scholarly journals Socio-biomedical predictors of child nutrition in India: an ecological analysis from a nationally representative Demographic and Health Survey, 2015–2016

2022 ◽  
Vol 41 (1) ◽  
Author(s):  
Ranjan Kumar Prusty ◽  
Mohan Bairwa ◽  
Fahmina Anwar ◽  
Vijay Kumar Mishra ◽  
Kamalesh Kumar Patel ◽  
...  

Abstract Background Despite significant economic growth and development, undernutrition among children remains a major public health challenge for low- and middle-income countries in the twenty-first century. In Millennium Development Goals, India committed halving the prevalence of underweight children by 2015. This study aimed to explain the geographical variation in child malnutrition level and understand the socio-biomedical predictors of child nutrition in India. Methods We used the data from India’s National Family Health Survey 2015–2016. The survey provided estimates of stunting, wasting, and underweight at the national, state, and district level to measure nutritional status of under-five children. Level of stunting, wasting and underweight at the district level are considered as outcome variables. We have used variance inflation factor to check the multicollinearity between potential predictors of nutrition. In this study, we performed spatial analysis using ArcGIS and multiple linear regression analysis using Stata version 15. Results Five states (Uttar Pradesh, Bihar, Madhya Pradesh, Jharkhand and Meghalaya) had very high prevalence of stunting (40% and above). High prevalence of wasting was documented in Jharkhand, Madhya Pradesh, Chhattisgarh, and Karnataka (23 to 29%). Jharkhand, Madhya Pradesh, Maharashtra, and Chhattisgarh had the highest proportion of underweight children in the country. We found that electricity and clean fuel use in the household, use of iodized salt, and level of exclusive breastfeeding had significantly negative influence on the stunting level in the districts. The use of iodized salt has similar effect on the wasting status of under-five children in the districts (b: − 0.27, p < 0.10). Further, underweight level had a negative association with clean fuel use for cooking (b: − 0.17, p < 0.01), use of iodized salt (b: − 0.36, p < 0.10), breastfeeding within one hour (b: − 0.18, p < 0.10), semisolid/solid food within 6–8 months (b: − 0.11, p < 0.05) and Gross Domestic Product of the districts (b: − 0.53, p < 0.10). Conclusion In the study, a variety of factors including electricity and clean fuel use in the household, use of iodized salt, level of exclusive breastfeeding, breastfeeding within one hour, semisolid/solid food within 6–8 months and Gross Domestic Product of the districts have a significant association with nutritional status of children.

2004 ◽  
Vol 7 (2) ◽  
pp. 311-317 ◽  
Author(s):  
Jane A Pryer ◽  
Stephen Rogers ◽  
Ataur Rahman

AbstractObjectives:To identify socio-economic demographic and environmental factors that predict better height-for-age for children under 5 years of age in a Dhaka slum population.Design:A panel survey, conducted between 1995 and 1997. A random sample of households was selected. Socio-economic, demographic and environmental variables were collected monthly by questionnaire and nutritional status was assessed.Setting:Dhaka slums in Bangladesh.Subjects:Three hundred and ninety-two children, surveyed in September–November 1996.Main outcome measures:Height-for-age Z-score (HAZ) above −2.Results:Thirty-one per cent of children had HAZ <−2. Logistic regression adjusted for cluster sampling showed that better nourished children were more likely to have taller mothers, to be from female-headed households and from families with higher income, electricity in the home, better latrines, more floor space and living in Central Mohammadpur. Better nourished children were less likely to have fathers who have taken days off from work due to illness.Conclusions:Interest in ‘positive deviance’ is motivated by the recognition that a focus on the malnourished only – the bottom tail of the distribution – provides indications of how families fail, but not of how they succeed in maintaining child nutrition in the face of adversity. Our analysis provides an alternative perspective on nutrition and vulnerability in an urban slum setting.


