scholarly journals Effect of Oral Nutritional Supplementation on Growth in Vietnamese Children with Stunting

2019 ◽  
Vol 13 (1) ◽  
pp. 43-52
Author(s):  
Dung T. Pham ◽  
Trong N. Hoang ◽  
Nhu T. Ngo ◽  
Long H. Nguyen ◽  
Trung Q. Tran ◽  
...  
Keyword(s):  
Linear Growth ◽  
Z Score ◽  
Intervention Period ◽  
Factors Associated ◽  
Low Weight ◽  
Younger Age ◽  
The Mean ◽  
The Impact ◽  
Height For Age ◽  
Weight For Age

Background: The impact of oral nutritional supplementations (ONS) is not well-elucidated in children with stunting. Objective: The aim is to evaluate the effect of ONS on growth in Vietnamese children with stunting. Methods: This 6-month, prospective, single-arm trial evaluated 121 children aged 24–48 months with stunting (height-for-age z-score [HAZ] < -2) and low weight-for-height z-score (WHZ < -1) in Vietnam. Children consumed ONS twice daily. The outcomes included the change in HAZ, WHZ, and weight-for-age z-score (WAZ) from baseline to 3- and 6 months; change in height and weight from baseline to 3- and 6 months; and the prevalence of stunting, wasting (WHZ < -2 SD), and underweight (WAZ < -2 SD) at 6 months. We also examined factors associated with a change in HAZ over the intervention period. Results: The mean age was 34.7 months and 49% were male. Height and weight increased from baseline to 3- and 6-months (p<0.0001). There was a significant increase in median HAZ (0.25 units), WHZ (0.72 units), and WAZ (0.65 units) from baseline to 6 months (p<0.0001). Notably, approximately 40% of children recovered from stunting at 6 months (p<0.0001). The prevalence of wasting and underweight status were also significantly lower at 6 months (p=0.0310 and p<0.0001, respectively) relative to the baseline. Lower HAZ and younger age at baseline were significantly associated with higher linear growth at 6 months. Conclusion: ONS helped improve linear and ponderal growth and reduce the prevalence of stunting, wasting, and underweight status in stunted children at risk of wasting.

scholarly journals Preoperative malnutrition is associated with increased mortality and adverse outcomes after paediatric cardiac surgery

2017 ◽  
Vol 27 (9) ◽  
pp. 1716-1725 ◽  
Author(s):  
Faith Ross ◽  
Gregory Latham ◽  
Denise Joffe ◽  
Michael Richards ◽  
Jeremy Geiduschek ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Cardiac Arrest ◽  
Cardiac Surgery ◽  
Adverse Outcomes ◽  
Z Score ◽  
Paediatric Cardiac Surgery ◽  
Increased Risk ◽  
The Impact ◽  
Height For Age ◽  
Weight For Age

AbstractBackgroundMalnutrition is common in children with CHD and is likely to place them at an increased risk for adverse surgical outcomes. We sought to evaluate the impact of preoperative malnutrition on outcomes after paediatric cardiac surgery.MethodsWe conducted a retrospective analysis of patients from age 0 to 5 years undergoing cardiac surgery at Seattle Children’s Hospital from 2006 to 2015. We used regression modelling to examine the impact of malnutrition on surgical outcomes.ResultsWe found a non-linear relationship between low height-for-age and weight-for-age z-scores and mortality after surgery. In the range of z-score ⩽−2, each additional unit decrease in height-for-age or weight-for-age z-score was associated with a 2.9 or 2.1% increased risk for mortality, respectively. Each unit decrease in height-for-age z-score was associated with a 1.2% increased risk for cardiac arrest, 1.1% increased risk for infection, and an average of 1.7 additional hours of mechanical ventilation, 6 hours longer ICU stay, and 13 hours longer hospital stay. Each unit decrease in weight-for-age z-score was associated with a 0.7% increased risk for cardiac arrest, 0.8% increased risk for infection, and an average of 1.9 additional hours of mechanical ventilation and 5.3 additional hours of ICU stay.ConclusionsThis study is unique in demonstrating a significant association between malnutrition and 30-day mortality and other adverse outcomes after paediatric cardiac surgery in a mixed population of CHD patients. By evaluating nutritional status as a continuous variable, we were able to clearly distinguish the point at which malnutrition begins to affect mortality.

