Implications of updated protocol for classification of childhood malnutrition and service delivery in world’s largest refugee camp amid this COVID-19 pandemic

Objectives: During the COVID-19 pandemic, the authorities made a change in the classification of malnutrition and concomitant service delivery protocol among the Rohingya children, residing in world’s largest refugee camp, located in Bangladesh. In this paper, we discussed the potential implications of this updated protocol on the malnutrition status among children from the Rohingya camp. Design: This paper reviewed relevant literature and authors’ own experience to provide a perspective of the updated protocol for the classification of malnutrition among the children in the Rohingya camps and its implication from a broader perspective. Setting: Rohingya refugee camps, Bangladesh Participants: Children aged less than five years residing in the Rohingya camps. Results: Major adaptation during this COVID-19 was discontinuation of using weight-for-height z-score (WHZ) and use of only MUAC and presence of edema for admission, follow up and discharge of malnourished children in camps. However, evidence suggest that use of MUAC only can underestimate the prevalence of malnutrition among the children in Rohingya camps. These apparently non-malnourished children are devoid of the rations that they would otherwise receive if classified as malnourished, making them susceptible to more severe malnutrition. Conclusions: Our analysis suggests that policymakers should consider using the original protocol of using both MUAC and WHZ to classify malnutrition and retain the guided ration size. We also believe that it would not take an extra effort to adopt the original guideline as even with MUAC only guideline, certain health measures needed to adopt during this pandemic.

Peningkatan Kemampuan Kader Melalui Edukasi Pemanfaatan Bahan Alam Untuk Meningkatkan Produksi ASI Di Kelurahan Banjarsari Surakarta

Background: The benefits of breastfeeding for infants include reducing infant mortality due to diarrhea and infection, reducing mortality among malnourished children, protecting against gastrointestinal infections, as well as being a source of energy and nutrition for infants aged 6 to 23 months. While the benefits for mothers who are breastfed are reducing the risk of ovarian cancer and providing breast support after milk production, as a natural prevention method in the first six months of birth, and helping to lose weight faster with pregnancy. Vegetables / natural plants that are easily available around us that can be used to increase breast milk production. Research in addition to carbohydrates, these vegetables also contain protein, minerals (phosphorus, calcium and iron, as well as a number of vitamins A, B1 and C). Methods: The method used is to present a booklet through education. The number of respondents was 20 mothers of health cadres. Results: The result of this community service activity is an increase in knowledge about the use of style materials for breastfeeding from 75% sufficient knowledge to 80% good knowledge. Conclusion: increasing knowledge and understanding of health cadres before and before providing education through natural plant booklets to increase breast milk.

Modified Dietetic Skim And Cotton Sheet Oil Dan Susu Formula 75 Terhadap Berat Badan Anak Balita Gizi Kurang

Children under five are a group that is prone to malnutrition because they are still experiencing a growth cycle, a development that requires more nutrients than other age groups. The impact of nutritional deficiencies; low body resistance, the body is susceptible to infectious diseases. The purpose of this study was to analyze the effectiveness of giving modified dietetic skim and cotton sheet oil (MODISCO) and Formula-75 milk to increase body weight of malnourished children in Puskesmas Waigete, Sikka Regency. The type of research used is Quasy experimental pretest and posttest design. The population of this research was 181 underweight children with malnutrition. The sampling technique used purposive sampling. The sample of this study was 24 underweight children with malnutrition, divided into 2 (two), namely group A was given MODISCO intervention and group B was given Formula-75 milk. The intervention was given once a day for 1 month at a dose of 150 kcal / kgbb / day for MODISCO and 1000 ml per day for 75 formula milk. Data analysis used Paired t-Test and Independent Samples Test. Paired T-Test analysis, groups A and B obtained P-value (0.000) <0.05, it was concluded that there was an increase in body weight after being given MODISCO and Formula-75 milk. Based on the analysis of the Independent Samples Test, groups A and B obtained a P-value (0.876)> 0.05, it was concluded that there was no difference in body weight for under-nourished toddlers who were given MODISCO and Formula-75 milk. There is no difference in body weight of malnourished underweight children in group A and group B, so it is concluded that MODISCO and Formula-75 milk can increase the weight of malnourished children underweight. The results of this study are an additional intervention to increase the weight of children under malnutrition.

