scholarly journals Determinants of Severe Acute Malnutrition Among Under 5 Children in Satar Community of Jhapa, Nepal

2020 ◽  
Author(s):  
Kajol Dahal ◽  
Deepak Kumar Yadav ◽  
Dharanidhar Baral ◽  
Birendra Kumar Yadav

Abstract Background: Severe acute malnutrition is the most extreme and visible form of undernutrition plagued by chronic poverty, household food insecurity, lack of education. One of the indigenous and marginalized community of Nepal, Satar/Santhal has often been neglected and is devoid of good education and are economically deprived. This predisposes under 5 children of Satar into malnutrition. The study aims to assess determinants of SAM among children under 5 years of age in Satar community of Jhapa district, Nepal. Material & Methods: A community based matched case control study was carried from September 2019 to February 2020 among under five children of Satar community residing in Jhapa district. Multistage random sampling technique was used to select 50 cases and 100 controls in the ratio of 1:2. Information was collected through personal interview with the parents and anthropometric measurement of the children was measured. Bivariate and multivariate conditional logistic regression analysis was to explore the determinants of severe acute malnutrition. Results: A total of 664 children between the age group of 6 – 59 months were screened for SAM. The prevalence of SAM was found 7.53%. Factors like, low economic status, birth interval less than 2 years, frequency of breast feeding <8 times/day and household food insecurity were found to be significant determinants of SAM. Multivariate logistic regression documented low economic status (AOR: 11.14, 95% CI 1.42 to 87.46); and frequency of breast feeding <8 times/day (AOR: 2.09, 95% CI 1.00 to 4.37) as determinants of SAM. Conclusion: Low economic status and frequency of breast feeding less than 8times/day were major determinants of SAM among children under 5yrs of age. Ending malnutrition will require greater efforts and integrated approaches to eradicate extreme poverty. Multi-sector approaches have been conducting for SAM in Nepal but there are no specific approaches for marginalized community.

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0245151
Author(s):  
Kajol Dahal ◽  
Deepak Kumar Yadav ◽  
Dharanidhar Baral ◽  
Birendra Kumar Yadav

Background Severe acute malnutrition (SAM) is the most extreme and visible form of undernutrition plagued by chronic poverty, household food insecurity, lack of education. One of the indigenous and marginalized community of Nepal, Satar/Santhal has often been neglected and is devoid of good education and are economically deprived. This predisposes under 5 children of Satar into malnutrition. The study aims to assess determinants of SAM among children under 5 years of age in Satar community of Jhapa district, Nepal. Material & methods A community based matched case control study was carried from September 2019 to February 2020 among under five children of Satar community residing in Jhapa district. Multistage random sampling technique was used to select 50 cases and 100 controls in the ratio of 1:2. Information was collected through personal interview with the parents and anthropometric measurement of the children was measured. Bivariate and multivariate conditional logistic regression analysis was used to explore the determinants of severe acute malnutrition. Results A total of 664 children between the age group of 6–59 months were screened for SAM. The prevalence of SAM was found 7.53%. Factors like, low economic status, birth interval less than 2 years, frequency of breast feeding <8 times/day and household food insecurity were found to be significant determinants of SAM. Multivariate logistic regression documented low economic status (AOR: 11.14, 95% CI 1.42 to 87.46); and frequency of breast feeding <8 times/day (AOR: 2.09, 95% CI 1.00 to 4.37) as determinants of SAM. Conclusion Low economic status and frequency of breast feeding less than 8times/day were major determinants of SAM among children under 5yrs of age. Ending malnutrition will require greater efforts and integrated approaches to eradicate extreme poverty. Multi-sector approaches have been conducting for SAM in Nepal but there are no specific approaches for marginalized community.


PeerJ ◽  
2016 ◽  
Vol 4 ◽  
pp. e1945 ◽  
Author(s):  
Bishwajit Ghose ◽  
Shangfeng Tang ◽  
Sanni Yaya ◽  
Zhanchun Feng