Author(s):  
Nivedita Roy ◽  
Rajan Gupt ◽  
Aparajita Chattapadhyay

The level and relationship of child health, wealth, and basic amenities are changing fast in India. How strong are the relationships of state wealth, i.e., state Gross Domestic Product and basic household amenities like sanitation facilities with child health? Using the published National Family Health Survey 2015-16 at a macro level, the paper compares the change of stunting, underweight and under-five mortality over ten years (National Family Health Survey 2005-06 to 2015-16) and explores how far child health indices are associated with state Gross Domestic Product. Though wealth and child health are positively associated in India, the strength of the relationship is declining over time, indicating that wealth per se may not guarantee the betterment of child health. Undertaking a case study with 510 children in a low-income community of Mumbai, we further establish that the availability of basic facilities and recent infections play a stronger role in determining child nutrition status when household wealth is controlled. Higher-income, more years of schooling, less crowding in a household, covered drainage system, the non-occurrence of Gastro intestine, and infectious disease are significantly associated with better child nutrition status. Sincere attention to policy on improving basic facilities and living environment to address child health issues has become mandatory. National Health Mission or health programs like Swachh Bharat Abhiyan are good initiatives to focus on improving basic facilities and living environment to address child health issues. Key Words: Wealth, Child health, Stunting, Slum, Mumbai


BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e047210
Author(s):  
Anurag Bhargava ◽  
Madhavi Bhargava ◽  
Banurekha Velayutham ◽  
Kannan Thiruvengadam ◽  
Basilea Watson ◽  
...  

IntroductionIndia has the largest burden of cases and deaths related to tuberculosis (TB). Undernutrition is the leading risk factor accounting for TB incidence, while severe undernutrition is a common risk factor for mortality in patients with TB in India. The impact of nutritional supplementation on TB incidence is unknown, while few underpowered studies have assessed its impact on TB mortality. We designed an open-label, field-based cluster randomised trial to assess the impact of nutritional supplementation (with food rations) on TB incidence in a group at higher risk of TB infection and disease, viz household contacts (HHC) of patients with microbiologically confirmed pulmonary TB (PTB) in Jharkhand, a state with a high prevalence of undernutrition.Methods and analysisWe shall enrol 2800 adult patients with PTB of the national TB programme, across 28 treatment units in 4 districts, and their approximately 11 200 eligible contacts. The sample size has 80% power to detect the primary outcome of 50% reduction in incidence of active TB in HHC over 2 years of follow-up. Patients and HHC in both the arms will undergo nutritional assessment and counselling. Patients will receive monthly food rations (supplying 1200 kcal and 52 g proteins/day) and multivitamins along with antitubercular treatment. The HHC in the intervention arm will receive food rations (supplying 750 kcal and 23 g proteins/day) and multivitamins while HHC in control arm will be on usual diet. The secondary outcomes in HHC will include effects on nutritional status, non-TB infections. Secondary outcomes in patients are effects on TB mortality, adherence, adverse effects, nutritional and performance status. Substudies will examine micronutrient status and effects on dietary intake, body composition, muscle strength and immune function.Ethics and disseminationThe institutional ethics committee of ICMR-NIRT, Chennai, approved the study (289/NIRT-IEC/2018). The results will be disseminated in publications and presentations.Trial registration numberClinical Trial Registry of India: CTRI/2019/08/020490.


Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2628
Author(s):  
Marius Baguma ◽  
Espoir Bwenge Malembaka ◽  
Esto Bahizire ◽  
Germain Zabaday Mudumbi ◽  
Dieudonné Bahati Shamamba ◽  
...  

This comparative cross-sectional study aimed to better understand the respective contributions of protein malnutrition and cassava-derived cyanide poisoning in the development of konzo. We compared data on nutritional status and cyanide exposure of school-age adolescent konzo-diseased patients to those of non-konzo subjects of similar age from three areas in the Eastern Democratic Republic of the Congo. Our results show that konzo patients had a high prevalence of both wasting (54.5%) and stunting (72.7%), as well as of cyanide poisoning (81.8%). Controls from Burhinyi and those from Idjwi showed a similar profile with a low prevalence of wasting (3.3% and 6.5%, respectively) and intermediate prevalence of stunting (26.7% and 23.9%, respectively). They both had a high prevalence of cyanide poisoning (50.0% and 63.0%, respectively), similar to konzo-patients. On the other hand, controls from Bukavu showed the lowest prevalence of both risk factors, namely chronic malnutrition (12.1%) and cyanide poisoning (27.6%). In conclusion, cassava-derived cyanide poisoning does not necessarily coexist with konzo outbreaks. The only factor differentiating konzo patients from healthy individuals exposed to cyanide poisoning appeared to be their worse nutritional status. This further suggests that, besides the known role of cyanide poisoning in the pathogenesis of konzo, malnutrition may be a key factor for the disease occurrence.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tsegaye Gebremedhin ◽  
Demiss Mulatu Geberu ◽  
Asmamaw Atnafu