scholarly journals THE IMPACT OF SMALL INTESTINAL BACTERIAL OVERGROWTH ON THE GROWTH OF CHILDREN AND ADOLESCENTS

2020 ◽  
Vol 38 ◽  
Author(s):  
Alexandre Neves da Rocha Santos ◽  
Ana Cristina Fontenele Soares ◽  
Ricardo Palmero Oliveira ◽  
Mauro Batista de Morais
Keyword(s):  
Children And Adolescents ◽  
Breath Test ◽  
Bacterial Overgrowth ◽  
Small Intestinal Bacterial Overgrowth ◽  
Z Score ◽  
Intestinal Bacterial Overgrowth ◽  
Small Intestinal ◽  
The Impact ◽  
Height For Age ◽  
Weight For Age

ABSTRACT Objective: To evaluate the association between small intestinal bacterial overgrowth (SIBO) and weight and height impairment in children and adolescents with gastroenterology diseases. Methods: Observational and retrospective study. All 162 patients aged less than 19 years old who underwent breath test in search of SIBO between 2011 and 2016 were studied. Breath test was collected after the intake of 10 grams of lactulose. The concentration of hydrogen and methane was measured for 180 minutes after the beginning of the test by 12i QuinTronMicroLyzer device. Results: SIBO was identified in 51 (31.5%) patients. There was no difference between the age of those with (mean=8.7y.o; 25th and 75th percentile: 4.6 and 11.3) and without (mean=7.9y.o 25th and 75th percentile: 4.8 and 12.2) SIBO (p=0.910). There was no association between gender and SIBO (male 26.3% vs. female 36.3%, p=1.00). A lower median of height-for-age Z score (mean=-1.32; 25th and 75th percentile: -2.12 and -0.08 vs. mean=-0.59; 25th and 75th percentile: -1.57 and 0.22; p=0.04) was demonstrated in children with SIBO when compared with children without it. There was no difference between the BMI-for-age Z score of patients with (mean=-0.48) and without SIBO (mean=-0.06) (p=0.106). The BMI of patients with SIBO (median=15.39) was lower than of those without it (median=16.06); however, the statistical analysis was not significant (p=0.052). The weight-for-age Z score was lower in patients with SIBO (mean=-0.96) than in those without SIBO (mean=-0.22) (p=0.02) Conclusions: Children and adolescents with SBIO associated with diseases of the gastrointestinal tract have lower weight and height values.

scholarly journals Association of Whole Blood Fatty Acids and Growth in Southern Ghanaian Children 2–6 Years of Age

Nutrients ◽  
2018 ◽  
Vol 10 (8) ◽  
pp. 954 ◽  
Author(s):  
Mary Adjepong ◽  
William Yakah ◽  
William Harris ◽  
Esi Colecraft ◽  
Grace Marquis ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Growth Parameters ◽  
Dietary Fatty Acids ◽  
Northern Ghana ◽  
Z Score ◽  
Omega 3 ◽  
Omega 6 ◽  
Z Scores ◽  
Height For Age ◽  
Weight For Age

In Ghana, stunting rates in children below 5 years of age vary regionally. Dietary fatty acids (FAs) are crucial for linear growth. The objective of this study was to determine the association between blood FAs and growth parameters in southern Ghanaian children 2–6 years of age. A drop of blood was collected on an antioxidant treated card and analyzed for FA composition. Weight and height were measured and z-scores calculated. Relationships between FAs and growth were analyzed by linear regressions and factor analysis. Of the 209 subjects, 22% were stunted and 10.6% were essential FA deficient (triene/tetraene ratio > 0.02). Essential FA did not differ between stunted and non-stunted children and was not associated with height-for-age z-score or weight-for-age z-score. Similarly, no relationships between other blood fatty acids and growth parameters were observed in this population. However, when blood fatty acid levels in these children were compared to previously reported values from northern Ghana, the analysis showed that blood omega-3 FA levels were significantly higher and omega-6 FA levels lower in the southern Ghanaian children (p < 0.001). Fish and seafood consumption in this southern cohort was high and could account for the lower stunting rates observed in these children compared to other regions.

