Multi-country analysis of the effects of diarrhoea on childhood stunting

PubMed Central

Checkley, William; Buckley, Gillian; Gilman, Robert H; Assis, Ana MO; Guerrant, Richard L; Morris, Saul S; Mølbak, Kåre; Valentiner-Branth, Palle; Lanata, Claudio F; Black, Robert E

2008-01-01

Diarrhoea is an important cause of death and illness among children in developing countries; however, it remains controversial as to whether diarrhoea leads to stunting. We conducted a pooled analysis of nine studies that collected daily diarrhoea morbidity and longitudinal anthropometry to determine the effects of the longitudinal history of diarrhoea prior to 24 months on stunting at age 24 months. Data covered a 20-year period and five countries. We used logistic regression to model the effect of diarrhoea on stunting. The prevalence of stunting at age 24 months varied by study (range 21–90%), as did the longitudinal history of diarrhoea prior to 24 months (incidence range 3.6–13.4 episodes per child-year, prevalence range 2.4–16.3%). The effect of diarrhoea on stunting, however, was similar across studies. The odds of stunting at age 24 months increased multiplicatively with each diarrhoeal episode and with each day of diarrhoea before 24 months (all P < 0.001). The adjusted odds of stunting increased by 1.13 for every five episodes (95% CI 1.07–1.19), and by 1.16 for every 5% unit increase in longitudinal prevalence (95% CI 1.07–1.25). In this assembled sample of 24-month-old children, the proportion of stunting attributed to ≥5 diarrhoeal episodes before 24 months was 25% (95% CI 8–38%) and that attributed to being ill with diarrhoea for ≥2% of the time before 24 months was 18% (95% CI 1–31%). These observations are consistent with the hypothesis that a higher cumulative burden of diarrhoea increases the risk of stunting. PMID:18567626

Determinants of childhood stunting in the Democratic Republic of Congo: further analysis of Demographic and Health Survey 2013-14.

PubMed

Kismul, Hallgeir; Acharya, Pawan; Mapatano, Mala Ali; Hatløy, Anne

2017-08-01

Prevalence of child stunting in the Democratic Republic of Congo (DRC) is among the highest in the world. There is a need to systematically investigate how stunting operates at different levels of determination and identify major factors contributing to the development of stunting. The aim of this study was to look for key determinants of stunting in the DRC. This study used data from the DRC Demographic Health Survey 2013-14 which included anthropometric measurement for 9030 under 5 year children. Height-for-Age Z score was calculated and classified according to the WHO guideline. The association between stunting and bio-demographic characteristics was assessed using logistic regression. Prevalence of stunting was much higher in boys than girls. There was a significant rural urban gap in the prevalence of stunting with rural areas having a larger proportion of children living with stunting than urban. Male children, older than 6 months, preceding birth interval less than 24 months, being from lower wealth quintiles had the highest odds of stunting. Several provinces had in particular high odds of stunting. Early initiation of breastfeeding, mother's age more than 20 years at the time of delivery had lower odds of stunting. The taller the mother the less likely the child was to be stunted. Similarly, mother's BMI, access to safe water, access to hygienic toilet, mother's education were found negatively correlated with child stunting in the bivariate logistic regression, but they lost statistical significance in multivariate analysis together with numbers of children in the family and place of residence. Child stunting is widespread in the DRC and increasing prevalence is worrisome. This study has identified modifiable factors determining high prevalence of stunting in the DRC. Policy implementation should in particular target provinces with high prevalence of stunting and address modifiable determinants such as reducing socioeconomic disparity. Nutrition promotion intervention, including early initiation of breastfeeding should be an immediate priority.

Measuring Socioeconomic Inequalities With Predicted Absolute Incomes Rather Than Wealth Quintiles: A Comparative Assessment Using Child Stunting Data From National Surveys.

PubMed

Fink, Günther; Victora, Cesar G; Harttgen, Kenneth; Vollmer, Sebastian; Vidaletti, Luís Paulo; Barros, Aluisio J D

2017-04-01

To compare the predictive power of synthetic absolute income measures with that of asset-based wealth quintiles in low- and middle-income countries (LMICs) using child stunting as an outcome. We pooled data from 239 nationally representative household surveys from LMICs and computed absolute incomes in US dollars based on households' asset rank as well as data on national consumption and inequality levels. We used multivariable regression models to compare the predictive power of the created income measure with the predictive power of existing asset indicator measures. In cross-country analysis, log absolute income predicted 54.5% of stunting variation observed, compared with 20% of variation explained by wealth quintiles. For within-survey analysis, we also found absolute income gaps to be predictive of the gaps between stunting in the wealthiest and poorest households (P < .001). Our results suggest that absolute income levels can greatly improve the prediction of stunting levels across and within countries over time, compared with models that rely solely on relative wealth quintiles.