Abstract Background The burden of low coverage of exclusive breastfeeding (EBF) has a significant impact on the health of a newborn and also on the family and social economy in the long term. Even though the prevalence of EBF practices in Ethiopia is low, the practices in the pastoral communities, in particular, are significantly low and affected by individual and community-level factors. Besides, its adverse outcomes are mostly unrecognised. Therefore, this study aimed to assess the individual and community-level factors of low coverage of EBF practices in the emerging regions of Ethiopia. Methods In this analysis, data from 2016 Ethiopian Demographic and Health Survey (EDHS) were used. A two-stage stratified sampling technique was used to identify 1406 children aged 0 to 23 months in the emerging regions of Ethiopia. A multilevel mixed-effect binary logistic regression analysis was used to determine the individual and community level factors associated with exclusive breastfeeding practices. In the final model, variables with a p-value of < 0.05 and Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) were found to be statistically significant factors that affect exclusive breastfeeding practices. Results Overall, 17.6% (95% CI: 15.6–19.6) of the children aged 0 to 23 months have received exclusive breastfeeding. Employed mothers (AOR: 0.33, 95% CI: 0.21–0.53), richer household wealth status (AOR: 0.39, 95% CI: 0.16–0.96), mothers undecided to have more children (AOR: 2.29, 95% CI: 1.21–4.29), a child with a history of diarrhoea (AOR: 0.31, 95% CI: 0.16–0.61) were the individual-level factors, whereas Benishangul region (AOR: 2.63, 95% CI: 1.44–4.82) was the community-level factors associated with the exclusive breastfeeding practices. Conclusions Less than one-fifth of the mothers have practised exclusive breastfeeding in the emerging regions of Ethiopia. The individual-level factors such as mother’s employment status, household wealth status, desire for more children, presence of diarrhoea and community-level factors such as region have contributed to the low coverage of exclusive breastfeeding. Therefore, the federal and regional health bureaus and other implementers should emphasise to those emerging regions by creating awareness and strengthening the existing community-based health extension program to enhance exclusive breastfeeding practices.


2021 ◽  
Vol 19 (1) ◽  
pp. 78-81
Author(s):  
E. N. Voronina ◽  
◽  
D. V. Pechkurov ◽  
A. A. Tyazheva ◽  
E. V. Kozarez ◽  
...  

The urgency of the problem of recurrent vomiting in children is due not only to the high prevalence of this syndrome, but also to a wide range of reasons for its development. The article presents a clinical case of observation of a child with recurrent vomiting syndrome. It shows the dynamics of the disease, the importance of identifying such «anxiety symptom» as the nutritional status violation. In this case, the cause of vomiting of central genesis was not immediately taken into account, although differential diagnosis presupposes an integrated approach, and doctors' oncological alertness should be constantly preserved even in pediatrics.


2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Mauricio Sanabria ◽  
Cesar Mauricio Doria ◽  
Edward Martinez ◽  
Carlos Simon ◽  
Jasmin Vesga ◽  
...  

