scholarly journals Childhood Undernutrition and Its Predictors in a Rural Health and Demographic Surveillance System Site in South Africa

Author(s):  
Perpetua Modjadji ◽  
Sphiwe Madiba

Background: Overweight and obesity are increasing at an alarming rate in South Africa, while childhood undernutrition remains persistently high. This study determined the magnitude and predictors of stunting and underweight among schoolchildren in the Dikgale and Health Demographic Surveillance System Site, a rural site in South Africa. Methods: A cross sectional study using multistage sampling was conducted among 508 schoolchildren and their mothers. Anthropometric measurements were taken from children and their mothers, while sociodemographic information was obtained from mothers using a questionnaire. The World Health Organization Anthro Plus was used to generate height-for-age and weight-for-age z-scores to indicate stunting and underweight, respectively, among the children. Maternal overweight and obesity were assessed using body mass index. Bivariate and multivariate logistic regression analyses were used to evaluate the predictors of stunting and underweight among schoolchildren. Results: Twenty-two percent (22%) of children were stunted and 27% were underweight, while 27.4% of the mothers were overweight and 42.3% were obese. The odds of being stunted were lower in younger children, whereas having a mother who was overweight/obese and had a short stature increased the odds of stunting. Access to water, having a refrigerator, and having a young mother were protective against being underweight. Having a mother who was overweight/obese increased the odds of being underweight. Conclusions: The study showed a high prevalence of stunting and underweight among children, and overweight and obesity among mothers, indicating a household double burden of malnutrition. The age of the child and maternal overweight/obesity and short stature were predictors of stunting and underweight, while having a younger mother and access to water and a refrigerator were protective against being underweight. The need for an evidence-based and feasible nutrition program for schoolchildren, especially those in rural schools, cannot be over-emphasized.

2020 ◽  
Vol 13 (1) ◽  
pp. 518-528
Author(s):  
Perpetua Modjadji

Background: South Africa continues to have significant high prevalence rate of overweight/obesity relative to its African counterparts, particularly, among women, owing to several factors such as nutrition transition and socio-demographic factors. Nonetheless, little is known about the socio-demographic determinants of overweight/obesity, especially in the rural settings. Objective: To investigate the socio-demographic determinants of overweight and obesity among mothers of primary school children living in a rural Dikgale Health and Demographic Surveillance System Site in South Africa Methods: A cross-sectional study was conducted among 508 mothers of primary school children from a rural setting. Body mass index (BMI) was calculated by dividing the body weight by height squared and the prevalence of overweight (BMI ≥ 25–29.9 kg/m2) and obesity (BMI ≥30 kg/m2) were determined. The socio-demographic variables were collected using an interviewer-administered questionnaire. Multiple logistic regression analysis was used to ascertain any relationships with overweight/obesity as an outcome measure. Data were analyzed using STATA 14. Results: The response rate was 98%. The mean age of mothers was 37±7years. Mothers were charecterized by singlehood (63%), unemployed (82%) and low literacy (41%). The odds of being overweight/obese were significantly higher among mothers living with spouses as household heads (AOR=3.5 95%CI: 1.97-6.31), had two to three pregnancies (AOR=2.4, 95%CI: 1.40-4.20), and five pregnancies and above (AOR=2.5, 95%CI: 1.0-6.37). Mothers who lived in households with a monthly income between $344.84 and $524,60 were less likely to be overweight or obese (AOR=0.31 95%CI: 0.14-0.70). Additionally, age, marital status and age at first pregnancy were significantly associated with being overweight/obese (χ2 test, p<0.05). Conclusion: The key determinants of overweight/obesity were living in spouse-headed household, household monthly income and more than one pregnancy. Evidence-based strategies that focus on strengthening the social aspects while addressing overweight and obesity among mothers of primary school children living in a rural Dikgale HDSS site, South Africa.