Factors associated with mobility apprehension in persons with lower limb amputation

2020 ◽  
Vol 44 (4) ◽  
pp. 208-214
Author(s):  
Shannon L Mathis
Keyword(s):  
Standard Deviation ◽  
Lower Limb ◽  
Avoidance Behavior ◽  
Pain Catastrophizing ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Walking Ability ◽  
Factors Associated ◽  
The Mean ◽  
The Impact

Background: Factors that are related to mobility apprehension were measured in a sample of persons with lower-limb amputation. Objectives: The purpose was to determine whether intensity, interference, or catastrophizing are associated with mobility apprehension. Study design: Cross-sectional study. Methods: Persons with amputation of a lower limb who were attending a national limb loss conference were recruited to complete a survey. Subjects were administered the Tampa Scale for Kinesiophobia to measure mobility apprehension. The Brief Pain Inventory was administered to quantify the affect of pain on general activity, walking ability, and enjoyment of life. The Pain Catastrophizing Scale was administered to assess the tendency to ruminate and magnify pain sensations. A multivariable linear regression was performed to determine factors associated with mobility apprehension. Results: Fifty-three people with lower-limb amputation participated in the study. The mean (standard deviation) score for mobility apprehension was 34.2 (6.0). Mean (standard deviation) pain intensity and interference scores were 1.6 (1.7) and 2.5 (2.6), respectively. The mean (standard deviation) pain catastrophizing score was 9.1 (10). Pain catastrophizing was the only variable associated with higher mobility apprehension ( β = 0.31, p < 0.001, R2 = 0.32). Results suggest that for every one-point increase in the pain catastrophizing score, mobility apprehension will increase by 0.3 of a point. Conclusion: These preliminary results suggest that pain catastrophizing was related to mobility apprehension in this cohort of persons with lower-limb amputation. This relationship indicates that the exploration of avoidance behaviors, such as pain catastrophizing, may be useful when developing a program for physical rehabilitation. Clinical relevance Pain catastrophizing, an avoidance behavior, may be associated with higher levels of mobility apprehension in persons with major lower-limb amputation. Understanding the impact of fear-avoidance behavior will allow clinicians to identify individuals at risk for poor outcomes following amputation surgery and to develop psychological strategies to complement treatment.

scholarly journals FOOD INTAKE, NUTRITIONAL STATUS AND GASTROINTESTINAL SYMPTOMS IN CHILDREN WITH CEREBRAL PALSY

2018 ◽  
Vol 55 (4) ◽  
pp. 352-357 ◽  
Author(s):  
Deise Cristina Oliva CARAMICO-FAVERO ◽  
Zelita Caldeira Ferreira GUEDES ◽  
Mauro Batista de MORAIS
Keyword(s):  
Cerebral Palsy ◽  
Food Intake ◽  
Gastroesophageal Reflux ◽  
Nutritional Status ◽  
Fluid Intake ◽  
Gastrointestinal Symptoms ◽  
Z Score ◽  
Children With Cerebral Palsy ◽  
Height For Age ◽  
Weight For Age

ABSTRACT BACKGROUND: Cerebral palsy may be associated with comorbidities such as undernutrition, impaired growth and gastrointestinal symptoms. Children with cerebral palsy exhibit eating problems due to the effect on the anatomical and functional structures involved in the eating function resulting in malnutrition. OBJECTIVE: The aim of this study was to investigate the association between food intake, nutritional status and gastrointestinal symptoms in children with cerebral palsy. METHODS: Cross-sectional study that included 40 children with cerebral palsy (35 with spastic tetraparetic form and 5 with non-spastic choreoathetoid form of cerebral palsy, all requiring wheelchairs or bedridden) aged from 4 to 10 years. The dietary assessment with the parents was performed using the usual household food intake inquiry. Anthropometric data were collected. Gastrointestinal symptoms associated with deglutition disorders, gastroesophageal reflux and chronic constipation were also recorded. RESULTS: The median of height-for-age Z-score (-4.05) was lower (P<0.05) than the median of weight-for-age (-3.29) and weight-for-height (-0.94). There was no statistical difference between weight-for-age and weight-for-height Z-scores. Three patients with cerebral palsy (7.5%) exhibited mild anemia, with normal ferritin levels in two. Symptoms of dysphagia, gastroesophageal reflux, and constipation were found in 82.5% (n=33), 40.0% (n=16), and 60.0% (n=24) of the sample, respectively. The patients with symptoms of dysphagia exhibited lower daily energy (1280.2±454.8 Kcal vs 1890.3±847.1 Kcal, P=0.009), carbohydrate (median: 170.9 g vs 234.5 g, P=0.023) and fluid intake (483.1±294.9 mL vs 992.9±292.2 mL, P=0.001). The patients with symptoms of gastrointestinal reflux exhibited greater daily fluid intake (720.0±362.9 mL) than the patients without symptoms of gastroesophageal reflux (483.7±320.0 mL, P=0.042) and a greater height-for-age deficit (Z-score: -4.9±1.7 vs 3.7±1.5, P=0.033). The patients with symptoms of constipation exhibited lower daily dietary fiber (9.2±4.3 g vs 12.3±4.3 g, P=0.031) and fluid (456.5±283.1 mL vs 741.1±379.2 mL, P=0.013) intake. CONCLUSION: Children with cerebral palsy exhibited wide variability in food intake which may partially account for their severe impaired growth and malnutrition. Symptoms of dysphagia, gastroesophageal reflux, and constipation are associated with different food intake patterns. Therefore, nutritional intervention should be tailored considering the gastrointestinal symptoms and nutritional status.

