Risk Factors of Mild and Severe Stunting Children in Rural and Urban Areas in Indonesia

The article's abstract is not available.

A cross sectional study on assessment of nutritional status and factors affecting anemia in children in tertiary care teaching hospital

Background: Earlier many studies were conducted to assess the prevalence of anemia in adults, pregnant women, and children under 5 years of age. Despite all the reasons, there is an immense need to assess the nutrition status and prevalence of anemia in a pediatric population. Therefore, the purpose of the present study was to assess the nutritional status and prevalence of anemia in the pediatric population of age group 1-12 years.Methods: The present study was a cross-sectional study with a sample size of 100 with age group 1-12 year, was conducted in Government general hospital, Guntur. The study was carried for a period of 6 months (October to March). Data were collected by using the NACS assessment guide tool for nutritional status and tallquist hemoglobin scale was used to measure hemoglobin.Results: Age group of 1-6 years had 26% severe stunting whereas in the age group lo 7-12 years, 5% of the people had severe stunting. Age group of 1-6 yr and 7-12 years had 16% of severe wasting and 13% of severe wasting respectively. The prevalence of anemia in children had a significant impact with maternal education (p<0.05), socioeconomic status of the family (p<0.05), birth order of the child (p<0.05) and doesn’t have any significant impact with father education (p>0.05), past medical history (p>0.05).Conclusions: From our study, we conclude that moderate anemia was more noticeable than mild and severe anemia in people of rural areas in and around Guntur. Severe stunting and moderate wasting was observed more in the age group of 1-6 years of children in both sexes.

Penyuluhan Kesehatan Cegah Stunting dengan Perbaikan Pola Makan, Pola Asuh Dan Sanitasi pada Ibu Hamil di UPT Puskesmas Antang

: Stunting is a chronic malnutrition problem caused by lack of nutritional intake for a long time, resulting in growth disorders in children, namely the child's height is lower or shorter (short) than the standard age. The condition of a child's short body is often said to be a hereditary factor (genetic) from both parents, so that many people just accept it without doing anything to prevent it. In fact, as we all know, genetics is a determinant of health that has the least effect when compared to behavioral, environmental (social, economic, cultural, political) factors and health services. In other words, stunting is a preventable problem. Stunting is a growth failure problem experienced by infants under 5 years of age who are malnourished since in the womb until the baby is born. Assessment of stunting nutritional status can be done through anthropometric measurements of TB/U classified through nutritional classification status. Stunting is a condition where the child's height is shorter than the height of children his age. According to UNICEF, stunting occurs in children aged 0 to 59 months with a height below minus (moderate and severe stunting) and minus three (chronic stunting) measured from the WHO child growth standards. In Indonesia, stunting is still a health problem in quite a large number. Based on the 2013 Basic Health Research, around 37.2 percent of Indonesian children under the age of 5 are stunted.

Urban-rural differences in the associated factors of severe under-5 child undernutrition based on the composite index of severe anthropometric failure (CISAF) in Bangladesh

Introduction Severe undernutrition among under-5 children is usually assessed using single or conventional indicators (i.e., severe stunting, severe wasting, and/or severe underweight). But these conventional indicators partly overlap, thus not providing a comprehensive estimate of the proportion of malnourished children in the population. Incorporating all these conventional nutritional indicators, the Composite Index of Severe Anthropometric Failure (CSIAF) provides six different undernutrition measurements and estimates the overall burden of severe undernutrition with a more comprehensive view. This study applied the CISAF indicators to investigate the prevalence of severe under-5 child undernutrition in Bangladesh and its associated socioeconomic factors in the rural-urban context. Methods This study extracted the children dataset from the 2017–18 Bangladesh Demographic Health Survey (BDHS), and the data of 7661 children aged under-5 were used for further analyses. CISAF was used to define severe undernutrition by aggregating conventional nutritional indicators. Bivariate analysis was applied to examine the proportional differences of variables between non-severe undernutrition and severe undernutrition group. The potential associated socioeconomic factors for severe undernutrition were identified using the adjusted model of logistic regression analysis. Results The overall prevalence of severe undernutrition measured by CISAF among the children under-5 was 11.0% in Bangladesh (rural 11.5% vs urban 9.6%). The significant associated socioeconomic factors of severe undernutrition in rural areas were children born with small birth weight (AOR: 2.84), children from poorest households (AOR: 2.44), and children aged < 36 months, and children of uneducated mothers (AOR: 2.15). Similarly, in urban areas, factors like- children with small birth weight (AOR: 3.99), children of uneducated parents (AOR: 2.34), poorest households (APR: 2.40), underweight mothers (AOR: 1.58), mothers without postnatal care (AOR: 2.13), and children’s birth order ≥4 (AOR: 1.75), showed positive and significant association with severe under-5 undernutrition. Conclusion Severe undernutrition among the under-5 children dominates in Bangladesh, especially in rural areas and the poorest urban families. More research should be conducted using such composite indices (like- CISAF) to depict the comprehensive scenario of severe undernutrition among the under-5 children and to address multi-sectoral intervening programs for eradicating severe child undernutrition.