Feeding patterns and stunting during early childhood in rural communities of Sidama, South Ethiopia

PubMed Central

Tessema, Masresha; Belachew, Tefera; Ersino, Getahun

2013-01-01

Introduction The period from birth to two years of age is a “critical window” of opportunity for the promotion of optimal growth, health and behavioral development of children. Poor child feeding patterns combined with household food insecurity can lead to malnutrition which is a major public health problem in developing countries like Ethiopia. Methods A community based cross-sectional study that involved 575 participants from rural Sidama was conducted from February to March 2011. A two-stage stratified sampling procedure was employed to select the required households. Multivariable logistic regression analyses were performed to compare stunting by feeding patterns and other characteristics. Results Only 14.4% of mothers fed their children optimally. Prevalence of stunting was higher for infants aged 6 to 8 months (43%) than for those in 0-5 months (26.6%) or 9-23 months (39%) category. Women who did not receive antenatal care(ANC) during pregnancy were 1.5 times more likely to practice pre-lacteal feeding and 2.8 and 1.9 times more likely to feed their children below minimum dietary diversity and minimum meal frequency, respectively (P=0.01). Mothers older than 18 years during the birth of index child were 86% less likely to feed their child below minimum meal frequency than their younger counterparts (P=0.01). Children who started complementary food either before or after the recommended 6 months time, were more likely to be stunted (P=0.01). Conclusion The feeding practices of most mothers did not meet WHO recommendations. Behavior change communication about the importance of optimal complementary feeding and ANC attendance should be strengthened through extensive use of the Health Extension Workers to reduce the level of child stunting in the study area. PMID:23646211

Association between chronic undernutrition and hypertension.

PubMed

Sawaya, Ana L; Sesso, Ricardo; Florêncio, Telma M de Menezes Toledo; Fernandes, Maria T B; Martins, Paula A

2005-07-01

In developing countries nutritional deficit during prenatal and continuing in post-natal life is very common. This condition leads to stunting and important metabolic changes. Over 30% of children in the world are stunted. The metabolic resultants of nutritional deficit during growth are classically known to aim at energy conservation. This review summarizes data from Brazil, a developing country undergoing the double burden of obesity and undernutrition, especially among the poor, and suggests that stunting or chronic undernutrition increases the risk of obesity and hypertension later in life. Around 60 million people are under the poverty line in Brazil. In São Paulo, the richest city of the country, 20% of the population live in slums and in Maceió, the capital of one of the poorest states, this percentage reaches 50%. Undernutrition in this population is around 20% among children, with high frequency of infections, anemia, and parasitic infestations, associated with poor sanitation. Among stunted adolescents, we found a high prevalence of hypertension (21%) that is a considerably higher estimate compared to non-stunted adolescents (less than 10%). The prevalence of hypertension in undernourished pre-school children, or in those who recovered from undernutrition, was higher than that in controls (29%, 20% and 2%, respectively, P < 0.001). Among stunted adults eating no more than 66% of the requirements (adjusted for stature), overweight/obesity was 35% in women and 25% in men. The prevalence of hypertension was 44% among stunted women and 18% among stunted men. Fifty per cent of stunted and obese women had hypertension. These data reinforce the important association between undernutrition and hypertension from childhood through adulthood. Health policies for preventing and combating childhood undernutrition should have an impact on the morbidity and mortality related to hypertension during adulthood.

A review of child stunting determinants in Indonesia.

