scholarly journals Development of LMS and Z Score Growth References for Egyptian Children From Birth Up to 5 Years

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 > 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.

Parasitology ◽  
2005 ◽  
Vol 131 (1) ◽  
pp. 51-56 ◽  
Author(s):  
M. S. PRADO ◽  
S. CAIRNCROSS ◽  
A. STRINA ◽  
M. L. BARRETO ◽  
A. M. OLIVEIRA-ASSIS ◽  
...  

This study sought to assess the effect of giardiasis on growth of young children. In Salvador, northeast Brazil, 597 children initially aged 6 to 45 months were followed for a year in 1998/9, measured anthropometrically thrice, every 6 months, and monitored for diarrhoea prevalence twice weekly. Stool samples were collected and examined during the second round of anthropometry, and infected children were treated 39 days later, on average (S.D. 20 days). For each 6-month interval, the gains in z-scores of infected and uninfected children were compared, after adjustment for potential confounding factors, including longitudinal prevalence of diarrhoea. No significant difference was found for the first interval but in the second, the gain in adjusted height-for-age z-score was 0·09 less in infected than uninfected children, equivalent to a difference in height gain of 0·5 cm. The shortfall in growth was greater in children who remained free of diarrhoea, and was significantly correlated with the proportion of the second interval during which the child had remained untreated. We conclude that Giardia can impede child growth even when asymptomatic, presumably through malabsorption. This finding challenges the view that young children found to have asymptomatic giardiasis in developing countries should not be treated.


Nutrients ◽  
2018 ◽  
Vol 10 (8) ◽  
pp. 954 ◽  
Author(s):  
Mary Adjepong ◽  
William Yakah ◽  
William Harris ◽  
Esi Colecraft ◽  
Grace Marquis ◽  
...  

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.


2002 ◽  
Vol 23 (4_suppl2) ◽  
pp. 16-25 ◽  
Author(s):  
U. Agnes Trinh Mackintosh ◽  
David R. Marsh ◽  
Dirk G. Schroeder

Save the Children's (SC) successful integrated nutrition program in Viet Nam, the poverty alleviation and nutrition program (PANP), uses the positive deviance (PD) approach to identify key growth promoting behaviors and provides participatory adult education allowing mothers to develop skills related to these behaviors. We investigated whether improvements seen during a PANP intervention (1993–1995) were sustained three and four years after SC's departure. Cross-sectional surveys were administered to 46 randomly selected households in four communes that had previously participated in the PANP and 25 households in a neighboring comparison community in 1998 and 1999. Two children per household, an older child who had participated in the PANP and a younger sibling who had not, were measured (total n = 142 children), and their mothers were interviewed. Older SC children tended to be better nourished than their counterparts. Their younger siblings were significantly better nourished than those in the comparison group, with adjusted mean weight-for-age Z scores of −1.82 versus −2.45 ( p = .007), weight-for-height Z scores of −0.71 versus −1.45 ( p < .001), and height-for-age Z scores of −2.11 and −2.37 (ns, p = .4), respectively. SC mothers reporting feeding the younger siblings more than their counterparts did (2.9 versus 2.2 main meals per day, p < .001, and 96.2% versus 52% offering snacks, p < .01]. SC mothers reported washing their hands “often” more than comparison mothers (100% vs. 76%, p < .001). Growth-promoting behaviors identified through PD studies and practiced through neighborhood-based rehabilitation sessions persisted years after program completion. These sustained behaviors contributed to better growth of younger siblings never exposed to the program.


2020 ◽  
Author(s):  
Som Kumar Shrestha ◽  
Don Vicendese ◽  
Bircan Erbas

Abstract Background: Evidence of the influence of water, sanitation and hygiene (WASH) behaviors on childhood nutritional status is inconsistent. Few studies have examined their interactive effects. This study aimed to examine associations and interactions between WASH variables and preschool child undernutrition. Methods: Data from a nationally representative sample of 2352 children assessed during the 2016 Nepal Demographic and Health Survey were analyzed by multi-variable linear regression to understand the association between height-for-age (HAZ), weight-for-height (WHZ) and weight-for-age (WAZ) z-scores and WASH variables. Interactions between WASH variables, sex and area of residence on childhood nutritional status were also examined. Results: The mean z-score [standard deviation] for children’s WAZ, HAZ and WHZ scores were -1.33 [1.1], -1.52 [1.3] and -0.65 [1.1], respectively. A unit increase in cluster sanitation coverage was associated with an increase of 0.30 (95%CI: 0.12 to 0.48) for WAZ and 0.28 (95%CI: 0.001 to 0.56) for HAZ scores. Household water purification practice was associated with an increase of 0.24 (95%CI: 0.07 to 0.41) in WHZ score. Handwashing practice with water and soap was associated with an increase of 0.15 (95%CI: 0.04 to 0.25) in WAZ and 0.13 (95%CI: 0.01 to 0.24) in WHZ scores. The effect of water purification practice was higher for rural areas compared to urban settings for HAZ scores (p-value for interaction=0.02). Conclusions: Consistent with findings from other countries in the South Asian region, findings of this study highlight the potential importance of good WASH practices, and therefore the potential of WASH interventions, to contribute to improved nutritional status in rural Nepal.