scholarly journals 2629. Respiratory Syncytial Virus Epidemiology and Factors Associated with Severity among Hospitalized Infants in Four Middle-Income Countries, 2015–2017

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S917-S918
Author(s):  
Holly Biggs ◽  
Eric A Simoes ◽  
Ilham Bulos Abu-Khader ◽  
Mark G Thompson ◽  
Aubree Gordon ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Severe Illness ◽  
Respiratory Tract Disease ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Weight ◽  
Younger Age ◽  
Syncytial Virus ◽  
Tract Disease ◽  
Weight For Age

Abstract Background Respiratory syncytial virus (RSV) is the most commonly identified viral pathogen among young children with acute lower respiratory tract infection. Understanding global RSV epidemiology and risk factors for severe illness in low- and middle-income settings is critical as new vaccine candidates become available. Methods We prospectively enrolled infants aged < 1 year hospitalized with any acute illness from sites in Albania, Jordan, Nicaragua and Philippines during 2015–2017. Standardized parental interviews and medical record review were conducted. Respiratory specimens collected during enrollment were tested for RSV using rRT–PCR. RSV A or B subgroup was determined using a CDC-developed rRT–PCR assay. Very severe RSV illness was defined as requiring ICU admission or supplemental oxygen. Factors potentially associated with severity were assessed using individual logistic regression models to adjust for age and study site. Results Overall, 1,129 (31%) of 3634 enrolled infants had RSV infection. The median age of RSV-positive infants was 2.7 (range: < 1 to 11.9) months, 665 (59%) were male, and 63 (6%) had ≥1 underlying medical condition. RSV subgroup was determined for 1,028 (91%); RSV A and B co-circulated at all sites with alternating predominance by study year (figure). 583 (52%) infants had very severe RSV illness, which was significantly associated with younger age (median: 2.0 vs. 4.3 months; P < 0.01), study site (aOR: Jordan 5.0, Albania 2.9, Philippines 1.2, Nicaragua reference; P < 0.01), birth by cesarean section (aOR: 1.4; 95% CI [CI] 1.0–1.8; P = 0.03), having received ICU care after birth (aOR: 1.6; CI 1.0–2.4; P = 0.03), chronic heart or respiratory tract disease (aOR: 1.9; CI 1.0–3.4; P = 0.04), and a low weight-for-age Z score (aOR: 1.8; CI 1.3–2.7; P < 0.01). RSV subgroup was not associated with severity (aOR: 1.0; CI: 0.7–1.3; P = 0.72). Conclusion RSV was associated with a substantial proportion of acute illness among hospitalized infants in middle-income countries. Subgroups co-circulated across sites and study years with varying predominance and resulted in similar illness severity. Significant comorbidities were uncommon, but factors including younger age, low weight-for-age and chronic heart or respiratory tract disease were associated with more severe illness. Disclosures All authors: No reported disclosures.

scholarly journals Nutrition Status and the Risk of Mortality in Children 6–36 Months Old in Tanzania

