ASSESSMENT AND COMPARISON OF PATTERNS OF MALNUTRITION AND ITS

Predictors of Stunting and Underweight Among Children Aged 6 to 59 months in Bussi Islands, Wakiso District, Uganda: A Cross-Sectional Study, 2022

Background: Child undernutrition is a major public health concern in Uganda that can lead to increased risks of death with its prevalence higher in rural hard-to-reach areas than in urban areas. While it is assumed that the prevalence will be more concerning in islands with restricted accessibility to healthcare resources, limited research has been conducted on the prevalence and associated factors of stunting and underweight among children in Bussi Islands of Uganda. This study aimed to assess the prevalence and predictors of stunting and underweight among children aged 6 to 59 months in Bussi Islands of Wakiso District in Uganda. Methods: A cross-sectional study was conducted in Bussi Islands of Wakiso District. Sociodemographic and anthropometric measurements were obtained for randomly sampled 409 caretaker-child pairs from 409 households. Data was collected using pre-tested structured electronic questionnaires validated by the Uganda Ministry of Health. Anthropometric indices were calculated using ENA-SMART version 2011 and data analysis was conducted using STATA version 14. Modified Poisson regression was used to generate Unadjusted and Adjusted Prevalence Ratios (APRs) with 95% confidence intervals. Results: Prevalence of stunting and underweight among children in Bussi Islands were 29.8% and 16.1%, respectively. Independent predictors of stunting included: suffering from diarrhea (APR: 1.8; 95% CI: 1.3, 2.5); household food insecurity (APR: 1.7; 95% CI: 1.2, 2.4); and child age of 12 to 23 months and 24 to 35 months (APR: 2.3; 95% CI: 1.3, 4.0 and APR: 2.0; 95% CI: 1.1, 3.6 respectively). Protective factors against stunting were not suffering from measles (APR: 0.62; 95% CI: 0.42, 0.92); receiving deworming tablets every 6 months (APR: 0.58; 95% CI: 0.42, 0.81); and daily household utilization of more than 80 L of water (APR: 0.48; 95% CI: 0.24, 0.95). Predictors of underweight were suffering from diarrhea (APR: 2.2; 95% CI: 1.4, 3.4) and having more than 9 household members (APR: 2.8; 95% CI: 1.1, 7.5). Conclusions: Child stunting and underweight are prevalent public health problems in Bussi Islands of Wakiso District. Therefore, the study suggests that nutrition interventions in the Islands should focus on childhood vaccination, family planning, sufficient safe water coverage, household food security, and health education of child caretakers on optimal infant and young child feeding and development.

African Health Sciences, 2008

IntroductionSince mid 1990s, Uganda has had an estimated 1.6 million internally displaced persons (IDPs) in the northern and eastern districts. A major cause of morbidity and mortality amongst children in displaced settings is protein energy malnutrition.ObjectiveTo estimate the prevalence of and describe the risk factors for protein energy malnutrition among under five years old children living in internally displaced persons camps in Omoro county Gulu district.MethodsThis was a cross sectional study undertaken among internally displaced people's in Omoro county, Gulu district during 13 – 23rd September 2006. Anthropometric measurements of 672 children aged 3 – 59 months were undertaken and all their caretakers interviewed. The anthropometric measurements were analyzed using z-scores of height-for-age (H/A) and weight-for-height (W/H) indices. Qualitative data were collected through 6 focus group discussions, key informant interviews and observation. Data were captured using Epi Data version 3.0 and analyzed using EPI-INFO version 3.3.2 and SPSS version 12.0 computer packages respectively. ResultsThe prevalence of global stunting was found to be 52.4% and of global acute malnutrition 6.0%. Male children are at risk of being stunted Adjusted OR 1.57 95% CI 1.15–2.13; p value=0.004. Children in the age group 3 – 24 months were at risk of acute malnutrition Adjusted OR 2.78 95% CI 1.26–6.15; p value=0.012 while de-worming was protective Adjusted OR 0.44 95% CI 0.22–0.88; p value=0.018. The main sources of foodstuff for IDPs include food rations distributed by WFP, cultivation and purchase.Conclusion and RecommendationsThere is high prevalence of protein energy malnutrition (stunting) among children in the internally displaced people's camps in Gulu district. Male children are at an increased risk of stunting while children aged between 3 – 24 months are at an increased risk of suffering from acute malnutrition. Stakeholders including local government and relief organizations should intensify efforts to improve the nutritional status of IDPs especially children in the camp settings. The quantity of and access to household food supplies, health education on infant and child feeding and integrated management of childhood illnesses (IMCI) activities in the camps should be strengthened.

