scholarly journals The prevalence and associated factors of undernutrition among under-five children in South Sudan using the standardized monitoring and assessment of relief and transitions (SMART) methodology

BMC Nutrition ◽  
2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Jackline Kiarie ◽  
Sarah Karanja ◽  
Julius Busiri ◽  
Diana Mukami ◽  
Colleta Kiilu

Abstract Background Conflict regions bear the heaviest brunt of food insecurity and undernutrition. South Sudan is one of the fragile countries following years of conflict that led to large displacements. Moderate to severe undernutrition among under-five children has been associated with elevated morbidity and mortality. This study, therefore, was conducted to assess the magnitude and factors influencing undernutrition (wasting, underweight and stunting) among children aged 6 to 59 months in Yambio County, South Sudan. Methods A cross-sectional study was conducted from 26 October to 6 November 2018 in Yambio County, South Sudan among 630 children aged 6–59 months from the 348 households surveyed in 39 clusters using two-stage cluster sampling design. Data were collected using questionnaires and nutritional anthropometric measurements. The Standardized Monitoring and Assessment of Relief and Transitions (SMART) Methodology was followed to obtain the prevalence of wasting, underweight and stunting based on respective z scores and according to the 2006 world health organization child growth standards. Data were exported to Stata version 16 for further analysis. Bivariate analysis of independent variables and undernutrition was done using binary logistic regression. Mixed effects logistic regression analysis was conducted to control for possible confounders and account for random effects at household and cluster levels. Unadjusted and adjusted odds ratios (cOR and aOR) with 95% confidence intervals (CI) and p-values were computed. P-values of ≤0.05 were considered statistically significant. Results The prevalence of undernutrition explained by wasting (weight-for-height Z-score (WHZ) < − 2), underweight (weight-for-age z-scores (WAZ) < − 2) and stunting (height-for-age z-scores (WHZ) < − 2) were 2.3% (1.3–4.1, 95% CI), 4.8% (3.1–7.5, 95% CI) and 23.8% (19.1–29.2, 95% CI). Male sex (aOR [95% CI], p-value: 5.6 [1.10–30.04], p = 0.038), older child’s age (aOR [95% CI], p-value: 30.4 [2.65–347.60], p = 0.006) and non-residents (cOR [95% CI], p-value: 4.2 [1.4–12.2] p = 0.009) were associated with increased risk of wasting. Household size (cOR [95% CI], p-value: 1.09 [1.01–1.18] p = 0.029) and younger child age (cOR [95% CI], p-value: 4.2 [1.34–13.23] p = 0.014) were significantly associated with underweight. Younger child age (aOR [95% CI], p-value: 5.4 [1.82–16.44] p = 0.003) and agricultural livelihood (aOR [95% CI], p-value: 3.4 [1.61–7.02] p = 0.001) were associated with stunting. Conclusion Based on a cut off of less than − 2 standard deviations for 2006 World Health Organization (WHO) child growth standards, the wasting prevalence was very low, underweight prevalence was low while stunting prevalence was high. The county lies in the only livelihood region in South Sudan with bimodal reliable rainfall pattern and it seems that the impact of the 2016 conflicts that lead to large displacements may not have greatly affected under-five undernutrition. Interventions targeted at improving food diversity, increasing nutrition knowledge and enhancing resilience in male children might reduce undernutrition. In the short-term, investment in continued surveillance of nutritional status should be a main focus.

2005 ◽  
Vol 25 (2) ◽  
pp. 247-265 ◽  
Author(s):  
E. Borghi ◽  
M. de Onis ◽  
C. Garza ◽  
J. Van den Broeck ◽  
E. A. Frongillo ◽  
...  

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Angela KC ◽  
Andrew Thorne-Lyman ◽  
Binod Shrestha ◽  
Swetha Manohar ◽  
Patrick Webb ◽  
...  

