBAL POPULATION OF COIMBATORE DISTRICT-A CROSS SECTIONAL STUDY

2020 ◽  
pp. 51-54
Author(s):  
T. Pravin ◽  
P.K. Govindarajan ◽  
A. John William Felix
Keyword(s):  
Nutritional Status ◽  
Maternal Education ◽  
Cross Sectional Study ◽  
Age Group ◽  
Sectional Study ◽  
Cross Sectional ◽  
Under Five ◽  
Under Five Children ◽  
Malnourished Children ◽  
Coimbatore District

Background: Under-five children are more vulnerable to malnutrition especially in rural areas resulting in more morbidity and mortality among them. The present study is aimed to assess the prevalence of malnutrition among children of 1-5 years of age in tribal hamlets of Valparai block, Coimbatore district in Tamil Nadu. Methods: A community-based, cross-sectional study was conducted among 95 children in the age group of 1-5 years during December-January 2020. Anthropometric measurements were taken. The indicators of nutritional status of children like stunting, underweight, and wasting were expressed using WHO growth standards. Results: The overall prevalence of malnutrition in our study was 31.6%. Among the 30 (31.6%) malnourished children, 40% were underweight, and 6.67% were severely underweight. 40% were stunted, of which 13.3% were severely stunted. Wasting was present in 23.3% of malnourished children. Severe wasting was not seen. Socio-demographic factors including the type of house, maternal education, BMI of the mother, age of mother at childbirth and place of delivery had significant association with malnutrition among under-five tribal children. Conclusions: Malnutrition poses a serious threat to under-five children. Though many known risk factors of malnutrition have been studied, understanding the local factors linked with malnutrition is so crucial while planning information, education, and communication programs in this area.

scholarly journals Iron Status in Malnourished Children : A Cross Sectional Study

2014 ◽  
Vol 13 (3) ◽  
pp. 50-53
Author(s):  
Shormin Ara Ferdousi ◽  
Rajat Sanker Roy Biswas ◽  
Nayan Kanti Paul ◽  
Mohammed Rezaul Karim
Keyword(s):  
Serum Iron ◽  
Iron Status ◽  
Transferrin Saturation ◽  
Age Groups ◽  
Cross Sectional Study ◽  
Iron Level ◽  
Serum Iron Level ◽  
Cross Sectional ◽  
Malnourished Children ◽  
Different Types

Objectives: Malnutrition is a common condition among children and iron status varies in different types of malnutrition. So the present study is aimed to find the different iron status among severe malnourished children in our context. Methods: A hospital based cross sectional study was done in the Paediatrics ward Chittagong Medical College Hospital in a period of 6 months from January to July 2013 among the 50 cases of malnourished children of age range between 1 to 5 years and Weight for Height Z score(WHZ) was <-2  SD. Sampling technique was continuous purposive sampling. Venous blood was collected to assay the different iron profile mainly serum iron level, total iron binding capacity(TIBC) and transferrin saturation(TSAT). Data was analyzed after correction by SPSS-19. Results: Among the 50 study children of different age groups 15 patients were 1 to 2 years, 18 patients were 2 to 3 years, 10 patients were 3 to 4 years and 7 patients were at 4-5 years of age groups. Among the patients, 29 (58%) of patients were female and 21(42%) of the patients were male. Most of the children were from the families of low socioeconomic status 38(76%). 2(4%) children were from upper middle class who had step mother. Among the selected patients the dominating clinical features were anemia was found among 45(90%) of patients which was mild(66.6%), moderate(26.6%) and severe(6.6%). Skin changes(32%), eye  changes (10%) and hair changes(48%) were also found. Among the 50 study subjects prelacteal feeding was given among 43(86%) children, breast feeding was given 45(90%), exclusive breast feeding was given to 24(48%) of children and complementary feeding after 6 months was given to 29(58%) patients. Among the 50 patients -2 to -3 SD weight for height was found in 20(40%) patients and <-3 SD was found in 30(60%) patients. Most of the children was found to have Mid Upper Arm Circumference (MUAC) 115-125 mm(50%). Iron status was measured among all patients where serum iron level was found 77.72 ± 11.22 mcgm/dl, TIBC was found 340.07 ± 22.67 mcgm/dl and transferrin saturation was found 22.38 ± 2.9 %. Iron status were measured among the different types of malnutrition where serum iron level and transferrin saturation was high among all patients with malnutrition while TIBC was lower than standard level in all patients. Different biochemical status were measured among the different types of malnutrition where serum total protein, serum albumin, Hb% were lower than standard level in all patients.Conclusion: Change in different iron status is a common findings in malnourished children. Screening of all children for anemia and providing iron and folic acid (IFA) or multiple micronutrients (MMN) supplements to children and Infant and Young Child Feeding (IYCF) should be addressed at all level to overcome the situation.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i3.21024

scholarly journals The association between nutritional status and motor development in children under five years old