Pan African Medical Journal, 2020

Introduction: displacement predisposes to deprivation and hunger and consequently malnutrition. In Nigeria, information on anthropometric characteristics and associated factors among displaced under-five children is important to strengthen strategies to ameliorate malnutrition and promote child health. This study was conducted to identify the determinants of anthropometric indices among under-five children in internally displaced persons' camps in Abuja, Nigeria. Methods: this cross-sectional study involved 317 mother-child (0-59 months) pairs selected using two-stage simple random sampling technique. Information on socio-demographic, care practices (infant feeding, immunization, deworming) and anthropometric characteristics of index children was obtained using semi-structured, interviewer-administered questionnaire. Weight and length/height were assessed using standard procedure and analysed using World Health Organization (WHO) Anthro software. Data were analysed using descriptive statistics and logistic regression at p<0.05. Results: median age was 24 months, 50.8% were male and 42.3% were delivered at health facility. Only 45.4% were exclusively breastfed, 28.8% were fed complementary foods too early, 45.4% were dewormed in the preceding six months and 43.9% had complete/up-to-date immunisation. Prevalence of underweight, stunting and wasting was 42%, 41% and 29.3%, respectively. Poor anthropometric indices were higher among male than female children, except wasting. Having good anthropometric index was 2.5 times higher among children <12 months than children ≥37 months (CI: 1.08-5.8), 2.4 times higher among 1 st birth orders than 5 th order (CI: 0.19-0.93), 1.7 times higher among female than male children (CI: 1.08-2.82). Conclusion: malnutrition is a major health problem among under-five children in internally displaced camps and major determinants include age, birth order, gender and deworming status.

Background Despite the multiple initiatives implemented to reduce stunting in Ecuador, it continues to be a public health problem with a significant prevalence. One of the most affected groups is the rural indigenous population. This study aimed to analyze the prevalence of chronic malnutrition in indigenous children under 5 years of age and its association with health determinants, focusing on one of the territories with the highest prevalence of stunting. Methods A cross-sectional study in 1,204 Kichwa indigenous children under the age of five, residing in rural areas of the counties with the highest presence of indigenous in the province of Chimborazo-Ecuador. A questionnaire on health determinants was applied and anthropometric measurements were taken on the child and the mother. Stunting was determined by the height-forage z-score of less than 2 standard deviations, according to the World Health Organization´s parameters. Data were analyzed using bivariate and multivariate Poisson regression. Results 51.6% (n = 646) of the children are stunted. Height-forage z-scores were significantly better for girls, children under 12 months, families without overcrowding, and families with higher family income. The variables that were significantly and independently associated with stunting were: overcrowding (PR 1.20, 95% CI 1-1.44), the mother required that the father give her money to buy medicine (PR 1.33, 95% CI 1.04-1.71), the father did not give her money to support herself in the last 12 months (1.58, 95% CI 1.15-2.17), mother's height less than 150 cm (PR 1.42, 95% CI 1.19-1.69) and the child was very small at birth (PR 1.75, 95% CI 1.22-2.5). Conclusion One out of every two rural indigenous children included in this study is stunted. The high prevalence of stunting in the indigenous and rural population is multicausal, and requires an intersectoral and multidisciplinary approach. This study identified three fundamental elements on which public policy could focus: (a) reduce overcrowding conditions, improving economic income in the rural sector (for example, through the strengthening of agriculture), (b) provide prenatal care and comprehensive postnatal care, and (c) promote strategies aimed at strengthening the empowerment of women.

Research Square (Research Square), 2024

Malnutrition remains a signi cant factor determining health and survival of children in countries with low and middle income. The indicators utilized traditionally to separately assess the magnitude of malnutrition in communities have been reported by recent studies to have ignored the impact of simultaneous anthropometric de cits. This study aimed to determine the feeding practices, prevalence and factors associated with concurrent wasting and stunting (WaSt) among children under 5 years attending health facilities in Southwestern Uganda (Bushenyi district) This was a health facility-based, cross sectional study that enrolled 321 patients. The data related to feeding practices and socio demographic factors was collected using interview of caregivers while the weight and length were obtained using a digital weighing scale and an infantometer/stadiometer respectively. Concurrent wasting and stunting (WaSt) was diagnosed if both weight for length and height for age were under - 2SD. Binary logistic regression was used to determine factors associated with concurrent wasting and stunting (WaSt) in SPSS version 26. The prevalence of WaSt was 4%. Early initiation of breast feeding was done in 85.1%, exclusive breastfeeding in 64.7%, continued breastfeeding in 63.1%, minimum diet diversity received in 33.7% and minimum meal frequency in 78.1%. The factors associated with WaSt were the presentation with diarrhea (aOR = 1.269, CI = 1.138-1.414, P < 0.001), pneumonia (aOR = 1.230, CI = 1.095-1.383, P = 0.001), not receiving minimum diet diversity (aOR = 1.235, CI = 1.052-1.265, P = 0.001), being a child to an unmarried mother, mother's MUAC < 22cm ((aOR = 1.316, CI = 1.144-1.514, P < 0.001) and not receiving nutritional counselling (aOR = 1.061, CI = 1.017-1.107, P = 0.006). The prevalence of concurrent wasting and stunting (WaSt) among children under ve years attending health facilities in Bushenyi district was in global prevalence range (4%). Complementary feeding practices indicators were poor particularly food diversity. Healthcare providers should screen systematically children under ve for multiple anthropometric de cits.