Background:Food insecurity and hidden hunger (micronutrient deficiency) affect about two billion people globally. Household food insecurity (HFI) has been shown to be associated with one or multiple micronutrient (MMN) deficiencies among women and children. Chronic food insecurity leads to various deficiency disorders, among which anemia stands out as the most prevalent one. As a high malnutrition prevalent country, Bangladesh has one of the highest rates of anemia among all Asian countries. In this study, we wanted to investigate for any association exists between HFI and anemia among women of reproductive age in Bangladesh.Methodology:Information about demographics, socioeconomic and anemia status on 5,666 married women ageing between 13 and 40 years were collected from a nationally representative cross-sectional survey Bangladesh Demographic and Health Survey (BDHS 2011). Food security was measured by the Household Food Insecurity Access Scale (HFIAS). Capillary hemoglobin concentration (Hb) measured by HemoCue® was used as the biomarker of anemia. Data were analysed using cross-tabulation, chi-square tests and multiple logistic regression methods.Results:Anemia prevalence was 41.7%. Logistic regression showed statistically significant association with anemia and type of residency (p = 0.459; OR = 0.953, 95%CI = 0.840–1.082), wealth status (Poorest: p < 0.001; OR = 1.369, 95%CI = 1.176–1.594; and average: p = 0.030; 95%CI = 1.017–1.398), educational attainment (p < 0.001; OR = 1.276, 95%CI = 1.132–1.439) and household food insecurity (p < 0.001; 95%CI = 1.348–1.830). Women who reported food insecurity were about 1.6 times more likely to suffer from anemia compared to their food secure counterparts.Conclusion:HFI is a significant predictor of anemia among women of reproductive age in Bangladesh. Programs targeting HFI could prove beneficial for anemia reduction strategies. Gender aspects of food and nutrition insecurity should be taken into consideration in designing national anemia prevention frameworks.


2015 ◽  
Vol 18 (16) ◽  
pp. 2915-2924 ◽  
Author(s):  
Kammi K Schmeer ◽  
Barbara A Piperata ◽  
Andrés Herrera Rodríguez ◽  
Virgilio Mariano Salazar Torres ◽  
Francisco José Centeno Cárdenas

AbstractObjectiveWomen (especially mothers) are theorized as critical to reducing household food insecurity through their work and caregiver roles. The present study tests these assumptions, assessing how maternal economic and social resources are associated with food insecurity in households with young children.DesignData from a population-based sample of households was collected in León, Nicaragua (n 443). Data include a newly validated measure of household food insecurity (ELCSA), maternal resource measures, and household economic status and demographics. Regression analysis tests the statistical associations (P<0·05) of maternal resources with household, adult-specific and child-specific food insecurity.SettingMunicipality of León, Nicaragua.SubjectsHouseholds with children aged 3–11 years in rural and urban León.ResultsOnly 25 % of households with young children were food secure, with 50 % mildly food insecure and 25 % moderately/severely food insecure. When mothers contributed substantially to household income, the odds of moderate/severe household food insecurity were 34 % lower than when their spouse/partner was the main provider. The odds of food insecurity were 60 % lower when mothers managed household money, 48 % lower when mothers had a secondary (v. primary) education, 65 % higher among single mothers and 16 % lower with each indicator of social support. Results were similar for adult- and child-specific food insecurity.ConclusionsThis research provides new evidence that maternal economic and social resources are important for reducing household food insecurity and adult- and child-specific food insecurity. Women’s social status, social support and access to economic resources need to be enhanced as a part of policies aimed to reduce food insecurity in high-poverty settings.


2017 ◽  
Vol 6 (2) ◽  
pp. 53-60
Author(s):  
Mohammad Rocky Khan Chowdhury ◽  
Russell Kabir ◽  
Konstantinos Papadopoulas ◽  
SM Yasir Arafat ◽  
Manzur Kader ◽  
...  

To examine the prevalence of household food insecurity (HHFI) among children aged between 6-23 months in Bangladesh. This paper also aims to identify the individual, household and community levels determinants of HHFI and the association between nutritional behavior and HHFI. Bangladesh Demographic Health Survey (BDHS), 2011 was used for this research. A total of 2,344 children were selected for analysis. Statistical analysis and tests were guided by the nature of the variables. Finally, logistic regression analysis was used to find out the association between independent variables and outcome. The overall prevalence of HHFI was 36.3% (95% CI: 33.6-39.0) among the participants (children). The prevalence of HHFI was significantly higher among children who did not receive nutritional items. In contrast, HHFI was more prevalent among children who were breastfed (37.0%) as compared to non-breastfed. Binary logistic regression analysis showed that children of illiterate mothers (adjusted OR: 2.20, 95% CI: 1.17-4.10), illiterate fathers (adjusted OR: 2.27, 95% CI: 1.41-3.66) and socio-economically poor families (adjusted OR: 11.35, 95% CI: 7.20-17.91) were more at risk of experiencing HHFI, whereas, rural children (adjusted OR: 0.72, 95% CI: 0.57-0.93) were more protective. In the adjusted logistic regression model, children who did not receive juice (adjusted OR: 1.54, 95% CI: 1.09-2.16) had experienced HHFI. The prevalence of HHFI among children is still high in Bangladesh. Therefore, to achieve the Millennium Development Goals, the Government of Bangladesh should priorities HHFI as a major public health issue. Strong collaborations among various stakeholders are also crucial to improve the situation.South East Asia Journal of Public Health Vol.6(2) 2016: 53-60


