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 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 &lt; 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 Tingkat Perkembangan Balita Usia 1 Bulan – 6 Tahun Di Kecamatan Cibiuk Kabupaten Garut

2018 ◽  
Vol 4 (1) ◽  
pp. 47
Author(s):  
Ikeu Nurhidayah ◽  
Henny Suzana Mediani ◽  
Sri Hendrawati
Keyword(s):  
Child Development ◽  
Motor Development ◽  
Rural Areas ◽  
Screening Test ◽  
Developmental Disorders ◽  
Developmental Screening ◽  
Fine Motor ◽  
Social Aspect ◽  
Gross Motor ◽  
Purposive Sampling

ABSTRAK Angka penyimpangan perkembangan pada anak saat ini semakin meningkat. Faktor yang penting untuk mendeteksi penyimpangan perkembangan adalah skrining perkembangan. Sejauh ini beberapa literatur lebih banyak membahas perkembangan pada anak di daerah perkotaan, dan sedikit sekali hasil penelitian yang memaparkan  perkembangan pada anak di daerah pedesaan. Penelitian ini dilakukan untuk mengetahui gambaran perkembangan anak usia 1 bulan – 6 tahun dalam aspek perkembangan personal sosial, adaptif motorik halus, bahasa, dan motorik kasar. Jenis penelitian ini adalah deskriptif kuantitatif. Penelitian dilakukan di Kecamatan Cibiuk Kabupaten Garut. Pengambilan sampel dengan cara purposive sampling, didapatkan 130 responden. Tingkat perkembangan diukur menggunakan Denver Development Screening Test II (DDST II). Analisis data dengan menggunakan distribusi frekuensi. Hasil penelitian menunjukkan bahwa sebagian besar anak mengalami perkembangan normal, yaitu usia 1-12 bulan 74% normal, usia >1-3 tahun 64% normal, dan usia >3-6 tahun 65% normal. Sedangkan berdasarkan empat aspek perkembangan didapatkan data bahwa persentase terbesar suspect (dicurigai adanya gangguan) terdapat pada aspek perkembangan personal sosial dialami anak usia >3-6 tahun, presentase suspect perkembangan adaptif-motorik halus terbesar dialami anak usia >3-6 tahun, presentase suspect perkembangan bahasa terbesar dialami anak usia >3-6 tahun, dan presentase suspect perkembangan motorik kasar terbesar dialami anak usia >1-3 tahun. Suspect (dicurigai adanya gangguan) pada tiap aspek perkembangan dipengaruhi oleh berbagai hal, yang paling berperan diantaranya adalah stimulasi. Sehingga gambaran perkembangan saat ini mungkin akan berbeda dengan gambaran perkembangan di masa yang akan datang, apabila anak dilakukan stimulasi. Peneliti merekomendasikan agar perawat meningkatkan diseminasi informasi mengenai stimulasi untuk mengoptimalkan perkembangan pada anak. ABSTRACT Developmental disorders in children is increasing. One of the factors that are important to detect developmental disorders are developmental screening. However, literature mainly discussed on child development in urban areas, and very little research that explained the development of children in rural areas. The aim of this study was to describe children developmental level age 1 month until 6 years in rural areas. The sub variabel that are studied personal social aspect, fine motor-adaftive, language, and gross motor development. The childen development screening can use Denver Development Screening Test II (DDST II), in which categories as normal and suspect. This study conducted in District of Cibiuk, Garut Residence. There were 130 respondent was taken with purposive sampling techique in this study. Design of this study was descriptive. Child development was measured by Denver Developmental Screening Test II. Data analysis was used distribution of frequency. This result of this study showed that most children had normal development level, there were 74% in children age 1-12 month, 64% in children 1-3 years old, and 65% in children >3-6 years old. Based on the developmental aspect, the result showed that the higher precentage of suspect on the personal sosial aspect were in children age >3-6 years old, higher precentage of suspect of the fine motor-adaftive aspect were in children age >3-6 years old, higher precentage of suspect of language aspect were in children age >3-6 years old, and higher precentage of suspect of the gross motor aspect were in children age >1-3 years old. The suspect in  developmental children were influenced by various factor, such as stimulation. Researcher recommend that nurses need to intensified dissemination of information about stimulation in children to optimize growth developmental in children.

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.

scholarly journals Status stunted dan hubungannya dengan perkembangan anak balita di wilayah pesisir Pantai Utara Kecamatan Lemahwungkuk Kota Cirebon

2010 ◽  
Vol 6 (3) ◽  
pp. 131 ◽  
Author(s):  
Alina Hizni ◽  
Madarina Julia ◽  
Indria Laksmi Gamayanti
Keyword(s):  
Child Development ◽  
Language Development ◽  
Motor Development ◽  
Coastal Area ◽  
Child Growth ◽  
Fine Motor ◽  
Chi Square ◽  
Cross Sectional ◽  
Gross Motor ◽  
Gross Motor Development