PubMed

Beal, Ty; Tumilowicz, Alison; Sutrisna, Aang; Izwardy, Doddy; Neufeld, Lynnette M

2018-05-17

Child stunting reduction is the first of 6 goals in the Global Nutrition Targets for 2025 and a key indicator in the second Sustainable Development Goal of Zero Hunger. The prevalence of child stunting in Indonesia has remained high over the past decade, and at the national level is approximately 37%. It is unclear whether current approaches to reduce child stunting align with the scientific evidence in Indonesia. We use the World Health Organization conceptual framework on child stunting to review the available literature and identify what has been studied and can be concluded about the determinants of child stunting in Indonesia and where data gaps remain. Consistent evidence suggests nonexclusive breastfeeding for the first 6 months, low household socio-economic status, premature birth, short birth length, and low maternal height and education are particularly important child stunting determinants in Indonesia. Children from households with both unimproved latrines and untreated drinking water are also at increased risk. Community and societal factors-particularly, poor access to health care and living in rural areas-have been repeatedly associated with child stunting. Published studies are lacking on how education; society and culture; agriculture and food systems; and water, sanitation, and the environment contribute to child stunting. This comprehensive synthesis of the available evidence on child stunting determinants in Indonesia outlines who are the most vulnerable to stunting, which interventions have been most successful, and what new research is needed to fill knowledge gaps. © 2018 The Authors. Maternal and Child Nutrition Published by John Wiley & Sons, Ltd.

Is there a threshold level of maternal education sufficient to reduce child undernutrition? Evidence from Malawi, Tanzania and Zimbabwe.

PubMed

Makoka, Donald; Masibo, Peninah Kinya

2015-08-22

Maternal education is strongly associated with young child nutrition outcomes. However, the threshold of the level of maternal education that reduces the level of undernutrition in children is not well established. This paper investigates the level of threshold of maternal education that influences child nutrition outcomes using Demographic and Health Survey data from Malawi (2010), Tanzania (2009-10) and Zimbabwe (2005-06). The total number of children (weighted sample) was 4,563 in Malawi; 4,821 children in Tanzania; and 3,473 children in Zimbabwe Demographic and Health Surveys. Using three measures of child nutritional status: stunting, wasting and underweight, we employ a survey logistic regression to analyse the influence of various levels of maternal education on child nutrition outcomes. In Malawi, 45% of the children were stunted, 42% in Tanzania and 33% in Zimbabwe. There were 12% children underweight in Malawi and Zimbabwe and 16% in Tanzania.The level of wasting was 6% of children in Malawi, 5% in Tanzania and 4% in Zimbabwe. Stunting was significantly (p values < 0.0001) associated with mother's educational level in all the three countries. Higher levels of maternal education reduced the odds of child stunting, underweight and wasting in the three countries. The maternal threshold for stunting is more than ten years of schooling. Wasting and underweight have lower threshold levels. These results imply that the free primary education in the three African countries may not be sufficient and policies to keep girls in school beyond primary school hold more promise of addressing child undernutrition.

Determinants of stunting among children aged 6-59 months at Kindo Didaye woreda, Wolaita Zone, Southern Ethiopia: Unmatched case control study

PubMed Central

Batiro, Bancha; Demissie, Tsegaye; Halala, Yoseph

2017-01-01

Background Stunting is a well-established risk marker of poor child development. Globally in 2017, 155 million children under 5 were estimated to be stunted. While different activities are being done to reduce the burden of stunted growth, the problem is overwhelming in Africa; it was increased by 24%. Therefore, identifying determinants of stunting among children aged 6–59 would help to set priorities for action and to the design of stunting reduction plan at a grassroots level. Methods The unmatched case-control study was conducted in randomly selected 8 rural kebeles of Kindo Didaye woreda, Ethiopia from February to April, 2016 to identify the determinants of stunting among children aged 6–59 months. The sampling frame was identified by enumeration of 6–59 months of age children in the entire households of the study area. From which 155 as cases and 310 as controls were chosen using anthropometric measurement based on the median of WHO 2006 reference population. The anthropometric data were analyzed by WHO Anthro 2010 software to generate Z-score values. Odds Ratio along with 95% confidence interval was estimated to identify determinants of stunting using the multivariable logistic regression. Results Drinking water from unsafe source (AOR = 7.06, 95% CI; 4.40–20.42),occasionally eating animal source food (AOR = 0.51, 95% CI; 0.02–0.68), ARI in the past two weeks (AOR = 3.04, (95% CI; 1.04–13.35), late initiation of breastfeeding after one hours after birth (AOR = 5.16, 95% CI; 2.24–15.90) and lack of vaccination (AOR = 6.38, 95% CI; 2.54–17.10)were significantly associated with stunting. Conclusions Factors like exposure to diarrhea disease, exposure to acute respiratory infection, late initiation of breast milk after child breath, squeeze out of 1st breast milk, lack of vaccination, animal source of food, and unsafe source of water for drinking could be used to set priorities for action and to the design of Kindo Didaye woreda plan for stunting reduction down to grassroots level. Therefore, zonal health department and Kindo Didaye woreda health office should promote the importance of colostrums feeding. Drinking water should be decontaminated. Expansion of vaccination program to enhance herd immunity at the community level is important. PMID:29261680

Determinants of overweight with concurrent stunting among Ghanaian children.

