scholarly journals Prevalence of Malnutrition in a Rural Residential Sanskrit School in Baglung, Nepal

2017 ◽  
Vol 56 (205) ◽  
pp. 153-157
Author(s):  
Bhawana Amatya ◽  
Nitesh Shrestha

Introduction: Under-nutrition is a condition in which there is inadequate consumption, poor absorption or excessive loss of nutrients. Nepal still faces high chronic as well as acute under‐nutrition in children. The following study was conducted a Sanskrit school in rural Baglung to find the prevalence of malnutrition among the children which could reflect the nutritional status of the community. Methods: Out of 60 students admitted to the school, only 43 were present at the time when we collected our data. Weight was measured with a standard weighing scale and standing height with a measuring tape attached to the wall. Data were filled up in proforma, entered in Microsoft Excel 2013 and were analyzed and indicators calculated with SPSS version 20 using WHO Child Growth Reference data for 5-19 years and macros. Results: Stunting (Z score < -2) was found in 53.5 % of the study group and severe stunting (Z score < -3) was found in 25.6%. 12.5% of the 8 children under 10 years in our study had weight for age < -2 Z score which indicates underweight. No one was severely underweight. In our study, 2.3% had severe thinness (Z-score < -3), 14% had thinness (Z-score < -2). No one was overweight or obese. Conclusions: The prevalence of malnutrition was high among the students of the rural Sanskrit school where the study was conducted.   Keywords: anthropometry; Baglung; malnutrition; Nepal; prevalence.

2020 ◽  
pp. 096228022095843
Author(s):  
TJ Cole

Growth reference centile charts are widely used in child health to assess weight, height and other age-varying measurements. The centiles are easy to construct from reference data, using the LMS method or GAMLSS (Generalised Additive Models for Location Scale and Shape). However, there is as yet no clear guidance on how to design such studies, and in particular how many reference data to collect, and this has led to study sizes varying widely. The paper aims to provide a theoretical framework for optimally designing growth reference studies based on cross-sectional data. Centiles for weight, height, body mass index and head circumference, in 6878 boys aged 0–21 years from the Fourth Dutch Growth Study, were fitted using GAMLSS. The effect on precision of varying the sample size and the distribution of measurement ages (sample composition) was explored by fitting a series of GAMLSS models to simulated data. Sample composition was defined as uniform on the age λ scale, where λ was chosen to give constant precision across the age range. Precision was measured on the z-score scale, and was the same for all four measurements, with a standard error of 0.041 z-score units for the median and 0.066 for the 2nd and 98th centiles. Compared to a naïve calculation, the process of smoothing the centiles increased the notional sample size two- to threefold by ‘borrowing strength’. The sample composition for estimating the median curve was optimal for λ=0.4, reflecting considerable over-sampling of infants compared to children. However, for the 2nd and 98th centiles, λ=0.75 was optimal, with less infant over-sampling. The conclusion is that both sample size and sample composition need to be optimised. The paper provides practical advice on design, and concludes that optimally designed studies need 7000–25,000 subjects per sex.


2017 ◽  
Vol 37 (1) ◽  
pp. 10-15 ◽  
Author(s):  
Mohammad Issa El Mouzan ◽  
Ahamed Shaffi ◽  
Abdullah Al Salloum ◽  
Mansour M. Alqurashi ◽  
Abdullah Al Herbish ◽  
...  

PEDIATRICS ◽  
1989 ◽  
Vol 84 (3) ◽  
pp. 475-481
Author(s):  
Joan M. O'Connell ◽  
Michael J. Dibley ◽  
Janet Sierra ◽  
Barbara Wallace ◽  
James S. Marks ◽  
...  

To examine the effects of a vegetarian diet on child growth, height and weight data of 404 vegetarian children aged 4 months to 10 years who lived in a collective community in Tennessee were studied. Height for age, weight for age, and weight for height were compared with the US growth reference. Birth weights, infant feeding patterns, and parental heights were also evaluated in relation to growth. Most of the height for age, weight for age, and weight for height (n = 833) were within the 25th and 75th percentiles of the US growth reference. The mean height for age and weight for age, however, were slightly less than the median of the reference population. For different age groups, the mean height ranged from 0.2 to 2.1 cm and the mean weight ranged from 0.1 to 1.1 kg less than the reference median. The largest height difference was observed at 1 to 3 years of age and may be partly the result of intrinsic irregularities in the US growth reference at those ages. By 10 years of age, children from The Farm averaged 0.7 cm and 1.1 kg less than the reference median, representing only 0.1 and 0.3 SD from the reference. Thus, these children have adequate attained growth, even though it was modestly less than that of the reference population.