Effects of Parental Education and Wealth on Early Childhood Stunting in Bangladesh

Background Malnutrition is considered to be a major public health challenge, which is associated with a range of health issues, including childhood stunting. Stunting is a reliable and well-recognized indicator of chronic childhood malnutrition. The objective of this study is to determine the effects of parental education and wealth on different specification of stunting among 17490 children below five years of age in Bangladesh. Methods Correlates of child stunting were examined using data generated by a cross-sectional cluster survey conducted in Bangladesh in 2019. The data includes a total of 17490 children (aged < 5 years) from 64400 households. Multiple logistic regressions were used to determine the risk factors associated with child stunting and severe stunting. Results The prevalence of stunting and severe stunting for children was 25.96% and 7.97%, respectively. Children aged 24 to <36 months [Odds Ratio (OR) = 2.65, 95% CI: 2.30, 3.05] and aged 36 to <48 months [OR = 2.33, 95% CI: 2.02, 2.69] had more risk of stunting compared to the children aged <6 months. Children from Sylhet division had the greatest risk of stunting of all the eight divisions [OR = 1.26, 95% CI: 1.09, 1.46]. Children of secondary complete or higher educated mothers were less likely to develop stunting [OR = 0.66, 95% CI: 0.56, 0.79] compared with children of mothers having no education at all. Similarly, children of secondary complete or higher educated father [OR = 0.74, 95% CI: 0.63, 0.87] were found to have lower risk of stunting compared with children whose father hadn’t any education. Substantially lower risk of stunting was observed among children whose mother and father both completed secondary education or above [OR = 0.59, 95% CI: 0.52, 0.69]. Children from richest households [OR = 0.49, 95% CI: 0.41, 0.58] had 51 % smaller odds on stunting compared to children from poorest families. Conclusions After controlling for socioeconomic and demographic factors, parental education and household position in wealth index were found as to be the most important determinants of child stunting in Bangladesh.

Severe Stunting Symptoms upon Nepovirus Infection Are Reminiscent of a Chronic Hypersensitive-Like Response in a Perennial Woody Fruit Crop

Virus infection of plants can result in various degrees of detrimental impacts and disparate symptom types and severities. Although great strides have been made in our understanding of the virus–host interactions in herbaceous model plants, the mechanisms underlying symptom development are poorly understood in perennial fruit crops. Grapevine fanleaf virus (GFLV) causes variable symptoms in most vineyards worldwide. To better understand GFLV-grapevine interactions in relation to symptom development, field and greenhouse trials were conducted with a grapevine genotype that exhibits distinct symptoms in response to a severe and a mild strain of GFLV. After validation of the infection status of the experimental vines by high-throughput sequencing, the transcriptomic and metabolomic profiles in plants infected with the two viral strains were tested and compared by RNA-Seq and LC-MS, respectively, in the differentiating grapevine genotype. In vines infected with the severe GFLV strain, 1023 genes, among which some are implicated in the regulation of the hypersensitive-type response, were specifically deregulated, and a higher accumulation of resveratrol and phytohormones was observed. Interestingly, some experimental vines restricted the virus to the rootstock and remained symptomless. Our results suggest that GFLV induces a strain- and cultivar-specific defense reaction similar to a hypersensitive reaction. This type of defense leads to a severe stunting phenotype in some grapevines, whereas others are resistant. This work is the first evidence of a hypersensitive-like reaction in grapevine during virus infection.

First report of banana bunchy top virus in banana and plantain (Musa spp.) in Tanzania