2021 ◽  
pp. 1-39
Author(s):  
Ana María Sansón-Rosas ◽  
Jennifer Bernal-Rivas ◽  
Stan Kubow ◽  
Andrés Suarez ◽  
Hugo Melgar-Quiñonez

Abstract Objective: This study aimed to examine in Colombian rural households the association between different severity levels of household food insecurity and the presence of the double burden of malnutrition (SCOWT), defined as the coexistence of a stunted child under five years and an overweight or obese (OWOB) mother. Design: A secondary data analysis was conducted using cross-sectional data from the Colombian National Nutritional Survey (ENSIN) 2015. Household food insecurity status was assessed by using the Latin-American and Caribbean Food Security Scale (ELCSA). The household SCOWT status (child stunting and OWOB mother) was determined using anthropometric data from a mother and her child. Setting: Rural Colombia Participants: 2.350 mother-child pairs living in the same household Results: Sixty-two percent of the households were food insecure and SCOWT was present in 7.8% of the households. Moderate (OR: 2.39 – CI: 1.36 - 4.21) and severe (OR: 1.86 – CI: 1.10 - 3.15) food insecurity was associated with SCOWT in an unadjusted logistic regression. Only moderate food insecurity remained significantly associated with SCOWT in a multivariate logistic regression (aOR: 2.41 - IC: 1.24 – 4.68). Conclusions: Colombian rural areas are not exempt from the worldwide concern of increasing OWOB rates while stunting is still persistent. These results highlight the need of implementing double duty rural actions targeting most vulnerable households to SCOWT, particularly in terms of overcoming food insecurity beyond hunger satisfaction to prevent all forms of malnutrition.


2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 188-188
Author(s):  
Olga Garcia ◽  
Karina Miranda ◽  
Hugo Melgar-Quiñonez ◽  
Jorge Rosado

Abstract Objectives To evaluate the relationship between household food insecurity and food insecurity of the mothers during her childhood with cognitive function in school children in Querétaro. Methods A total of 153 children (6–10 y) of public elementary schools in the municipality of Querétaro participated in a cross-sectional study. Household food insecurity was measured using the ELCSA (Latin American and Caribbean Food Security Scale) and a validated questionnaire to measure food insecurity of the mother during her childhood. Anthropometric measurements (weight, height, waist circumference) were taken by standardized personnel and the WISC IV scale adapted to children for the determination of cognitive function was applied by trained psychologists. Statistical ANOVA tests were used to determine mean differences in cognitive function between children with and without food insecurity. A logistic regression was also calculated to determine the odds of having low cognitive function in the presence of food insecurity, both at the household level and of the mother during her childhood. All analyses were adjusted for maternal level of education as a confounder. Results The children had a combined prevalence of overweight and obesity of 39.9%. A total of 54.3% of the households had food insecurity and 80.4% of the mothers had food insecurity in their childhood. The prevalence of the average score of the Total Intelligence Quotient (TIQ) of the children was 52.3%, and 38.2% had TIQ below average. Children living in households with food insecurity and with mothers that had food insecurity in their past had lower TIQ (89.08 ± 8.23, and, 91.87 ± 11.18, respectively) compared with children in food secure households (95.39 ± 12.20) and with mothers that had food security in their childhood (96.87 ± 12.03). However, after adjusting for maternal level of education, no relationship was observed between food insecurity and TIQ. Similarly, the adjusted logistic regression model showed no relationship between food insecurity in the household and mother's food insecurity in the past with TIQ. Conclusions In the present study, food insecurity was not related to cognitive function of school-aged children in Querétaro, Mexico. Funding Sources Partially funded by CONACYT.