Nutrients ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2632
Author(s):  
Yasir Bin Nisar ◽  
Victor M. Aguayo ◽  
Sk Masum Billah ◽  
Michael J. Dibley

In South Asia, an estimated 38% of preschool-age children have stunted growth. We aimed to assess the effect of WHO-recommended antenatal iron, and folic acid (IFA) supplements on smaller than average birth size and stunting in South Asian children <2 years old. The sample was 96,512 mothers with their most recent birth within two years, from nationally representative surveys between 2005 and 2016 in seven South Asian countries. Primary outcomes were stunting [length-for-age Z-score (LAZ) < –2], severe stunting [length-for-age Z-score (LAZ) < –3], length-for-age Z score, and perceived smaller than average birth size. Exposure was the use of IFA supplements. We conducted analyses with Poisson, linear and logistic multivariate regression adjusted for the cluster survey design, and 14 potential confounders covering the country of the survey, socio-demographic factors, household economic status, maternal characteristics, and duration of respondent recall. The prevalence of stunting was 33%, severe stunting was 14%, and perceived smaller than average birth size was 22%. Use of antenatal IFA was associated with a reduced adjusted risk of being stunted by 8% (aRR 0.92, 95% CI 0.89, 0.95), of being severely stunted by 9% (aRR 0.91, 95% CI 0.86, 0.96) and of being smaller than average birth size by 14% (aRR 0.86, 95% CI 0.80, 0.91). The adjusted mean LAZ was significantly higher in children whose mothers used IFA supplements. Maternal use of IFA in the first four months gestation and consuming 120 or more supplements throughout pregnancy was associated with the largest reduction in risk of child stunting. Antenatal IFA supplementation was associated with a significantly reduced risk of stunting, severe stunting, and smaller than average perceived birth size and improved LAZ in young South Asian children. The early and sustained use of antenatal IFA has the potential to improve child growth outcomes in South Asia and other low-and-middle-income countries with high levels of iron deficiency in pregnancy.


2021 ◽  
Vol 8 ◽  
Author(s):  
Ali M. El Shafie ◽  
Fady M. El-Gendy ◽  
Dalia M. Allahony ◽  
Hossam H. Hegran ◽  
Zein A. Omar ◽  
...  

Background: The Lambda-Mu-Sigma (LMS) and Z score methods are important for assessment of growth and nutritional status. In Egypt, there is a lack of this tool for monitoring growth in preschool children.Objective: To develop LMS and Z score growth references for assessment of growth and nutritional status for Egyptian children from birth up to 5 years.Methods: A total of 27,537 children [13,888 boys (50.4%) and 13,649 girls (49.6%)] from birth up to 5 years were included in a multistage cross sectional randomized study from different Egyptian geographic districts to create LMS and Z score references for weight, length/height, and body mass index corresponding to age in addition to weight for length/height. Healthy term infants and children, exclusive breast feeding for at least 4 months and not suffering from any chronic diseases were included in this study. Children with dysmorphic features, preterm infants, admitted in neonatal or pediatric intensive care units and having any chronic diseases (hematological, cardiac, hepatic, and renal) were excluded. In addition any health condition that affects child growth including nutritional disorders was also excluded. Un-paired t-test was calculated to compare the means of weight for age, length/height for age, weight for length/height, and BMI for-age z scores of the Egyptian and WHO reference values.Results: Through detailed tables and graphs, LMS and Z scores for weight for age, length/height for age, weight for length/height, and BMI for age of both sexes were represented. Our findings showed no statistically significant difference between reference charts of WHO and Egyptian Z score charts (P &gt; 0.05).Conclusion: This study provides the first reference for Egyptian children from birth up to 5 years based on Z score tool for assessment the growth and nutritional status in various clinical conditions and research, also allows comparison with references of other countries.