Abstract Background and Aims Fatigue is a symptom with a high prevalence in patients on hemodialysis therapy due to uremic toxins, anemia, associated comorbidity, and hemodialysis treatment per se. Our objective is to evaluate the prevalence of fatigue reported by patients and their association with the nutritional status. Method This was a prospective observational, multicenter cohort study. Prevalent patients on HD therapy for at least 90 days, older than 18, at the Baxter Renal Care Services were included between September 1, 2017, to November 30, 2017 with one-year follow-up. Socio-demographic and clinical characteristics of all patients were summarized descriptively, the nutritional status was evaluated by protein Energy waste (PEW). Patient reported fatigue was measured with high flux membrane and medium cut-off membrane (Theranova). A generalized linear binomial multivariable model was conducted to assess the effect of PEW on fatigue symptom controlling for some confounding variables. Results We found that the fatigue reported by the patients has a prevalence of 55% [95% CI: 52.2 to 57.7] in our population, there are no statistical differences due to the use of different types of membranes p= 0.911, and neither did we find that the nutritional status is an independent factor that explains this symptom. If we find that women and diabetics have a higher risk of fatigue; RR=1.17 [95% CI: 1.06 to 1.29] and RR= 1.19 [95% CI: 1.00 to 1.42] respectively. Conclusion The fatigue is a prevalent symptom in the chronic hemodialysis population; being a woman and the diagnosis of diabetes are risk factors associated with this outcome. PEW and the type of dialysis membrane used were not associated with this symptom. Studies evaluating the recovery time from post-dialysis symptoms and its relationship with the type of membrane are necessary.


2021 ◽  
Vol 7 (1) ◽  
pp. 1-21
Author(s):  
Relisa Nuris Shifa ◽  
Sulistiawati ◽  
Endyka Erye Frety ◽  
Astika Gita Ningrum

Background: The first six months after birth are part of the first 1000 days, a golden period for child development. In this period, the child needed proper nutrition to support optimal development and as nutrition programming. WHO recommends exclusive breastfeeding (EBF) for the first 6th-month. Adequacy of nutrition and optimal growth can be assessed using the nutritional status.  Aim: This study analyzes the relationship between EBF for the first 6 months with the nutritional status of a full-term infant aged 0-6 months. The nutritional status assessed using anthropometric measurements and child growth standards. Methods: This type of literature review research uses the PRISMA, PICO, and Boolean Operator methods. The research question with PICO standard "What is a relationship between exclusive breastfeeding practice and nutritional status of children aged 0-6 months?". Relevant literature was obtained from 8 databases: Scopus, Portal Garuda, Proquest, Mendeley, Pubmed, Oxford, Science Direct, and Sage. Literature was limited to the last 10 years. There are 6 relevant pieces of literature included for review. The literature quality assessment uses a quantitative study quality assessment tool released by the EPHPP (Effective Public Health Practice Project) and produces 5 pieces of literature worthy of review.  Results: From 5 kinds of literature, there were various indicators of nutritional status such as weight-for-age (WAZ), length-for-age (LAZ), weight-for-length (WLZ), Body Mass Index (BMI)-for-age, and head circumference (HC)-for-age. The results were dominated by insignificant results, except the HC-for-age indicator stated that there were significant results. The author explores the causes of insignificant results. Explores based on the indicators that include in studies, the information based on studies, and the possible consequences that adjusted to the data based on the studies. The Author found that the mother plays an important role in the production and provision of breast milk. The quality of breastmilk depends on the mother, also how she gives it to their infant. It has to be based on the WHO recommendation. Conclusion: The result of these studies affirms that EBF didn't significantly affect the indicators of WAZ, LAZ, WLZ, and BMI-for-age, but significantly affected the head circumference-for-age indicator.


2020 ◽  
Author(s):  
Mesfin Wudu Kassaw ◽  
Aele Mamo ◽  
Biruk Abate ◽  
Ayelign Kassie ◽  
Seteamlak Masresha

Abstract Objective: The aim of this study was to assess the prevalence and association of child mortality in the pastoralist regions of Ethiopia. The study is a further analysis from 2016 Ethiopian Demographic and Health Survey data. Results: The prevalence of under-five child mortality in the pastoralist’s regions was 23.2%, 95%CI (21.4%, 24.6%). The prevalence of mortality among daughters was 15.4%, 95%CI (14.2, 16.6%), and sons 16.8%, 95%CI (15.6, 18.1%).In logistic regression, wealth index, head of household, Khat chewing, type of child birth, husband education, and child age in months were associated with under-five mortality irrespective of the deceased children’s gender. The prevalence of under-five child mortality in the pastoralist regions of Ethiopia was high, which was far highest in relative to the national under-five mortality prevalence. In assessing the effect of variables on under-five child mortality by gender, almost all the variables that have an effect on female or male child are similar. The government should emphasize on the pastoralists’ regions to decrease the high prevalence of under-five child mortality.


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