Food Security ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 407-416 ◽  
Author(s):  
Spyros Kolovos ◽  
Gerardo A Zavala ◽  
Anne Sophie Leijen ◽  
Hugo Melgar-Quiñonez ◽  
Maurits van Tulder

AbstractThe objective of this cross-sectional study was to assess the relationship between food insecurity and depression in the Mexican population. We used data from the 2012 health and nutrition survey (ENSANUT), which is representative of the Mexican population. Food insecurity was determined by the Latin American and Caribbean Food Security Scale (ELCSA). Depressive symptoms were evaluated using the Center for Epidemiological Studies Depression Scale Short-Form (CES-D-SF). Adjusted logistic regression analyses and ANCOVA were used. Out of 33,011 participants, 5788 (18%) had high depressive symptoms and 24,098 (73%) experienced food insecurity. The adjusted logistic regression analysis showed that, participants with mild food insecurity, (OR = 1.47,95% CI = 1.27 to 1.71), moderate food insecurity (OR = 2.14,95% CI = 1.85 to 2.47) and severe food insecurity (OR = 3.01,95% CI = 2.51 to 3.60,) were more likely to have high depressive symptoms than food secure participants. Participants with moderate food insecurity (OR =1.45, 95% CI = 1.28 to 1.64) and severe food insecurity (OR =2.04, 95% CI = 1.76 to 2.37) were more likely to suffer from depression as compared to participants with mild food insecurity. Participants with severe food insecurity were more likely (OR=1.41, 95% CI = 1.21 to 1.65) to suffer from depression compared to participants with moderate food insecurity. This paper provides an overview of the complex problem of food insecurity and mental health. Despite the unknown causality, the analysis suggests a strong association between depression and food insecurity. This problem calls for much more attention from the scientific community. Given the high prevalence of depression and the high prevalence of household food insecurity in Mexico, the implementation of successful public health programs to improve food security is necessary.


2021 ◽  
Author(s):  
Mohammad Ashraful Islam ◽  
Mahfuzur Rahman ◽  
Md. Fakhar Uddin ◽  
Md. Tariqujjaman ◽  
Gobinda Karmakar ◽  
...  

Abstract BackgroundDespite recent progress in rural economic development and food production, the prevalence of household food insecurity (FI) and use of unimproved toilet facilities are widespread in Bangladesh. Limited studies have sought to understand the relationship of household FI and sanitation, separately and in combination, with child morbidity. This paper aimed to assess the effect of FI and unimproved toilet facility of households on adverse health outcomes of children less than five years of age in Bangladesh.MethodsWe used data from a cross-sectional survey that was conducted as part of an evaluation of the Maternal, Infant and Young Child Nutrition (MIYCN) Program in Bangladesh. The study population included children aged 6-59 months and their caregivers, identified using a two-stage cluster-sampling procedure. Child morbidity status was the outcome variable, and household FI status and type of toilet used were considered the main exposure variables in this study. We performed logistic regression, calculated adjusted odds ratios (AOR) to assess the association of child morbidity with household FI and unimproved toilet facility after adjusting for potential confounders. ResultsA total of 1,728 households were eligible for this analysis. About 23% of the households were food-insecure, and a large number of households had improved toilet facilities (93.4%). In the multivariable logistic regression model, we found that children in food-insecure households with unimproved toilet facility had 5.88 (AOR: 5.88; 95% CI 2.52, 13.70) times more chance, of being morbid compared to the children of food-secure households with improved toilet facility. A similar association of FI and toilet facilities with each of the morbidity components was observed, including diarrhea (AOR:3.6; 95% CI 1.79, 7.89), fever (AOR:3.47; 95% CI 1.72, 6.99), difficult or fast breathing with cough (AOR:3.88; 95% CI 1.99, 7.59), and difficult or fast breathing with blocked or running nose (AOR:1.29; 95% CI 0.56, 2.95).ConclusionsOur study shows that household FI and unimproved toilet facility jointly have more deteriorative effects on child morbidity than either of these conditions alone. Therefore, it is important to consider these two critical factors while designing a public health intervention for reducing morbidity among under-five children.