Mutu Gizi Aneka Kudapan Cokibus

Snacks are small meals usually served with drinks, both for daily use and for special occasions. Cokibus snack is a snack that is made to complement the intake of nutrients, especially for children who experience stunting. Makassar City has more malnourished children than other cities/districts, namely 22.1% underweight, 25.2% stunting, and 9.4% wasting. This study aims to determine changes in nutritional quality, namely the levels of macronutrients, iron, and calcium in various Cokibus snacks. This type of research is laboratory research. The sample consisted of 4 kinds of snacks, 1 type of Cokibus consisting of standard, and one substitution treatment of 10% snakehead fish meal. Each sample was repeated twice, so there were 16 samples in total. The research was conducted at the Food Technology Laboratory, Department of Nutrition, Poltekkes, Ministry of Health, Makassar, and the sample was examined at the Quality Control Laboratory of SMTI Makassar. The results showed that per 100 grams of various Cokibuses, the average carbohydrate content decreased -0.1%, protein content increased between 0.21% to 0.72%, fat increased 0.02% to 0.12%, iron increased between 0.43% to 0.63%. Calcium also increased between 0.29% to 0.85%. The snack with the highest increase in nutritional content was Charrot muffins, and the lowest increase in nutritional value was Chobus cupcakes.

Comparative Evaluation of the Nutritional Status and Habits of Students Studying in Private and Government Schools in a Semi-Urban Town in India –Kumbakonam Urban Rural Epidemiological Study - KURES -1

Malnutrition is a universal and an ever-rising problem due to changes in the lifestyle and eating habits among the children. The malnourished children are prone to illness. Hence, we planned to conduct a study in school children, both in Government set up and a private set up, to review their nutritional status and the influencing factors. Two thousand students in the age group of 8-17 years were interviewed for their food habits, asking them to fill up a proforma along with anthropometric measurements. Among the children interviewed 72% were malnourished, but only 0.06% were obese. The nourishment was significantly better in private school children but still 58% were underweight. There was a strong liking for fast food among children from both the groups. The playing time was less than an hour in a majority of students. Conclusion: There is an alarming census of underweight children in a semi-urban Indian town, but obesity is not that alarming, with an incidence rate < 1%. There is an urgent need to promote games among children of all socioeconomic status. A blanket ban on fast food items in the school campus is the need of the hour. Undernourished children form majority of students going to school in India. This includes children attending private paid schools. The incidence of obesity is still so low so that any community level action on the same is presently not needed in India.

Childhood malnutrition and hypo mineralized molar defects: a cross sectional study

Background: Malnutrition is well-known to yield high morbidities and mortalities and considering its consequence on the oral cavity, malnutrition is shown to have pre-eruptive and post-eruptive outcomes. The objective was to assess the prevalence of hypo-mineralized second primary molar (HSPM), molar–incisor hypo-mineralization (MIH) and dental caries in malnourished children as well as addressing the relation between types of malnutrition of the children and their dental morbidities represented in HSPM, MIH and dental caries. Methods: This is a cross sectional analytical study. Malnourished children aged 5-10 years and presented to the Outpatient Clinic of Pediatric Dentistry Department, Faculty of Dentistry, Cairo University were examined for HSPM. MIH using European Academy of Pediatric Dentistry criteria and dental Caries using def/ DMF indices. Results: A consecutive sample (a long six months) of 54 malnourished children were enrolled in the study. Dental caries was a greater dental morbidity in the overweight and obese group. Besides, stunting was a greater risk in HSPM and MIH. There was an association between HSPM and MIH in a considerable percentage of the study group. Conclusions: Malnutrition is a risk factor for dental abnormalities. HSPM could expect the presence of MIH.