Banana (including plantain; Musa spp.) is an important vegetatively propagated food staple grown as a semi-perennial crop in fields and backyard gardens in Tanzania. Banana bunchy top disease (BBTD), caused by the banana bunchy top virus (BBTV, genus Babuvirus), is the most economically important viral disease of banana, infection of which results in severe stunting and reduction in fruit production by 90-100% within two seasons. The virus is spread by the banana aphid, Pentalonia nigronervosa, and through vegetative propagation of infected sources. BBTV is an introduced virus first reported in sub-Saharan Africa (SSA) in the 1960s in the Democratic Republic of Congo. Since then, BBTV spread was confirmed in 15 countries in Central, Southern, and Western African regions but was not detected in any previous surveys in the East African sub-region. During banana pests and disease surveys conducted in December 2020 – January 2021 in Buhigwe District in the Kigoma Region of Tanzania revealed banana plants with typical BBTV symptoms (severe stunting, leaves with shortened petioles, chlorotic streaks, and yellow leaf margins) in several banana fields in Muhinda (lon. 29.78662, lat. -4.53672) and Mwayaya (lon. 29.8218, lat. -4.49203) villages. Most of the affected plantations were 5 to 15 years old. Leaf samples (N=21) from symptomatic (N=6) and asymptomatic (N=15) banana plants were collected and used for total DNA extraction and BBTV detection by polymerase chain reaction (PCR) using the primer pair BBTV-1 and BBTV-2 to amplify ~240 bp sequence of DNA-R encoding for core master replication initiator protein gene. All samples from symptomatic plants tested positive and asymptomatic plants were negative. To further confirm the virus identity, four samples, each from symptomatic (PCR positive) and asymptomatic (PCR negative) plants from Muhinda and Mwayaya villages, were tested by Triple Antibody Sandwich-Enzyme-linked Immunosorbent Assay (TAS-ELISA) using BBTV ELISA reagent set (Cat. # SRA24700-1000, Agdia, France) following the manufacturer's protocol. Samples from symptomatic plants reacted positively in TAS-ELISA, and asymptomatic plants were negative. The 240-bp PCR product of two isolates was purified, and both strands were sequenced. A BLAST search of the nucleotide sequences (NCBI GenBank Acc.# MW711671 and MW711672) revealed 99% identity with DNA-R sequences of several other BBTV isolates from Africa (Acc. No# JF755994). Further analysis of the 240-bp nucleotide sequences with Maximum-likelihood phylogenetic analysis using MEGA-X software has grouped the two BBTV sequence isolates with the SSA sub-clade of the South-Pacific group. To our knowledge, this is the first report of BBTV infecting bananas in Tanzania, and East Africa endowed with rich banana diversity and popular East African Highland banana clone. BBTV presents a new threat to banana production in this sub-region due to the high risk of further spread through vegetative propagation, traditional planting material exchange practices, and the ubiquitous banana aphid vector. This study warrants delimitation surveys to assess the extent of spread, with simultaneous efforts to raise awareness about BBTD recognition and control measures among banana growers, including eradicating infected mats and replanting with healthy planting material to recover banana production.

Degradation of hop latent viroid during anaerobic digestion of infected hop harvest residues

The citrus bark cracking viroid (CBCVd) was identified as causal agent for a severe stunting disease in hops. Viroids are highly stable parasitic RNAs, which can be easily transmitted by agricultural practices. Since CBCVd has recently been detected in two European countries a growing concern is that this pathogen will further spread and thereby threaten the European hop production. Biogas fermentation is used to sanitize hop harvest residues infected with pathogenic fungi. Consequently, the aim of this study was to test if biogas fermentation can contribute to viroid degradation at mesophilic (40 °C) and thermophilic (50 °C) conditions. Therefore, a duplex reverse transcription real-time PCR analysis was developed for CBCVd and HLVd detection in biogas fermentation residues. The non-pathogenic hop latent viroid (HLVd) was used as viroid model for the pathogenic CBCVd. The fermentation trials showed that HLVd was significantly degraded after 30 days at mesophilic or after 5 days at thermophilic conditions, respectively. However, sequencing revealed that HLVd was not fully degraded even after 90 days. The incubation of hop harvest residues at different temperatures between 20 and 70 °C showed that 70 °C led to a significant HLVd degradation after 1 day. In conclusion, we suggest combining 70 °C pretreatment and thermophilic fermentation for efficient viroid decontamination.

First report of sweet potato chlorotic stunt virus infecting sweet potatoes in Hungary