Texila International Journal of Public Health, 2019

Malnutrition is one of the leading causes of morbidity and mortality among children globally has been linked to 60% of the 10.9million deaths annually of children under five. The median stunting prevalence in WHO African region is 31.3%. Aweil Center of South Sudan has consistently high malnutrition rates despite running nutrition projects with relative stability. Results from nutrition survey in November 2013 indicated a severe acute malnutrition (SAM) prevalence rate of 6.3% (95% CI, 4.5-8.9) and a global acute malnutrition (GAM) rate of 22.4% (95% CI, 17.8-27.7). Both prevalence rates were above the WHO thresholds of 15% and 2% respectively. A cross-sectional study done with two-stage cluster sampling method showed that generally children 6-59 months in Aweil Center have poor nutritional status with GAM (<-2 z-score and/or edema) of 23.2% (95% CI, 19.0-27.9) and SAM (% < -3SD) of 7% (95% CI, 4.9%-9.9%). However, stunting based on height/length-for-age z-scores was 8.7% (95% CI, 6.5-11.6), which was within the acceptable new WHO’s threshold regarded as low probably due to genetic factors for tallness for Dinka tribe. The study revealed high burden of infectious diseases at 94.5% with p-value 0.00022 (95%C. I, 0.1667-0.291). Poor feeding and family planning practices; poor access roads to markets contribute to childhood malnutrition. Multifaceted approach is needed to root out the chronic malnutrition from Aweil center shift from food Aid to support of food production, scale up of primary health care and iCCM interventions and community awareness on feeding practices among others. Keywords: Prevalence, Associated-factors, Malnutrition, Children 6-59 months, Infectious diseases, Genetics.

International Journal for Equity in Health, 2013

Introduction: The prevalence of undernutrition, which is closely associated with socioeconomic and sanitation conditions, is often higher among indigenous than non-indigenous children in many countries. In Brazil, in spite of overall reductions in the prevalence of undernutrition in recent decades, the nutritional situation of indigenous children remains worrying. The First National Survey of Indigenous People's Health and Nutrition in Brazil, conducted in 2008-2009, was the first study to evaluate a nationwide representative sample of indigenous peoples. This paper presents findings from this study on the nutritional status of indigenous children < 5 years of age in Brazil. Methods: A multi-stage sampling was employed to obtain a representative sample of the indigenous population residing in villages in four Brazilian regions (North, Northeast, Central-West, and Southeast/South). Initially, a stratified probabilistic sampling was carried out for indigenous villages located in these regions. Households in sampled villages were selected by census or systematic sampling depending on the village population. The survey evaluated the health and nutritional status of children < 5 years, in addition to interviewing mothers or caretakers. Results: Height and weight measurements were taken of 6,050 and 6,075 children, respectively. Prevalence rates of stunting, underweight, and wasting were 25.7%, 5.9%, and 1.3%, respectively. Even after controlling for confounding, the prevalence rates of underweight and stunting were higher among children in the North region, in low socioeconomic status households, in households with poorer sanitary conditions, with anemic mothers, with low birthweight, and who were hospitalized during the prior 6 months. A protective effect of breastfeeding for underweight was observed for children under 12 months. Conclusions: The elevated rate of stunting observed in indigenous children approximates that of non-indigenous Brazilians four decades ago, before major health reforms greatly reduced its occurrence nationwide. Prevalence rates of undernutrition were associated with socioeconomic variables including income, household goods, schooling, and access to sanitation services, among other variables. Providing important baseline data for future comparison, these findings further suggest the relevance of social, economic, and environmental factors at different scales (local, regional, and national) for the nutritional status of indigenous peoples.