Author(s):  
Nanees Salem ◽  
Ashraf Bakr

Abstract Objectives Growing skeleton is uniquely vulnerable to impaired mineralization in chronic kidney disease (CKD). Continued debate exists about the optimal method to adjust for body size when interpreting dual energy X-ray absorptiometry (DXA) scans in children with CKD given the burden of poor growth. The study aimed to evaluate the clinical usefulness of size-adjustment techniques of lumber-spine DXA measurements in assessing bone mineralization in children with kidney failure on maintenance hemodialysis (HD). Methods Case-control study included 93 children on maintenance HD (9–18 years; 48 males). Participants were subjected to spinal-DXA-scan to obtain areal bone mineral density (aBMD; g/cm2). Volumetric-BMD (vBMD; g/cm3) was mathematically estimated. Z-scores of aBMD for chronological age (aBMDZ-CA), aBMD adjusted for height age (aBMDZ-HA), and vBMDZ-score were calculated using mean and SD values of age subgroups of 442 healthy controls (7–18 years). Results In short-for-age CKD patients, aBMDZ-CA was significantly lower than vBMDZ-score, while aBMDZ-HA was significantly higher than aBMDZ-CA and vBMDZ-score. In normal height-for-age CKD patients, no significant difference between aBMDZ-scores and vBMDZ-score was detected. aBMDZ-CA was significantly lower and aBMDZ-HA was significantly higher in short-for-age compared to normal height-for-age patients without significant differences in vBMDZ-score. We observed age-related decrements in the percentage of HD patients with normal densitometric Z-scores, the effect of age was less pronounced in aBMDZ-HA than vBMDZ-score. vBMDZ-score correlated negatively with age, but not with heightZ-score. Conclusions Estimated vBMD seems to be a convenient size-adjustment approach of spinal-DXA measurements in assessing BMD especially in older short-for-age children with CKD. aBMDZ-CA underestimates, while aBMDZ-HA overestimates BMD in such patients.


2018 ◽  
Vol 55 (4) ◽  
pp. 352-357 ◽  
Author(s):  
Deise Cristina Oliva CARAMICO-FAVERO ◽  
Zelita Caldeira Ferreira GUEDES ◽  
Mauro Batista de MORAIS

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.


Author(s):  
Qianling Tian ◽  
Xiao Gao ◽  
Tingting Sha ◽  
Qiong He ◽  
Gang Cheng ◽  
...  

Background: At present, whether to use the World Health Organization’s (WHO) growth standards or native growth standards to assess the nutritional status in a given population is unclear. This study aimed to compare the differences between the WHO’s growth standards and China’s growth standards in assessing the nutritional status of children aged 0~36 months. Methods: We used z-scores to evaluate the nutritional status of children. The weight-for-age z-scores (WAZs), length/height-for-age z-scores (LAZ/HAZs), and weight-for-length/height z-scores (WLZ/WHZs) were calculated using the WHO’s growth standards and China’s growth standards. MeNemar’s test was used to compare the nutritional status of children. Results: The results in this study showed that there were differences between the WHO’s standards and China’s standards in assessing children’s nutritional status except for stunting and obesity. The prevalence of underweight assessed using China’s standards was higher than when using the WHO’s standards (except when 3 and 36 months old). The prevalence of wasting was significantly higher when assessed using China’s standards than when using the WHO’s standards from 12 to 36 months. The prevalence of overweight was higher when assessed using the WHO’s standards from 3 to 8 months. Conclusions: Both the WHO’s and China’s growth standards are useful measures in assessing children’s nutritional status but with key significant differences. Therefore, caution should be taken in selecting appropriate measures in a given population.


2013 ◽  
pp. 15-22 ◽  
Author(s):  
MS Islam ◽  
AAM Kurshed ◽  
TMA Azad ◽  
MAH Bhuyan