PubMed

Atsu, Benedicta K; Guure, Chris; Laar, Amos K

2017-07-27

Malnutrition (undernutrition and overnutrition) is a major public health problem in Ghana -affecting growth and development of individuals and the nation. Stunting and overweight are of particular interest, as recent national surveys show a rising trend of overnutrition and stubbornly high burden of stunting among Ghanaian children. There are currently no data on the simultaneous occurrence of overweight and stunting within individuals in Ghana. This paper presents the burden, the individual-level, and contextual determinants of overweight with concurrent stunting among Ghanaian children. This study analyzed data set of the fourth round of the Ghana Multiple Indicator Cluster Survey (MICS4). Bivariate analyses were used to describe selected characteristics of survey respondents and their children. Hierarchical modelling approach facilitated identification of significant distal, intermediate and proximal factors/determinants of concurrent stunting and overweight. Both crude and adjusted prevalence ratios via a multivariable Poison regression model with their corresponding 95% Confidence Intervals (CI) are reported. Variables with p ≤ 0.25 at the bivariate level were included in the multivariable analysis. An alpha value of 5% was used to indicate significance. Of 7550 cases (children) analyzed, the prevalence of stunting was 27.5%; underweight was 17.3%; and wasting was 7.7%. The prevalence of overweight and concurrent overweight and stunting were respectively 2.4% and 1.2%. Children who belonged to the fourth wealth quintile, were more likely to be overweight and concurrently stunted as against children belonging to the poorest quintile (aPR = 1.010; 95% CI, 1.003-1.017). Compared to religious (Christians/Muslim/Traditionalist) household heads, children whose household heads did not belong to any religion had 2 times the rates of the Overweight with concurrent stunting (PR = 2.024; 95% CI, 1.016-4.034). Children with mothers aged 20-34 and 35-49 had an increased though insignificant prevalence ratio of association (aPR = 1.001; 95% CI, 0.994-1.005) and (aPR = 1.001; 95% CI, 0.998-1.012) respectively. This analysis determined the prevalence of concurrent stunting and overweight among Ghanaian children to be 1.2%. Four contextual variables (breastfeeding status, religion, geographic region, and wealth index quintile) were associated with overweight with concurrent stunting. We conclude that, only contextual factors are predictive of DBM among children under five living in Ghana.

Trends in stunting and overweight in Peruvian pre-schoolers from 1991 to 2011: findings from the Demographic and Health Surveys.

PubMed

Urke, Helga Bjørnøy; Mittelmark, Maurice B; Valdivia, Martín

2014-11-01

To examine trends in stunting and overweight in Peruvian children, using 2006 WHO Multicentre Growth Reference Study criteria. Trend analyses using nationally representative cross-sectional surveys from Demographic and Health Surveys (1991-2011). We performed logistic regression analyses of stunting and overweight trends in sociodemographic groups (sex, age, urban-rural residence, region, maternal education and household wealth), adjusted for sampling design effects (strata, clusters and sampling weights). Peru. Children aged 0-59 months surveyed in 1991-92 (n 7999), 1996 (n 14 877), 2000 (n 11 754), 2007-08 (n 8232) and 2011 (n 8186). Child stunting declined (F(1, 5149) = 174·8, P ≤ 0·00) and child overweight was stable in the period 1991-2011 (F(1, 5147) = 0·4, P ≤ 0·54). Over the study period, levels of stunting were highest in rural compared with urban areas, the Andean and Amazon regions compared with the Coast, among children of low-educated mothers and among children living in households in the poorest wealth quintile. The trend in overweight rose among males in coastal areas (F(1, 2250) = 4·779, P ≤ 0·029) and among males in the richest wealth quintile (F(1, 1730) = 5·458, P ≤ 0·020). The 2011 levels of stunting and overweight were eight times and three and a half times higher, respectively, than the expected levels from the 2006 WHO growth standards. The trend over the study period in stunting declined in most sociodemographic subgroups. The trend in overweight was stable in most sociodemographic subgroups.