Sweet potato chlorotic stunt virus (SPCSV), a crinivirus in the family Closteroviridae, is a quarantine pest in Europe and one of the most economically important viruses of sweet potato (Ipomoea batatas (L.) Lam) crops globally. It forms synergies with other viruses in sweet potato, leading to yield loss of 30-100% (Qin et al., 2014). In summer 2020, 62 symptomatic and 38 symptomless sweet potato vines were randomly collected in farmers’ fields in the south (Ásotthalom, Szeged) and central (Galgahévíz) parts of Hungary and transplanted in an insect-proof greenhouse. Six of the plants expressed SPCSV-like symptoms, including stunting, vein clearing and leaf purpling (Suppl1). To check for common viruses of sweet potato (Suppl2), total RNA and DNA were extracted from leaves of each of the 100 plants using Trizolate reagent (UD-GenoMed, Debrecen, Hungary) and Zenogene kit (Zenon Bio, Szeged, Hungary), respectively. Primer pair Ch2N (Suppl2) was designed using Primer3 (v. 0.4.0) to amplify a 194 bp fragment of SPCSV RNA1. Presence of the RNA viruses was checked by qPCR using qPCRBIO SyGreen 1-step qPCR kit (PCR Biosystems, London, UK), while DNA viruses were checked by PCR using DreamTaq DNA Polymerase (Thermo Scientific, Vilnius, Lithuania), followed by 1% agarose gel electrophoresis. Four samples (labelled A5.1, A6.1, A6V9-1, A6V9-2) out of the 100 tested positive for SPCSV. Two of them (A6V9-1 and A6V9-2) were co-infected with SPCSV, a badnavirus sweet potato pakakuy virus (SPPV) and a potyvirus sweet potato virus 2 (SPV2), while the other two (A5.1 and A6.1) lacked SPV2. Plants infected with SPCSV, SPV2 and SPPV displayed more severe symptoms. To confirm the results, cDNA synthesized from the four SPCSV positive samples using RevertAid first strand cDNA synthesis kit (Thermo Scientific, Vilnius, Lithuania) underwent PCR (94oC 4 min, 94oC 1 min, 53oC 30 s, 72oC 70 s and 72oC 10 min for a total of 30 cycles) using primers CL43U and CL43L for the viral heat shock protein 70 gene (Maliogka et al., 2020). An expected band size of 486 bp was obtained in all cases. The amplicon from sample A6.1 was sequenced and found to be identical to SPCSV Guatemalan isolate GT:B3:08 (acc. JF699628). RNA1 and RNA2 complete sequences from sample A6.1 were obtained via PCR amplifications of cDNA using primers (Suppl2) designed (from acc. KC888966 for RNA1 and acc. KC888963 for RNA2) to amplify overlapping fragments of West African strain of SPCSV. QIAquick gel extraction kit (QIAGEN, Hilden, Germany) was used to purify the PCR fragments, which were then cloned into pGEM-T Easy Vector (Promega, Madison, USA) and sequenced using Sanger sequencing technique (Biomi, Gödöllő, Hungary). BLASTn search revealed that RNA1 of our isolate Hun_01 (acc. MW892835) had 99.63% sequence identity to SPCSV isolate su-17-10 (acc. MK802073), while RNA2 of Hun_01 (acc. MW892836) was 99.68% similar to SPCSV isolate min-17-1 (acc. MK802078) and isolate 24-1 (acc. MK802080). Phylogenetic analysis using MegAlign (v. 7.1.0, 44.1) showed a close relationship between our isolate and those isolated in China, suggesting that they may have a common origin (Suppl1). Severe stunting and leaf yellowing symptoms developed in I. setosa indicator plants grafted with SPCSV infected sweet potato scions. qPCR test for the virus confirmed its presence in the I. setosa leaves. To the best of our knowledge, this is the first report on the occurrence of SPCSV in Hungary and the third in Europe (Valverde et al. 2004; EPPO 2021).

Poverty and childhood malnutrition: Evidence-based on a nationally representative survey of Bangladesh

Background Malnutrition contributes to children’s morbidity and mortality, and the situation undermines the economic growth and development of Bangladesh. Malnutrition is associated with lower levels of education that decrease economic productivity and leads to poverty. The global burden of malnutrition continues to be unacceptably high amid social and economic growth, including in Bangladesh. Therefore, identifying the factors associated with childhood malnutrition and poverty is necessary to stop the vicious cycle of malnutrition leaded poverty. Methods The study utilized the 2017–18 Bangladesh Demographic and Health Survey (BDHS), accumulating 7,738 mother-child pairs. Associations between potential risk factors and nutritional status were determined using chi-square tests, and multivariate logistic regression models were utilized on significant risk factors to measure their odds ratio (OR) with their 95% confidence intervals (CI). Results The prevalence of moderate and severe wasting was 7.0% and 1.8%, respectively, whereas the prevalence of moderate and severe stunting was 19.2% and 8.0%, while 16.4% and 3.6% of children were moderately and severely underweight. Children from the poorest and poor households were suffering from at least one form of malnutrition. Adjusted ORs were estimated by controlling socio-economic and demographic risk factors, such as poor maternal body mass index, parents’ lower education level, use of unhygienic toilet, child age in months, and recent experience of diarrhea and fever. The pattern was almost similar for each malnutrition status (i.e., stunting, underweight, and wasting) in the poorest and poor households. Conclusion Bangladesh achieved the Millennium Development Goals, focusing primarily on health-related indicators and working to achieve the Sustainable Development Goals. Even considering this success, the prevalence of malnutrition and poverty in same household remains relatively high compared to other developing countries. Therefore, the study recommends the implementation of nationwide systematic measures to prevent poverty and malnutrition.