2018 ◽  
Vol 36 (2) ◽  
pp. 64-69 ◽  
Author(s):  
Fahmida Chowdhury ◽  
Mujibul Hoque ◽  
Md Manajjir Ali ◽  
Md Anisul Hossain

Background: Congenital heart disease (CHD) is the commonest of all congenital lesions and is the most common type of heart diseases among children. Anthropometric evaluation is very important for early recognition of growth failure in children with cyanotic and acyanotic congenital heart diseases.Methods: This comparative cross sectional study was undertaken with the objective to compare the growth of children with cyanotic and acyanotic congenital heart disease using anthropometric measurement in Department of Paediatrics, Sylhet MAG Osmani Medical College Hospital from March, 2014 to September, 2014. Sixty children aged 6 months to 60 months with CHD, were included in this study, where 30 children with cyanotic and 30 children with acyanotic CHD, confirmed by Echocardiogram.Results: All the children (100%) with cyanotic congenital heart disease were underweight (Weight for age Z score). Among them, 23.33% had moderate and 76.67% had severe underweight. In children with acyanotic congenital heart disease, 93.33% had underweight. Among them, 20% had moderate and 73.33% had severe underweight. The p-value was 0.35008. In cyanotic congenital heart disease, 96.67% children had stunting. Among them, 13.33% had moderate and 83.33% had severe stunting. In acyanotic congenital heart disease, 43.33% children had stunting. Among them, 33.33% had moderate and 10% had severe stunting. There was significant statistical deference in between the two groups, (pvalue was <0.0001). In cyanotic congenital heart disease, 43.33% children had wasting. Among them, 30% had moderate and 13.33% had severe wasting. In acyanotic congenital heart disease, 76.67% children had wasting. Among them, 30% had moderate and 46.67% had severe wasting. There was significant deference in the groups (p value was 0.0077).Conclusion: Growth failure was common in children with both cyanotic and acyanotic congenital heart disease. There was no significant difference in weight for age Z score (WAZ) of patients with cyanotic and acyanotic CHD but stunting was significantly higher in patients with cyanotic CHD and wasting was significantly higher in patients with acyanotic CHD.J Bangladesh Coll Phys Surg 2018; 36(2): 64-69


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Rina Das ◽  
Md. Ahshanul Haque ◽  
Mohammod Jobayer Chisti ◽  
A. S. G. Faruque ◽  
Tahmeed Ahmed

AbstractBoth Campylobacter- and Shigella-induced invasive enteritis are common in under-5 Bangladeshi children. Our study aimed to determine the factors associated with Campylobacter and Shigella enteritis among under-5 children, the post-infection worsening growth, and the household cost of invasive enteritis. Data of children having Shigella (591/803) and Campylobacter (246/1148) isolated from the fecal specimen in Bangladesh were extracted from the Global Enteric Multicenter Study (GEMS) for the period December 2007 to March 2011. In multiple logistic regression analysis, fever was observed more frequently among shigellosis cases [adjusted OR 2.21; (95% CI 1.58, 3.09)]. Breastfeeding [aOR 0.55; (95% CI 0.37, 0.81)] was found to be protective against Shigella. The generalized estimating equations multivariable model identified a negative association between Shigella and weight-for-height z score [aOR − 0.11; (95% CI − 0.21, − 0.001)]; a positive association between symptomatic Campylobacter and weight-for-age z score [aOR 0.22; (95% CI 0.06, 0.37)] and weight-for-height z score [aOR 0.22; (95% CI 0.08, 0.37)]. Total costs incurred by households were more in shigellosis children than Campylobacter-induced enteritis ($4.27 vs. $3.49). Households with low-level maternal education tended to incur less cost in case of their shigellosis children. Our findings underscore the need for preventive strategies targeting Shigella infection, which could potentially reduce the disease burden, associated household costs, and child growth faltering.


2018 ◽  
Vol 39 (2) ◽  
pp. 219-230 ◽  
Author(s):  
Megan Huang ◽  
Christopher Sudfeld ◽  
Abbas Ismail ◽  
Said Vuai ◽  
Julius Ntwenya ◽  
...  

Objective: To identify predictors of maternal dietary diversity in rural Dodoma, Tanzania and assess its association with child growth outcomes. Methods: A cross-sectional survey of 361 mothers with children under 24 months of age was conducted in 5 villages in rural Dodoma, Tanzania. Maternal diets were assessed using food frequency questionnaires, and dietary diversity was categorized using Minimum Dietary Diversity for Women (MDD-W) guidelines. Child anthropometric measures were taken to calculate height-for-age z-score (HAZ), weight-for-height z-score (WHZ), and weight-for-age z-score (WAZ). Linear and logistic regressions were used to examine the association between maternal dietary diversity and children’s growth outcomes. Results: About 40% of mothers did not consume a diverse diet (MDD-W < 5), and 35% of children were stunted. Household production of greater number of crops was associated with greater MDD-W scores ( P < .01). Greater maternal dietary diversity was associated with significantly greater child WHZ (mean difference = 0.44; 95% confidence interval [CI]: 0.10-0.78; P = .01), WAZ (mean difference = 0.37; 95% CI: 0.08-0.65; P = .01), and reduced risk of wasting (odds ratio = 0.22; 95% CI: 0.07-0.66; P = .01). Conclusions: Greater maternal dietary diversity was associated with improved child WHZ and WAZ outcomes. Sustainable interventions to increase maternal dietary diversity may improve WHZ and WAZ in young children in similar settings.