To see the improvement in lifestyle, food intake and nutritional status of Beneficiary people of Shiree Project under Dushtha Shasthya Kendra, a comparative cross sectional study was done in Kamrangirchar slum among extreme poor people of Dhaka city and compared with non–beneficiary households. Beneficiary households of MDG-1 under Shiree Project got household economic intervention packages. In this stuy it is found that mean monthly income of the family was 6175.65 Tk in beneficiary group and 4288.14 Tk in non-beneficiary group. The mean monthly expenditure on food items of family was 3787.83 Tk in beneficiary group and 2796.61 Tk in non-beneficiary group. About 34 percent beneficiary households and 75 percent of all non-beneficiary households were poor having household’s monthly income less than 3000 taka. Some 15.7 percent beneficiary households had five amenities out of selected six and only 1.7 percent non-beneficiary households had five amenities. So, socio-economic condition of beneficiary extreme poor people has improved. Consumption of food items was significantly more in beneficiary households than non-beneficiary ones. Some 74 percent beneficiary households consumed four or more food items daily and 26 percent non-beneficiary households consumed four or more food items daily. On average 3.37 food items were consumed by beneficiary households and 2.49 food items by non-beneficiary households daily. More than 60% of the beneficiary people ate full stomach meals and less than 25 % of non-beneficiary people could afford to eat the same. So, beneficiary people were more food secure and more food diversified than non-beneficiary people. Nutritional status of the children by MUAC, Weight for Age Z-score, and Height for Age Z-score showed no significant difference between beneficiary and non-beneficiary group. Prevalence rate of underweight (Weight for Age Z-score) was 60.5% in beneficiary children and 65.9% in non-beneficiary children. Significant difference (P=0.044) was found by Weight for Height Z-score in both beneficiary and non-beneficiary group. The difference of mothers’ nutritional status by BMI between beneficiary group and non-beneficiary group was not statistically significant, though percentage of CED was lower and overweight was higher in beneficiary mothers than non-beneficiary ones. Though socio-economic status, food security and food intake were better in beneficiary people than non-beneficiary ones, the outcome of these factors were not significant in clinical and anthropometric status. Beneficiary households were on the way to meet first target of MGD-1 which is related to poverty reduction. But they were far away from reaching the second target and halving prevalence of underweight as described in MDG-1. DOI: http://dx.doi.org/10.3329/bjnut.v24i0.14033 Bangladesh J. Nutr. Vol. 24-25 Dec 2011-2012 pp.15-22


Author(s):  
Veronicah Kirogo ◽  
◽  
Wambui K.M ◽  
Nelson M.M ◽  

A comparative, retrospective cross-sectional study was conducted to investigate the role of irrigation on improvement of nutritional status of children aged 6 – 59 months in a semi-arid setting. Two equal samples of fifty-nine children (aged 6 – 59 months) hereafter, referred to as the Project and the Non-project groups, respectively were randomly selected from households with a nd without access to irrigation water in Kieni East Division of Nyeri District, Kenya. The study area is situated in the drier western leeward side of Mt. Kenya and is characteristic by unreliable rainfall of between 500 to 1200 mm per annum. Weight, height and age of index children were determined and the corresponding standard deviations of weight-for-age, we ight-for-height and height-for-age calculated and compared to the reference standards developed by the US National Centre for Health Statistics. Energy and nutrient intake was determined using 24-hour dietary recall method. The findings on socio-demographic characteristics showed that the Project and Non-project households were similar in terms of household size, land size, marital status of the respondent, maternal and paternal education and occupation. The calorie intake of over two-fifth (42%) of the children from the Non-project households compared to 39% from the Project households was below the Recommended Daily Allowance. The children from commercial farming Project households had significantly higher weight-for-age Z-score than those from commercial farming Non-project households. Similarly, children from high-income Project households had significantly higher height-for-age Z-score than those from high-income Non-project households. The prevalence of stunting was also significantly lower in the high-income Project households compared to high-income N on-project households. Among the male children, the prevalence of underweight was significantly higher in Non-project households than in Project households. Overall, the prevalence of stunting and underweight which are indicators of long-term nutritional deprivation were higher in Non-project households than Project households. The findings of the study led to the conclusion that irrigation contributes to increased per capita food availability resulting in higher energy intakes and subsequently enables households to safeguard young children against chronic malnutrition. Also, poverty as characterised by low household income remains a main determinant of nutritional status.


2016 ◽  
Vol 7 (2) ◽  
pp. 143-145 ◽  
Author(s):  
Md Aynal Hoque ◽  
Md Abu Sayeed ◽  
Mohammed Rizwanul Ahsan ◽  
Mohammad Abdullah Al Mamun ◽  
Farhana Salim

Background : Malnutrition is a serious public health problem that has been linked to increase risk of morbidity and mortality. Child malnutrition causes 27% of child deaths in developing countries in 2015.Objective : To estimate the nutritional status of under five children of a selected slum in Dhaka city.Methodology : This was a descriptive cross sectional study and conducted among 100 under 5 children purposively selected at Agargaon slum in Dhaka city during January-2015 to July-2015. Anthropometric measurements were taken by using standard methods. Those were weight, height, MUAC. Information regarding age of children was taken from patient’s birth certificates or hospital records. Nutritional status was estimated by calculating Z-score, weight for age, height for age, weight for height and mid upper arm circumference. Data were analyzed using SPSS version 16.Results : Mean age of the study population was 32.95 months. Male was 52% and female was 48%. Regarding Anthropometric assessment according to weight for height Z-score, 39% were wasted moderately and 13% were severely wasted and height for age Z-score, showed 47% of children were stunted moderately and 14% children were severely stunted. According to weight for age Zscore, 46% of children were moderately underweight and 16% children were severely underweight. According to MUAC classification 43% of children were in border line and 16% were malnutrition.Conclusions : Overall, nutritional status of the under 5 child of slum of Agargaon were not satisfactory.Northern International Medical College Journal Vol.7(2) Jan 2016: 143-145


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