Abstract Objectives Estimate the national and agro-ecological zonal prevalence of preschool child undernutrition and review temporal trends in the prevalence of undernutrition. Methods In 2016, we conducted the last in a series of 3 (also 2013 and 2014) nationally representative, annual, same-season, mixed-longitudinal nutrition surveys – PoSHAN Community Studies – in the same 21 Village Development Committees sampled across the Mountains, Hills and Tarai of Nepal. Height/length and weight measurements of 5479 children < 5 years were converted to z-scores of height-for-age (HAZ) and weight-for-height (WHZ) based on World Health Organization growth standards. Cut-offs of < -2 z-scores of HAZ and WHZ were applied to define stunting and wasting, respectively. Rates of stunting and wasting were compared to four Demographic and Health Surveys of Nepal (NDHS) from 2001–2016. Annual rates of decline in stunting and wasting were calculated. Results Preschool stunting and wasting rates from PoSHAN in 2016 were 34% [95% CI: 29.5 to 38.9%] and 13.7% [11.0 to 16.9%], similar to those observed in the 2016 NDHS: 35.8% [33.5 to 38.3%] and 9.7% [8.4 to 11.1%], respectively. Stunting was highest in the Mountains (40.6%), and wasting in the Tarai (18.9%). PoSHAN surveys revealed an annual decrease in the prevalence of stunting of 1.5% from 2013–2016 and 2.3% from 2011–2016, representing a lesser decline than in the earlier period of 2001–2011 (3.3%) (Figure 1 a). In contrast, neither series of surveys has revealed a marked decline in the national prevalence of wasting over the past 15 years (Figure 1 b). Conclusions The rates of stunting and wasting seen in the PoSHAN survey were comparable to other contemporary surveys in 2016 and suggest that the current rate of decline is inadequate to meet Nepal's 2025 World Health Assembly (WHA) target of reducing stunting to 26.5%. However, wasting has changed very little, threatening the potential to reach Nepal's national WHA target of 5%. Funding Sources Funded by USAID Feed the Future Nutrition Innovation Lab, with assistance from Sight and Life and The Gates Foundation. Supporting Tables, Images and/or Graphs


2013 ◽  
Vol 57 (2) ◽  
pp. 258-264 ◽  
Author(s):  
Dominique Turck ◽  
Kim F. Michaelsen ◽  
Raanan Shamir ◽  
Christian Braegger ◽  
Cristina Campoy ◽  
...  

2019 ◽  
Vol 2 (1) ◽  
pp. 8
Author(s):  
Jean Fanny Junita Timban ◽  
Ellen Grace Tangkere ◽  
Jelly Ribka Danaly Lumingkewas

Stunting in under-five children is a reduced growth rate primarily caused by chronic undernutrition that leads to a child having height much less than is normal for age. This condition manifests mostly after two years old. The definition of stunting according to the World Health Organization (WHO) is for the "height for age" value to be less than two standard deviations of the WHO Child Growth Standards median. Indonesia has been plagued recently with stunting. In 2015, the World Bank indicates that stunting has cost 3 to 11 percent of the gross domestic product. Previous research works have documented that mothers play an important role in preventing stunting through antenatal care and child nursing. The objective of this study is to explore the role played by the mothers in Bunaken, Manado, in antenatal care and child nursing that prevent stunting. Samples are drawn using purposive sampling and data are analysis descriptively. The results show that the mothers’ roles include taking antenatal check up to four times during pregnancy, daily use of FE 90 pill, participating in pregnancy counseling and care, delivery by health professionals, attending integrated service post (posyandu), visiting health professionals for postnatal care, completing universal immunization on child over 12 months old, and participating in educational activities for under-five nursing and nutritional fulfillment at least once a month. Of these eight recorded roles, however, there are merely 20% mothers indicate they regularly taking part in pregnancy counseling and care. Furthermore, only one percent (n = 3) respondents that report they attending educational activities for under-five nursing and nutritional fulfillment.


Author(s):  
Wen-Chien Yang ◽  
Chun-Min Fu ◽  
Bo-Wei Su ◽  
Chung-Mei Ouyang ◽  
Kuen-Cheh Yang