Determinants of child stunting in the Royal Kingdom of Bhutan: an in-depth analysis of nationally representative data

PubMed Central

Aguayo, Victor M; Badgaiyan, Nina; Paintal, Kajali

2015-01-01

Stunting is associated with poor survival and development in children. Our analysis identifies the factors most significantly associated with child stunting in Bhutan using a nationally representative sample of 2085 children 0–23 months old. We find that 27.5% of children were stunted and almost half (42.6%) of the stunted children were severely stunted. Children's mean height-for-age z-score deteriorated significantly with age (from −0.23 in infants 0–5 months old to −1.60 in children 18–23 months old) and levels of severe stunting were significantly higher among boys. Multivariate regression analysis indicates that children from the Eastern/Western regions had a 64% higher odds of being stunted than children from the Central region (OR 1.64; 95% CI 1.29–2.07); similarly, children from the two lower wealth quintiles had 37% higher odds of being stunted than children from the two upper wealth quintiles (OR 1.37; 95% CI 1.00–1.87). Children whose mothers received three or fewer antenatal care visits during the last pregnancy had a 31% higher odds of being stunted (OR 1.31; 95% CI 1.01–1.69) while children whose mothers did not receive antenatal care from a doctor, nurse or midwife had a 51% higher odds of being stunted (OR 1.51; 95% CI 1.18–1.92). Recommended complementary feeding practices tended to be associated with lower odds of stunting, particularly in the first year of life. Specifically, children who were not fed complementary foods at 6–8 months had about threefold higher odds of being severely stunted than children who were fed complementary foods (OR 2.73; 95% CI 1.06–7.02). PMID:25536283

Trends in inequalities in child stunting in South Asia.

PubMed

Krishna, Aditi; Mejía-Guevara, Iván; McGovern, Mark; Aguayo, Victor; Subramanian, S V

2017-10-19

We analysed socio-economic inequalities in stunting in South Asia and investigated disparities associated with factors at the individual, caregiver, and household levels (poor dietary diversity, low maternal education, and household poverty). We used time-series analysis of data from 55,459 children ages 6-23 months from Demographic and Health Surveys in Bangladesh, India, Nepal, and Pakistan (1991-2014). Logistic regression models, adjusted for age, sex, birth order, and place of residency, examined associations between stunting and multiple types of socio-economic disadvantage. All countries had high stunting rates. Bangladesh and Nepal recorded the largest reductions-2.9 and 4.1 percentage points per year, respectively-compared to 1.3 and 0.6 percentage points in India and Pakistan, respectively. Socio-economic adversity was associated with increased risk of stunting, regardless of disadvantage type. Poor children with inadequate diets and with poorly educated mothers experienced greater risk of stunting. Although stunting rates declined in the most deprived groups, socio-economic differences were largely preserved over time and in some cases worsened, namely, between wealth quintiles. The disproportionate burden of stunting experienced by the most disadvantaged children and the worsening inequalities between socio-economic groups are of concern in countries with substantial stunting burdens. Closing the gap between best and worst performing countries, and between most and least disadvantaged groups within countries, would yield substantial improvements in stunting rates in South Asia. To do so, greater attention needs to be paid to addressing the social, economic, and political drivers of stunting with targeted efforts towards the populations experiencing the greatest disadvantage and child growth faltering. © 2017 John Wiley & Sons Ltd.

Anaemia and malnutrition in children aged 0-59 months on the Bijagós Archipelago, Guinea-Bissau, West Africa: a cross-sectional, population-based study.

PubMed

Thorne, C J; Roberts, L M; Edwards, D R; Haque, M S; Cumbassa, A; Last, A R

2013-08-01

Childhood malnutrition is the leading risk factor for the global burden of disease. Guinea-Bissau is a politically unstable country with high levels of childhood malnutrition and mortality. To determine the nutritional status of children on three remote islands of the Bijagós Archipelago, Bubaque, Rubane and Soga, and to identify factors associated with malnutrition and anaemia in this population in order to provide a baseline for future public health interventions. A cross-sectional, population-based, door-to-door household survey of randomly selected households was undertaken to collect data on children aged 0-59 months (n = 872). Dietary information was collected using a validated questionnaire. Anthropometric measurements were collected using World Health Organization techniques. Capillary blood samples were analysed using a Hemocue®, with anaemia defined as Hb<11 g/dl. The prevalences of stunted, wasted and underweight children were 21.8%, 9.4% and 3.7%, respectively. These figures indicate moderate chronic malnutrition. The significant predictor variables for stunting were: age in months (OR 1.03), rural residence (OR 2.32), anaemia (OR 3.55) and residence on Soga island (OR 0.44). Stunting was more prevalent in males (25.4%) than in females (18.6%) (P = 0.03). The prevalence of anaemia was 80.2%. Age (OR 0.96), male gender (OR 1.81) and stunting (OR 2.87) were significant predictors. The Minimum Acceptable Diet was achieved by only 8.7% of children. The prevalence of malnutrition on the Bijagós Archipelago is less than half that on the mainland. This study is the first to determine the prevalence of anaemia in Guinea-Bissau, which, at 80.2%, is of severe public health concern. Future research should focus on the aetiology of stunting and anaemia, especially the contribution of infectious diseases and mother-child interaction. Iron supplementation should be strongly considered in this population.