2020 ◽  
Vol 103 (10) ◽  
pp. 1099-1106

Background: The appropriate assessment of nutritional status in children is an essential aspect of health supervision. Currently, there are two references used for growth assessment in Thailand. The WHO child growth standard, which has been widely used since 2007, and the Thai growth reference developed by the Ministry of Public Health, which has been used since 1998. However, there were very few studies that made a direct comparison between both tools. Objective: To compare the nutritional status of healthy pediatric patients in Ramathibodi Hospital assessed by the World Health Organization (WHO) child growth standard and the Thai growth reference. Materials and Methods: The present study was a cross-sectional study. The data were collected from all pediatric patients registered in the outpatient department (OPD) of Faculty of Medicine, Ramathibodi Hospital between January 2013 and December 2018. All healthy children (aged 0 to 15 years) were included. Exclusion criteria of possibly chronically ill children were defined by those who were 1) visiting subspecialty clinics, 2) OPD and emergency room (ER) visits more than ten times per year, 3) having ICD-10 of chronic conditions, or 4) had been admitted in the hospital during the study. The weight and height or length data were extracted from the Electronic Medical Record system. All data were analyzed by the Stata Statistical Software focusing on age and sex-specific Z-scores, which references the WHO child growth standard and the Thai growth reference. Results: Sixty-two thousand one hundred four OPD visits were divided into 31,662 OPD visits for boys and 30,442 OPD visits for girls. Percent of weight for age and height or length for age more than +2 Z-score of both boys and girls when using the Thai growth reference was greater than that using the WHO child growth standard, especially for children aged 0 to 12 months. The Thai growth reference classified as overweight were approximately 10.26% to 31.12% more than using the WHO child growth standard. There was no difference in classification of height by both standards. Conclusion: There was a difference in classification of nutritional status between the Thai growth reference and the WHO child growth standard. Keywords: Nutritional status, Pediatric growth reference, Assessment tool, Overweight


1995 ◽  
Vol 44 (3-4) ◽  
pp. 169-178 ◽  
Author(s):  
B. Luke ◽  
S. Leurgans ◽  
L. Keith ◽  
D. Keith

AbstractThe objective of this study was to assess the childhood growth of twin children in terms of the effects of intrauterine growth retardation (IUGR) and discordancy at birth on the incidence and severity of stunting and discordancy in current height and weight. The study was part of a cross-sectional field project conducted at the Annual Twins Days Festival in Twinsburg. Ohio, USA, during 1990, 1991, and 1993, and including all twin children between 2 and 12 years of age. Mothers of twins were interviewed regarding their children's birthweights and gestational age; the twin children were measured for their current heights and weights. The study population included 990 twin children, including 555 boys and 435 girls, of which there were 254 boy pairs and 194 girl pairs. Birthweight for gestational age and current weight and height were each converted into Z-scores and characterized as severe (Z-score <−2,0), or moderate IUGR or stunting (Z-score > −2.0 and < −1.2). For the present study discordancy in birthweight, and current height and weight was calculated for like-gender twin pairs. Only twin children with severe IUGR at birth showed an increased risk of stunting in their current height or weight, and this risk was only for moderate, not severe, stunting. Boy twins with severe IUGR at birth were at increased risk of moderate stunting in their current weight (OR 2.67, 95% CI 1.55, 4.58, P = 0.002), while girl twins with severe IUGR at birth were at increased risk of moderate stunting in their current height (OR 4,09, 95% CI 1.49, 10.99, p = 0.003). Among like-gender twin pairs, there were no differences in mean or categories of birthweight or current weight discordancy, but boy twin pairs did show a significantly greater proportion of current weight discordancy compared to girl twin pairs (p = 0.005). Overall, there was a significant tendency for differences in height and weight between like-gender twin pairs to disappear over time, with the effect being greater for boy twin pairs. We conclude from these findings that twin children tend to overcome growth retardation and discordancy present at birth, and although children who had severe IUGR or discordancy at birth were more likely to have some residual moderate stunting or discordancy in height or weight, they still tended to be within normal values for their gender and current age.


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