1991 ◽  
Vol 13 (4) ◽  
pp. 1-6 ◽  
Author(s):  
Olivia Yambi ◽  
Michael C. Latham ◽  
Jean-Pierre Habicht ◽  
Jere D. Haas
Keyword(s):  
Fold Increase ◽  
Nutrition Status ◽  
Registration System ◽  
Fourfold Increase ◽  
Probability Of Survival ◽  
Low Weight ◽  
One Year ◽  
Increase In Risk ◽  
Height For Age ◽  
Weight For Age

Anthropometric measurements were taken on 2,452 children between 6 and 36 months of age at baseline and at two-month intervals thereafter in rural Tanzania. The children were followed for one year. All deaths occurring in this group were recorded using a village registration system introduced as part of a village nutrition status monitoring system. The relationship between the anthropometric indicators (weight for age, height for age, and weight for height, as well as weight increment) and subsequent mortality was assessed. The results indicate that over the one-year period, nutrition status was a significant predictor of mortality, with the probability of survival lower in children of low nutrition status. Low weight for age (<60% of the standard) was associated with a nine-fold increase in risk compared to weight for age above 80%; low weight for height (<80%) earned an almost fourfold increase in risk compared to weight for height>90%; and low height for age had a twofold increase in risk compared to the normal categories. An overall linear relationship was found between nutrition status and mortality, suggesting a gradual increase in mortality as nutrition status deteriorates. Incremental weight appears to be a good short-term predicator of mortality.

Assessment of Nutrition Status in Children with Leukemia: A Study from a Developing Country

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 1317-1317
Author(s):  
Soma Mukhopadhyay ◽  
Tusi Dutta ◽  
Sonali Dey ◽  
Somnath Datta ◽  
Ashis Mukhopadhyay
Keyword(s):  
Nutritional Status ◽  
Serum Albumin ◽  
Disease Free Survival ◽  
Skin Fold Thickness ◽  
Skin Fold ◽  
Low Weight ◽  
Arm Circumference ◽  
Height For Age ◽  
Weight For Age ◽  
Low Serum

Abstract Background: In developing countries 40 % children suffer from mal-nutrition. It has been shown that a good nutritional status can reduce complications of treatment, strengthen the immune system and contribute to the patient’s general well being throughout treatment. A good nutritional status is therefore essential for optimal treatment of a leukemic child. The aim of our study was to see the nutritional status of leukemic children on diagnosis and effect of nutrition on outcome of therapy. Material & Methods: During period from January 2004 to December 2007 we prospectively analyzed the nutritional status of 400 paediatric patients in Netaji Subhash Chandra Bose Cancer Research Institute, a tertiary cancer center of Eastern India. The age of the patients were 1 to 18 years (median age 12.5 years). The parameter analyzed were weight for age, height for age, total protein, serum albumin and skin fold thickness. The weight for age, height for age and skin fold thickness were taken as normal if they were between 3rd and 97th percentile curve of the growth chart recommended by the Indian Council of Medical Research. The albumin level and the total protein was considered normal if the value is equal to or more than 3gm% and 5.8gm% respectively. Result: It was seen that total 56 patients (14% children) were low weight for age, 40 patients (10% children) were low height and 67 patients (16.75% children) had low mid arm circumference. Total 44 patients (11% children) had low serum albumin while 80 patients (20% children) had low serum protein. It was found that low weight for age, low serum albumin and low mid arm circumference were significance factors in remission induction, disease free survival and toxicity of chemotherapy (p &lt; 0.005). Conclusion: We conclude that mal-nutrition is a major finding in cancer patients with leukemia in developing country like ours. The patient with mal-nutrition had less remission in induction, disease free survival and more toxicities during therapy as compared to well-nourished children.

Malnutrition and intestinal helminth infections in schoolchildren from Dibanda, Cameroon

2012 ◽  
Vol 87 (1) ◽  
pp. 46-51 ◽  
Author(s):  
J.V. Mbuh ◽  
N.E. Nembu
Keyword(s):  
Geometric Mean ◽  
World Health ◽  
Vulnerable Groups ◽  
Intestinal Helminth ◽  
Z Score ◽  
Major Health Problem ◽  
Major Health ◽  
Helminth Infections ◽  
Height For Age ◽  
Weight For Age