2016 ◽  
Vol 45 (3) ◽  
pp. 107
Author(s):  
Nurhayati Masloman ◽  
Stefanus Gunawan
Keyword(s):  
Nutritional Status ◽  
Motor Development ◽  
Cross Sectional Study ◽  
Physical Growth ◽  
Severe Malnutrition ◽  
Cross Sectional ◽  
Under Five ◽  
Malnourished Children ◽  
Child Health Surveillance ◽  
Moderate Malnutrition

Background Severe malnutrition in children is closely related todelayed physical growth and mental development. Very few re-ports mention the effects of mild to moderate malnutrition on mo-tor development.Objective The objective of this study was to determine the rela-tionship between nutritional status and motor development in earlychildhood.Methods In this cross-sectional study, we examined body weightof children under 5 years of age, the ability to sit or walk withoutsupport, and parachute sign in those under 2 years of age whocame to community child health surveillance posts in TumintingSubdistrict, Manado, Indonesia.Results Among 359 under-five children, 296 were well-nourishedand 63 had mild to moderate malnutrition. The ability to sit withoutsupport in malnourished children was significantly delayed com-pared to that in well-nourished ones (P=0.03). The ability to walkwithout support and parachute sign were not significantly differentbetween the two groups.Conclusion The ability to sit without support in children with mildto moderate malnutrition is delayed compared to that in well-nour-ished ones

scholarly journals Evaluation of anthropometric indicators in malnourished children at Nutritional Rehabilitation Center, Gujarat, India

2019 ◽  
Vol 6 (4) ◽  
pp. 1410
Author(s):  
Dhara Patel ◽  
Nisha Upadhyay
Keyword(s):  
Severe Acute Malnutrition ◽  
Nutritional Intervention ◽  
Cross Sectional Study ◽  
Acute Malnutrition ◽  
Daily Weight Gain ◽  
Cross Sectional ◽  
Clinical Criteria ◽  
Anthropometric Indicators ◽  
Malnourished Children ◽  
Intervention Measures

Background: It is very difficult to recognize the cases with mild-to-moderate malnutrition because clinical criteria for their diagnosis are imprecise and are difficult to interpret accurately. The objective of the study was daily weight gain in gram/kg/day in severely malnourished children.Methods: This was a hospital based cross sectional study in which total of 114 consecutive patients of SAM less than 5 years treated for complications of severe acute malnutrition using WHO protocol. The study design included 114 children from the NRC and then followed up the period of 6 months to assess the nutritional status during the period of initial stage and the entire follow up period using available record of anthropometry indicators of the admitted children recruited in the study at the NRC.Results: Mean weight at admission was 6.4 Kg, 6.5 Kg and 6.2 Kg of overall, boys and girls respectively. Mean weight at discharge was 6.8 Kg, 6.7 Kg and 6.6 Kg of overall, boys and girls respectively. Mean MUAC at admission was 10.7 cm, 10.9 cm and 10.6 cm of overall, boys and girls respectively. Mean MUAC at discharge was 10.9 cm, 10.9 cm and 10.8 cm of overall, boys and girls respectively.Conclusions: For treatment of severe acute malnutrition, systematic guidelines required, thus this study indicates that following WHO guidelines, it has become easier to manage SAM in hospital settings, with least possible stay at hospital. The objective of the study was to know the effect of nutritional intervention measures on selected anthropometric indicators of severe acute malnourished children.

scholarly journals Study on determinants of nutritional status of a school going children in a village of Tumakuru taluk

2019 ◽  
Vol 6 (7) ◽  
pp. 2828
Author(s):  
Ravindra Y. Mandolikar ◽  
Smitha Jadhav ◽  
Mahabaleshwar Mahanthappa Angadi
Keyword(s):  
Nutritional Status ◽  
General Information ◽  
Formative Period ◽  
Personal Hygiene ◽  
World Population ◽  
Healthy Children ◽  
Cross Sectional ◽  
Balanced Diet ◽  
Malnourished Children ◽  
Grade 3

Background: Children (0-14 years) contribute to 26% of world population and 28.4% of India’s population. School going age is a formative period, physically as well as mentally, transferring child into a promising adult. Malnourishment in this age group compromises both physical and mental growth. The objective of the study was to assess the nutritional status and morbidity status among school going children.Methods: A cross sectional descriptive study was conducted at Greenberg international school Kannenahalli, Tumkur. After inclusion and exclusion criteria, which comprised children between 3-12 years of age, total 123 students were included in the study. A pre structured and pre tested proforma was used to collect the data on general information of the child, anthropometric measurements, physical examination, personal hygiene and clinical examination and blood grouping was done.Results: Out of 123 study participants, 30.9% were found to be malnourished and 35.77% had various morbidity conditions. Out of the 39 students who had malnutrition, 20 students (51.3%) were having grade 1 malnutrition, 15 students (38.5%) were having grade 2 malnutrition and 4 students (10.3%) were having grade 3 malnutrition.Conclusions: It concluded that, balanced diet for all the malnourished children to improve their nutritional status and also for healthy children to maintain their health and nutrition. Grade 3 malnourished children were referred to NRC (nutritional rehabilitation center) to improve their nutritional status.

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