Stunting does not impair physical fitness in Indonesian school children

Background Physical fitness is decreased in malnourished children and adults. Poor appearance and muscular flaccidity are among the first signs of malnutrition. Malnutrition is often associated with stunting. Objectives We test the hypotheses that stunted children of low social strata are physically less fit than children of high social strata. Sample We investigated 354 school girls and 369 school boys aged 5.83 to 13.83 (mean 9.54) years from three different social strata in Kupang (West-Timor, Indonesia) in 2020. Methods We measured height, weight, and elbow breadth, calculated standard deviation (SDS) of height and weight according to CDC references, and the Frame index as an indicator of long-term physical fitness, and we tested physical fitness in standing long jump and hand grip strength. Results Children of low social strata are physically fittest. They jump longer distances, and they have higher values in the Frame index. No association exists between height SDS and physical fitness, neither in respect to standing long jump, nor to hand grip strength. Conclusion Stunting does not impair physical fitness in Indonesian school children. Our results support the concept that SEPE (social-economic-political-emotional) factors are involved in the regulation of human growth.

Use of homeopathic formula in malnourished children

The present intervention study sought to assess the results of homeopathic treatment in malnourished children aged 1-19 years old below the 3th percentile in the weight-height ratio at San Juan Policlinic, Ranchuelo County, Cuba, between November 2004 and December 2005. A total of 99 children were randomly allocated by Mathcad in two groups, one (n=50) was given homeopathic treatment, and the control group (n=49) that did not. Administration of medication was defined by clinical criteria. Inclusion, exclusion and exit criteria were defined. Variables were identified and operationalized, and the information collected from both groups was interpreted. After one-year follow-up, 42 out of 50 children (84%) treated with homeopathy attained normal weight, whereas only 15 out of 49 (30%) of the children in the control group attained normal weight.

Factors Associated with Congenital Heart Disease in Severely Malnourished Children under Five and Their Outcomes at an Urban Hospital, Bangladesh

Congenital heart disease (CHD) is one of the most common types of birth defect with a high morbidity and mortality, particularly in severely malnourished children under five. In this study, we aim to identify the predicting factors for CHD and their outcomes. 694 malnourished children under five years of age admitted between April 2015 and December 2017 constituted the study population. Of them, 64 were cases of CHD, and by comparison 630 were without CHD. CHD was diagnosed clinically and confirmed by echocardiogram. 64% of the cases had a single defect. Cases were more likely to be present with diarrhea, cough, respiratory distress, cyanosis, hypoxemia, hypoglycemia and hypernatremia on admission. The cases also had a high proportion of severe sepsis, bacteremia, heart failure, respiratory failure and death, compared to those without CHD. Cough (95% CI = 1.09–18.92), respiratory distress (95% CI = 1.46–5.39) and hypoxemia (95% CI = 1.59–6.86) were found to be the independent predictors for CHD after regression analysis, and their early identification might be helpful to lessen ramifications, including mortality, in such populations, especially in resource-limited settings.

Community-Based Management of Acute Malnutrition for Infants Under 6 Months of Age Is Safe and Effective: Analysis of Operational Data

Objective: To assess the effectiveness of outpatient management with ready-to-use and supplementary foods for infants under 6 months (u6m) of age who were unable to be treated as inpatients due to social and economic barriers. Design: Review of operational acute malnutrition treatment records. Setting: 21 outpatient therapeutic feeding clinics in rural Malawi. Participants: Infants u6m with acute malnutrition treated as outpatients because of barriers to inpatient treatment. The comparison group consisted of acutely malnourished children 6-9 months of age who were being treated at the same time in the same location in the context of two different randomized clinical trials. Results: A total of 323 infants u6m were treated for acute malnutrition (130 severe and 193 moderate). A total of 357 infants 6-9 months old with acute malnutrition (74 severe and 283 moderate) were included as contemporaneous controls. Among infants u6m with severe acute malnutrition, 98 (75.4%) achieved nutritional recovery; in comparison, 56 (75.7%) of those with SAM 6-9 months old recovered. Among infants u6m with moderate acute malnutrition, 157 (81.3%) recovered; in comparison 241 (85.2%) of those aged 6-9 months recovered. Conclusions: In a rural Malawian population of infants u6m who had generally already stopped exclusive breastfeeding and were now acutely malnourished, treatment with therapeutic or supplementary foods under the community management of acute malnutrition model was safe and effective. In settings where social and financial factors make hospital admission challenging, consideration should be given to lowering the recommended age of ready-to-use therapeutic and supplementary foods to infants u6m.