High prevalence of child underweight and stunting in high-altitude areas has often been reported. However, most previous studies on this topic were cross-sectional. Another critical concern is that using the World Health Organization (WHO) Child Growth Standards to evaluate child growth in high-altitude areas may lead to overestimations of underweight and stunting. Our study aimed to evaluate the long-term growth pattern of children (3 to 18 years) above the altitude of 3500 m in Ladakh, India. The participants’ body weight (BW), body height (BH), and body mass index (BMI) were measured annually according to the WHO Child Growth Standards for children under 5 years old and the WHO reference data for children aged 5 to 19 years. The generalized estimating equation (GEE) was used to estimate the means and z-scores of BW, BH, and BMI at different ages. A total of 401 children were enrolled from 2012 to 2018. Their mean z-scores of BW, BH, and BMI were −1.47, −1.44, and −0.85 in 2012 and increased to −0.74, −0.92, and −0.63 in 2018. This population’s specific growth curve was also depicted, which generally fell below the 85th percentile of the WHO standards. This is the first cohort study about long-term child growth patterns in a high-altitude area. The detailed underlying mechanisms of our findings need future research on more representative data of high-altitude populations.


2020 ◽  
Vol 7 (10) ◽  
Author(s):  
Natasha O Moraka ◽  
Sikhulile Moyo ◽  
Christiana Smith ◽  
Maryanne Ibrahim ◽  
Gloria Mayondi ◽  
...  

Abstract Background We sought to identify predictors of child cytomegalovirus (CMV) infection overall and by maternal HIV status and to assess associations of child CMV status with growth and neurodevelopmental outcomes at 24 months of age in Botswana. Methods Data and samples were used from the Botswana-based observational Tshipidi study (2010–2014), enrolling pregnant women living with and without HIV and following their infants through 2 years of age. Child plasma samples were tested at 18 months of age for anti-CMV immunoglobulin G (IgG). Associations were assessed between detectable anti-CMV IgG and growth (using the World Health Organization Child Growth Standards) and neurodevelopment (using the Bayley Scales of Infant and Toddler Development III and the Developmental Milestones Checklist) at 24 months of age. Results Of 317 children, 215 (68%) had detectable anti-CMV IgG at 18 months of age. Comparatively, 83% (n = 178) of HIV-unexposed uninfected (HUU) children had positive CMV serology vs 47% (n = 139) of HIV-exposed uninfected (HEU) children (P &lt; .01); 100% of HUU vs 10.5% of HEU children breastfed. Child CMV infection was not associated with weight-for-age, weight-for-length, or length-for-age z-scores at 24 months. In HUU children, CMV infection was associated with smaller head circumference (P &lt; .01). No difference was observed by child CMV status in any neurodevelopmental domain at 24 months. Conclusions We observed high CMV seropositivity in 18-month-old children in Botswana, with higher seropositivity among breastfed (HUU) children. Positive CMV serostatus was not associated with 24-month child growth or neurodevelopmental outcomes, with the exception of smaller head circumference among HUU CMV-positive children.


2006 ◽  
Vol 9 (7) ◽  
pp. 942-947 ◽  
Author(s):  
Mercedes de Onis ◽  
Adelheid W Onyango ◽  
Elaine Borghi ◽  
Cutberto Garza ◽  
Hong Yang ◽  
...  

AbstractObjectivesTo compare growth patterns and estimates of malnutrition based on the World Health Organization (WHO) Child Growth Standards (‘the WHO standards’) and the National Center for Health Statistics (NCHS)/WHO international growth reference (‘the NCHS reference’), and discuss implications for child health programmes.DesignSecondary analysis of longitudinal data to compare growth patterns (birth to 12 months) and data from two cross-sectional surveys to compare estimates of malnutrition among under-fives.SettingsBangladesh, Dominican Republic and a pooled sample of infants from North America and Northern Europe.SubjectsRespectively 4787, 10 381 and 226 infants and children.ResultsHealthy breast-fed infants tracked along the WHO standard's weight-for-age mean Z-score while appearing to falter on the NCHS reference from 2 months onwards. Underweight rates increased during the first six months and thereafter decreased when based on the WHO standards. For all age groups stunting rates were higher according to the WHO standards. Wasting and severe wasting were substantially higher during the first half of infancy. Thereafter, the prevalence of severe wasting continued to be 1.5 to 2.5 times that of the NCHS reference. The increase in overweight rates based on the WHO standards varied by age group, with an overall relative increase of 34%.ConclusionsThe WHO standards provide a better tool to monitor the rapid and changing rate of growth in early infancy. Their adoption will have important implications for child health with respect to the assessment of lactation performance and the adequacy of infant feeding. Population estimates of malnutrition will vary by age, growth indicator and the nutritional status of index populations.


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