Background: The problem of protein energy inadequacy is a major problem among under-fives that affects the process of child growth and development. The prevalence of stunted status among under-fives in developing countries in 2008 was estimated as much as 33%. In Cirebon Municipality the prevalence was 10.27% and in north coastal area of Cirebon Municipality was 11.4%.Objective: To identify the association between stunted status and development of under-fives at north coastal area of sub district of Lemahwungkuk Cirebon Municipality.Method: This was an observational study with a cross sectional design carried out at north coastal area of sub district of Lemahwungkuk Cirebon Municipality from November 2008 to January 2009. Subject of the study consisted of 166 under-fives and the respondents were parents of those children. Samples were chosen purposively. Research instruments consisted of questionnaire, length board, microtoise, forms, and Denver II test. Data analysis used chi square and logistic regression with confidence interval (CI) 95%.Result: There was significant association between stunted status and development of fine motor adaptive, language, and gross motor capacity. There was significant association between education of mothers and personal social, fine motor adaptive, language and gross motor development. There was significant association between occupation of mothers and personal social, fine motor adaptive, language and gross motor development. There was significant association between stunted status, education of mothers, and occupation of mothers and child development. The result of multivariate analysis showed that stunted status had greater risk for delayed language development of under-fives than other indicators of child development.Conclusion: There was no association between stunted status and child development; however stunted status had greater risk for delay in language development, and risk factors dominantly affecting child development were occupation and education of mothers.

PENGEMBANGAN FISIK MOTORIK ANAK USIA DINI DENGAN BERMAI

Edupedia ◽  
2019 ◽  
Vol 3 (2) ◽  
pp. 67-77
Author(s):  
Farhatin Masrurah ◽  
Khulusinniyah Khulusinniyah
Keyword(s):  
Early Childhood ◽  
High Activity ◽  
Motor Skills ◽  
Motor Development ◽  
Rapid Growth ◽  
Skills Development ◽  
Fine Motor ◽  
Fine Motor Skills ◽  
Gross Motor ◽  
Gross Motor Skills

The first five years of a children’s age is the period of rapid growth with physical and motor development. Those process will develop well if stimulated continuously. Early childhood always identic with high activity requires the opportunity to express their abilities. Therefore playing method is very urgent inchildren’s gross motor skills and fine motor skills development through a variety of playing activities both indoors and outdoors. Playing is an activity that cannot be separated from early childhood’s world. All playing activities will be carried out happily. By the same token learning by playing will be done happily without any sense of being forced or oppressed.

scholarly journals A Case Study on Management of Rett Syndrome by Wholistic approach

2020 ◽  
Vol 11 (2) ◽  
pp. 351-357
Author(s):  
Renu Rathi ◽  
Bharat Rathi ◽  
Rakesh Khatana ◽  
Suraj Sankh
Keyword(s):  
Case Report ◽  
Rett Syndrome ◽  
Motor Development ◽  
Autism Spectrum ◽  
Severe Form ◽  
Fine Motor ◽  
Gross Motor ◽  
Gross Motor Development

Background: Rett syndrome-RS comes under Autism spectrum disorder-ASD which is a neurodevelopmental syndrome. It is diagnosed by the main differentiating features of lack of interpersonal and communication skills, poor eye contact, delayed speech with pervasive abnormal body movements. Aim and Objectives: This case report is aimed at dissemination of comprehensive role of Ayurveda in management of ASD, Rett syndrome. Material and Methods: RS is the severe form of ASD. This case study of 2.3 year’s girl presented with RS and global delay, being treated with wholistic approach. It comprises Ayurveda chikitsa and other therapies like Yoga, hydrotherapy, occupational, music, physiotherapy and many more. Observation and Result: Patient has shown promising results in all developmental milestones such as gross motor, fine motor and personal social in 6 months duration except language. Different varieties of massage therapy, diet and Basti, Nasya (Panchkarma) procedures, Omkar mantra chanting, passive Yogasana were done. Conclusion: In this case report, mainly Ayurveda interventions were implemented with wholistic approach as an adjuvant, received good result in gross motor development which is very difficult in RS, hence it is a unique case. It also opened the door of wholistic approach with the hope to deliver the good result in similar disorders.

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 The Effect of Play-Based Math Activities on Different Areas of Development in Children 48 to 60 Months of Age

SAGE Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. 215824402091953
Author(s):  
Meral Taner Derman ◽  
Elvan Şahin Zeteroğlu ◽  
Arzu Ergişi Birgül
Keyword(s):  
Preschool Children ◽  
Motor Development ◽  
Fine Motor ◽  
Control Group ◽  
Gross Motor ◽  
Physically Active ◽  
Significant Difference ◽  
Quasi Experimental ◽  
Language Areas ◽  
Experimental Group

There are previous studies in the literature conducted on the effect of play-based math activities on the mathematical skills, language, and cognitive development of preschool children. However, the number of studies conducted to determine the effect of play-based math activities on different areas of development in preschool children was too few. The purpose of this study is to investigate the effect of play-based math activities on different developmental areas (personal-social, fine motor, language, and gross motor development) of children 48 to 60 months of age. The pretest/posttest quasi-experimental research design with control and experimental groups was employed in this study. The research group of this study is composed of 45 children 22 of whom (10 girls and 12 boys) were in the experimental group and 23 (10 girls and 13 boys) in the control group. Denver II Developmental Screening Test was used as the data collection tool. As a result, it was determined that there was a significant difference between the subscales and pretest-posttest total scores concerning personal-social, fine motor, and language areas in the experimental group, while there was no statistically significant difference in the gross motor subscale. In addition, it was observed that there was statistically no significant difference between pretest–posttest scores concerning personal-social, fine motor, language, gross motor subscales and total scores of the control group. The result revealed that play-based math activities have a positive effect on personal-social, fine motor, language, and gross motor developments of children. Further studies can be planned to investigate the effects of play-based mathematics education integrated with different activities where children can have fun and be physically active on children’s developmental areas.

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