2014 ◽  
Vol 9 (1) ◽  
pp. 50
Author(s):  
Titih Huriah ◽  
Laksono Trisnantoro ◽  
Fitri Haryanti ◽  
Madarina Julia

Malnutrisi akut berat merupakan malnutrisi yang paling serius yang memengaruhi balita dan merupakan masalah kesehatan utama di negara-negara berkembang. Malnutrisi telah meluas baik di perkotaan maupun perdesaan. Akar permasalahan malnutrisi di negara berkembang salah satunya adalah faktor sosial demografi. Tujuan penelitian untuk melihat perbedaan kejadian malnutrisi dan determinannya di area perkotaan dan pedesaan di Yogyakarta. Penelitian menggunakan desain potong lintang dengan responden adalah semua balita malnutrisi akut berat di Kabupaten Sleman (23 balita) dan Kota Yogyakarta (33 balita). Analisis data menggunakan statistik deskriptif dan inferensial. Penelitian dilaksanakan pada Bulan Desember 2012 - Februari 2013. Prevalensi balita malnutrisi akut lebih banyak di perkotaan daripada di pedesaan (59% vs. 41%). Persentase faktor risiko kejadian malnutrisi pada kelompok urban dan rural adalah jumlah balita dalam keluarga satu orang (60,7%), jenis kelamin laki-laki (58,9%), riwayat pemberian ASI tidak eksklusif (60,7%), usia ibu kurang dari 35 tahun (62,5%), pekerjaan non-PNS (98,2%), penghasilan orang tua lebih dari UMR (58,9%), tingkat pendidikan ayah dan ibu tinggi (71,4% dan 64,3% ) dan pengasuh balita di rumah adalah ibu (82,1%). Perbedaan yang signifikan (p<0,05) pada variabel pekerjaan dan penghasilan orang tua, tingkat pendidikan orang tua dan pengasuh balita, sedangkan hasil pengukuran antropometri tidak menunjukkan adanya perbedaan. Determinan kejadian malnutrisi pada kelompok urban dan rural adalah jumlah balita dalam keluarga.Severe acute malnutrition is the most serious form of malnutrition affecting children under-five and widely recognized as a major health problem in developing countries. It is wide spread in rural and urban areas. Social demographic factor is one of the main causes of severe acute malnutrition. This study was conducted to determine the prevalence of severe acute malnutrition and determinants of children in urban and rural area in Yogyakarta. A cross-sectional study was used in this study, where the respondents were all children with severe acute malnutrition in Sleman and Yogyakarta (23 and 33 children respectively). Descriptive and inferencial statistic were used to analyze the data. The study was carried out in December 2012-February 2013. The prevalence of severe acute malnutrition children was higher in urban than rural communities (59% vs. 41%). Risk factors percentage of malnourished were number of children in family was one person (60.7%), male gender (58.9%), the history of not exclusive breastfeeding (60.7%), mother age less than 35 years old (62.5%), lower class job (98.2%), monthly income was high (58.9%), higher education of father and mother (71.4% and 64.3% respectively), and children caregiver was mother (82.1%). There were a significant diference (p<0.05) in father profession, parents’ education, household economic status, and caregiver of children, whereas anthropometric measurement did not show any difference between two groups. Determinants of malnutrition in urban and rural groups is the number of children in the family.


2019 ◽  
Vol 1 (1) ◽  
pp. 01-10
Author(s):  
Ahmed Abdurahman

Background: Consuming scarce and poorly diversified diet, along with inadequate breastfeeding, contribute seriously to the complete scope of child undernutrition like stunting, wasting, underweight and micronutrient deficiency. Objective: To determine the association between dietary diversity score (DDS) and nutritional status among children aged 24 to 59 months in Haromaya district, Ethiopia. Methods: Children aged 24-59 months (N= 453) were enrolled in this cross-sectional study with a representative sample of households selected by a multistage sampling procedure in Haromaya district. Anthropometry and 24hr dietary recall were administered. Multinomial logistic regression models were applied to select variables that are candidate for multivariable model. Structural equation modeling was applied to test the mediatory effect of DDS on the relationship between household food insecurity (HFI) and child nutritional status. Results: The mean DDS was 3.62 (SD 1.09), and 50% of the children indicated poor and average DDS with only 20% children in very good DDS. By logistic regression analysis and after adjusting for the confounding factors, poor DDS was highly significant predictor of wasting, stunting and underweight (AOR = 4.09, C.I = 1.31 - 12.76, p = .01), (AOR = 2.28, C.I = 1.11 - 4.69, p = .03) and (AOR = 2.48, C.I = 1.17 - 5.24, p = .02) respectively. HFI had a significant direct effect on wasting though no significant indirect effect on wasting through mediation variable, DDS, (β1 reduced from 0.06 (S.E. = 0.027, p < .05) to 0.05 (S.E. = 0.028, p > .05). Conclusion: Poor DDS was a predictor of wasting, stunting and underweight. Additionally, DDS had a role in the association between HFI and nutritional status.


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