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Kilee Kimmel ◽  
Teresia Mbogori ◽  
Mengxi Zhang ◽  
Jayanthi Kandiah ◽  
Youfa Wang

Abstract Objectives Disease and lifestyle patterns have been changing rapidly worldwide including Africa due to recent changes in economic growth and urbanization. However, research related to the effects of these changes on nutrition status in Africa is limited. This study investigated the shifts in nutritional status (undernutrition, overweight, obesity) in children and adults in 4 carefully selected low-, middle- and high income countries in Africa, identified factors associated with the shifts, and provided recommendations for future work. Methods Malawi, Kenya, Ghana, and South Africa were selected based on their economic status, population size, urbanization, etc. Nationally representative data was obtained from sources such as 2017 Global Nutrition Report, Demographic Health Surveys (DHSs), Food and Agriculture Organization Corporate Statistical Database (FAOSTAT), and World Health Organization (WHO). The prevalence of underweight, overweight and obesity (ov/ob), and some ratios were assessed and compared across the countries between 1998 and 2016. Results Varied nutrition status and shifts were observed among the countries during 1998–2016. Countries with the higher economic status also had higher prevalence and faster increasing trends of ov/ob. South Africa had the highest GDP and highest ov/ob rates in children <5, children 5-18, and adults >18 (13.3%, 24.7%, and 51.9% respectively). Malawi, with the lowest GDP, had the highest stunting rate (37%). In each country, but most notably in South Africa, trends indicated the increasing ov/ob rate (11.8%) was much greater than the declining underweight rate (2.4%). Slight declines in overweight in children under 5 years were observed in Malawi, Kenya, and Ghana, which might be due to reduced stunting rates. Sex differences existed in older children and adults, with higher rates of ov/ob in females and undernutrition among males. Conclusions Nutrition shifts, heavily influenced by economic development, are rapidly occurring in sub-Saharan Africa. The double-burden of malnutrition posts prioritization challenges for policymakers. Because undernutrition is now a declining issue, the focus should be shifted towards prevention of obesity, at least in higher income countries in Africa. Funding Sources The study is funded in part by a center grant from the US National Institutes of Health (NIH, U54HD070725).


2021 ◽  
pp. 2277436X2110436
Author(s):  
Binu Dorjee ◽  
Pallabi Saha ◽  
Jaydip Sen

The present study assesses the association of different socio-economic variables with children’s BMI-for-age z-scores (BAZ) and influence of children’s height on BAZ, a proxy index of nutritional status. The study was undertaken among 322 girls belonging to the Bengali Hindu Caste Population (BHCP) aged 5–13 years. These girls were the students of two schools located in Siliguri town of West Bengal, India. The prevalence of short stature, underweight and overweight was assessed using the World Health Organization’s ( WHO, 2007 , Growth Reference Data for 5–19 years) references. The statistical analyses used were St. Nicolas House Analysis (SNHA), analysis of variance (ANOVA), linear and logistic regression. The prevalence of underweight, overweight and obesity was 19.3%, 17.8% and 5.9%, respectively. The prevalence of short stature (−2.0 HAZ) was 8.7%. The range of BAZ was from −5.69 to 4.15. The variation of BAZ explained by height-for-age z-scores (HAZ) was 11.4%. The BAZ was observed to be associated with mothers’ occupation as revealed by 2% variation through SNHA analysis. The present study observed the usefulness of SNHA for non-parametric data with unequal sub-sample or categories. However, SNHA was not devised to assess the direction and magnitude of variables of interest. The finding of the present study supports the use of BAZ as a proxy adiposity measure among the overweight/obese populations and populations with normal growth in height. The study further supports the recommendations that mother empowerment can help improve nutritional status of a girl child.


Curationis ◽  
2006 ◽  
Vol 29 (2) ◽  
Author(s):  
K Peltzer ◽  
P Seoka ◽  
T Babor ◽  
I Obot

Although progress has been made in developing a scientific basis for alcohol screening and brief intervention (SBI), training packages are necessary for its widespread dissemination in primary care settings in developing societies. Using a training package developed by the World Health Organisation 121 nurses from one rural site (29 clinics in Vhembe District) and one urban site (3 clinics and 6 mobile clinics in Polokwane/ Seshego) in South Africa were compared before and after SBI training regarding knowledge and attitudes, and the subsequent practice of SBI in routine clinical practice. Although the training effects were at times moderate, all changes were in a direction more conducive to implementing SBI. Health care providers significantly increased in knowledge, confidence in SBI and higher self-efficacy in implementing SBI at followup after 9 months after receiving the training. When delivered in the context of a comprehensive SBI implementation programme, this training is effective in changing providers’ knowledge, attitudes, and practice of SBI for at-risk drinking.


2021 ◽  
Vol 14 (1) ◽  
pp. 1874138
Author(s):  
Sunday A. Adedini ◽  
Dineo Thaele ◽  
Matshidiso Sello ◽  
Portia Mutevedzi ◽  
Cleopas Hywinya ◽  
...  

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