AbstractIntestinal helminth infections and malnutrition constitute a major health burden in developing countries, with infants and children being the most vulnerable groups. The extent of the burden of intestinal helminth infections and malnutrition was investigated in a cross-sectional study involving 265 children aged between 4 and 14 years residing in Dibanda, a semi-rural area located in Buea, South West Region, Cameroon. The prevalence of intestinal helminth infections was determined microscopically after faecal samples were prepared by the formol-ether sedimentation concentration technique of stool analysis. Nutritional status was determined using age and the anthropometric parameters of weight and height. Standard deviation (SD) or Z scores of height-for-age (HAZ), weight-for-age (WAZ) and weight-for-height (WHZ) were computed based on the World Health Organization 2006 growth reference curves. Anaemia was assessed by packed cell volume (PCV). The prevalence of intestinal helminth infection in the study population was 47.2% (125/265). All infections were of low intensity, withAscarisrecording the highest geometric mean egg count (GMEC) ±  SEM of 363.51 ± 60.35 (egg count range: 76–3000 eggs/gram of stool). Overall, 42.3% of children had PCV < 31%. Also, 47.2% of those with intestinal helminth infections also had PCV < 31%. The prevalence of malnutrition was 30.2% (80/265). Of 80 malnourished children, 5.3% were wasted ( < − 2SD weight-for-height Z-score), 7.2% underweight ( < − 2SD weight-for-age Z score) and 24.2% stunted ( < − 2SD height-for-age Z score). The mean values of all the anthropometric indices were lower in helminth-infected children. Findings from this study are strongly suggestive that intestinal helminth infections and malnutrition exist in children residing in Dibanda and constitute a major health problem that needs to be addressed immediately to reduce morbidity and mortality.

scholarly journals Multilevel analysis of risk factors associated with severe underweight among children under 5 years: evidence from the 2014 Ghana Demographic and Health Survey

2021 ◽  
Vol 2 (1) ◽  
pp. 166-172
Author(s):  
Justice M K Aheto ◽  
Ogum-Alangea Deda
Keyword(s):  
Risk Factors ◽  
Health Survey ◽  
Maternal Education ◽  
Demographic And Health Survey ◽  
Multiple Birth ◽  
Demographic And Health Surveys ◽  
Z Score ◽  
Household Level ◽  
Factors Associated ◽  
Weight For Age

Background: Undernutrition among children <5yr. is a global public health problem, especially in developing countries like Ghana. Undernutrition increases the risk of child morbidity and mortality. There is paucity of data on household-level effects on severe underweight and associated factors. Objective: The study investigated the risk factors associated with severe underweight among children < 5yr.in Ghana and examined unobserved differences across households based on the 2014 Ghana Demographic and Health surveys (GDHS) data. Methods: Data from a population-based cross-sectional study was obtained from the 2014 Ghana Demographic and Health Survey. Data on 2720 children nested within 1972 households was extracted for analysis. Our regression analysis used data on 2716 children with complete data on the outcome and risk factors. Children with weight-for-age Z-score below -3 standard deviations were classified as severely underweight based on the 2006 WHO child growth standards. We applied random intercept multilevel logistic regression to examine whether severe underweight status in children differ across households while simultaneously identifying potential risk factors. Results: A total of 2720 children had valid weight-for-age z-score and 53 (1.95%) of them were identified as severely underweight. In the univariate model, child level variables such as multiple birth [odds ratio (OR), 4.03;95%confidence interval (CI): 1.85-8.76]and child born average (OR, 2.17;95%CI: 1.09-4.32) or small (OR, 4.08; 95%CI: 2.01-8.28) in size at birth are associated with increased odds of severe underweight. Maternal/household level variables such as increase in number of children below 5 yr. (OR, 1.61; 95%CI: 1.28-2.04), poorest households (OR, 4.85; 95%CI: 1.14-20.59) and increase in number of births in last 5 yr. (OR, 1.80, 95%CI: 1.24-2.60) were associated with increased odds of severe underweight. Increase in maternal years of education (OR, 0.89; 95%CI: 0.83-0.95) was associated with reduced odds of severe underweight. In the multilevel logistic model, only type of birth (OR, 1.61;95%CI: 1.28-2.04), size of child (average: OR, 2.12;95%CI: 1.04-4.33; small: OR, 3.87;95%CI: 1.80-8.33) at birth, and maternal education (OR, 0.92;95%CI: 0.84-1.00) were independently associated with severe underweight. There were no significant residual household-level variations in severe underweight status. Conclusion: Our findings suggest that improving maternal education, socioeconomic conditions of families, and family planning are critical in addressing severe underweight

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