In this study, I studied the Assessment of Nutritional status under five years old Children in Hamar Jajab IDPs. The major objective of the study was to know nutritional status for the Children IDPs who are the most Vulnerable and susceptible to became Malnourished then others. Using Simple random sampling technique, I selected 50 respondents from 200 Households live in IDP Camp in Hamar Jajab District Mogadishu-Somalia with the use of questionnaire as instrument; Data was analyzed using descriptive statistics of mean and frequency (percentage). Results: Number of screened children was 50, 4% ware Severe Acute malnutrition (SAM), 14% were Moderate Acute Malnutrition (MAM) and 82% were Normal based on the findings, the researcher suggests that, make it sustainable for current Nutrition programmes existing with inclusive development projects for the IDPs such income generation activities to be self reliance. The research also concludes that most of Mothers doesn’t well understand the necessary need of child nutrition. So that in this study I recommended that this needs extra researchers should launch researches on Nutritional Status as to check, intervene or minimize the effects may result from malnutrition in community through mobilizing and health education for community workers, and Make free from harmful.

Journal of Food and Nutrition Sciences

Malnutrition, poor child feeding practices and low dietary diversity are common in low income households, where food insecurity is prevalent. Therefore, this study was designed to assess and compare nutritional status, feeding practices and dietary diversity scores of children (aged 2-5 years) in food secure and insecure households of Kuyu woreda. A community based comparative, cross sectional study was conducted in March, 2016. Multi stages sampling methods were employed to select 612 children, out of which 304 children were from food secure and 308 from insecure households. Dietary diversity score was assessed using a 24 hrs recall method. Anthropometric measurements of children were taken and nutritional status was generated using WHO Anthro v.3.2.2. Statistical Package for Social Sciences (SPSS) version 20.0 was used to perform descriptive statistics, independent samples T test and chi-square test analyses. P value <0.05 was considered as statistically significant. The prevalence of stunting, underweight and wasting was 48.7%, 36.7% and 20.5% respectively for children in food insecure households. While the prevalence of stunting was 43%, underweight 30.9% and wasting 16.8% for children in food secure households. Daily meal frequency; having breakfast, midmorning, afternoon and bedtime snack among children in food secure households were significantly higher than food insecure households (p<0.05). In addition, children restriction and pressure during meal were significantly (p<0.05) higher in food insecure households compared to their counterparts. Moreover, this study found that food secure and insecure households were significantly different in children's dietary diversity scores (x 2 =13.1, p<0.001), child feeding practices (x 2 =11.2, p= 0.001), consumption of dairy products (x 2 =15.44, p<0.001) and vitamin A rich fruits and vegetables (x 2 =8.37, p=0.004). Most importantly, the study revealed that nutritional statuses of children from food secure households were significantly better compared to those from their counterparts. Therefore, all responsible bodies should support poor communities through providing foods or cash money to improve the nutritional status, child feeding practices and dietary diversity scores of children in the study area.

2020

Background: Globally, stunting affects over 161 million children under the age of ve, and one million deaths each year. Stunting hits hard on African and Asian children. In Ethiopia, the level of stunting is critically high and remains a major public health challenge among those under the age of ve. Numerous factors such as poor maternal health and nutrition, inadequate feeding practices for infants and young children, de ciencies in micronutrients, infections and environmental health conditions are related to stunting. There is, however, dearth of evidence in Ethiopia's pastoral populations. Methods: A community-based cross-sectional study was conducted from 2-31 January 2018 to assess the prevalence and associated factors of stunting among children 6-59 months of age in Dubti District, Afar Region, north East Ethiopia. For this study, a total of 554 children were included, and multi-stage sampling technique was used to select the study participants. Data was entered in EPI-Info version 7.2 and height for age was converted to Z-score with WHO Anthro software. A binary logistic regression analysis was conducted to identify factors associated with stunting. The signi cance of the associations was determined at p-value < 0.05 and the adjusted odds ratio at 95% CI was calculated to evaluate the strength of the associations. Results: The prevalence of stunting was 39.5% (95% CI: 35.4-43.5%). The odds of stunting was increased, so does age of the child increased as compared to 6-11 months of children. Initiating breast feeding after 1 hour after birth (AOR = 1.99; 95% CI: 1.22, 3.23), not exclusively breast feeding for at least 6 months (AOR = 2.57; 95% CI: 1.49, 4.42), poor dietary diversity (AOR = 1.93; 95% CI: 1.03, 3.62), and using unprotected water sources for drinking (AOR = 1.68; 95% CI: 1.21, 2.94) were signi cant factors. Conclusion: Stunting levels in pastorals was critically high among children aged 6-59 months. The study showed that stunting was associated with different nutritional and non-nutritional factors. Intersectoral coordination is required to tackle stunting by enhancing the community's safe water supply, optimal breast feeding practice, food diversity and economic status.