Differences of Fundamental Motor Skills Stunting and Non Stunting Preschool Children in Kindergarten in North Padang

NASA Astrophysics Data System (ADS)

Komaini, A.; Mardela, R.

2018-04-01

The problem that emerged is based on the result of research done by the writer in kindergarten in North Padang Sub-district which concluded that: there were kindergarten students in this sub-district who were still lack of motor ability, research data shows that 59 people (37,34%) and then 34 people (21, 52%) were in very good category, 35 people (22.15%), were in moderate category, 22 people (13.92%) were in the poor category, and 5 (5,06%) were in the very poor category. Based on this data, the authors thought that the dominant factors that affect the above situation was a nutritional factor. It could be seen from the physical appearance of kindergarten children who tend to slow growth. The purpose of this study is to explain the description and differences in stunting and non stunting Fundamental motor skills capabilities in early childhood (preschool) children. This research is comparative study with cross sectional approach. The population in this study was the students of Kindergarten of Perwari II which consisted of 60 people consisting of 37 children of stunting and 23 non stunting children in Kindergarten of North Padang Sub district, the sample was taken as a whole. The data were collected with Fundamental motor skills tests including jumping, walking, running, balance exercises, throwing and catching the ball. Technique of data analysis in this research was descriptive statistic. The result of data analysis shows that there is difference of Fundamental motor skills between stunting and non stunting children. Fundamental motor skills of non stunting or normal children are better than those who were stunting or short. While the results of Fundamental motor skills of kindergarten children in North Padang District as a whole is at a good level.

The double burden of malnutrition in indigenous and nonindigenous Guatemalan populations.

PubMed

Ramirez-Zea, Manuel; Kroker-Lobos, Maria F; Close-Fernandez, Regina; Kanter, Rebecca

2014-12-01

As the prevalence of obesity increases in developing countries, the double burden of malnutrition (DBM) has become a public health problem, particularly in countries such as Guatemala with a high concentration of indigenous communities where the prevalence of stunting remains high. The aim was to describe and analyze the prevalence of DBM over time (1998-2008) in indigenous and nonindigenous Guatemalan populations. We used 3 National Maternal and Child Health Surveys conducted in Guatemala between 1998 and 2008 that include anthropometric data from children aged 0-60 mo and women of reproductive age (15-49 y). We assessed the prevalence of childhood stunting and both child and adult female overweight and obesity between 1998 and 2008. For the year 2008, we assessed the prevalence of DBM at the household (a stunted child and an overweight mother) and individual (stunting/short stature and overweight or anemia and overweight in the same individual) levels and compared the expected and observed prevalence rates to test if the coexistence of the DBM conditions corresponded to expected values. Between 1998 and 2008, the prevalence of childhood stunting decreased in both indigenous and nonindigenous populations, whereas overweight and obesity in women increased faster in indigenous populations than in nonindigenous populations (0.91% compared with 0.38%/y; P-trend < 0.01). In 2008, the prevalence of stunted children was 28.8 percentage points higher and of overweight women 4.6 percentage points lower in indigenous compared with nonindigenous populations (63.7% compared with 34.9% and 46.7% compared with 51.3%, respectively). DBM at the household and individual levels was higher in indigenous populations and was higher in geographic areas in which most of the population was indigenous, where there was also a greater prevalence of stunting and DBM at the individual level, both in women and children. In Guatemala, DBM is more prevalent in indigenous than in nonindigenous populations at the household and individual levels. To enhance effectiveness, current strategies of national policies and programs should consider DBM and focus on indigenous populations. © 2014 American Society for Nutrition.

Determinants of stunting and severe stunting among Burundian children aged 6-23 months: evidence from a national cross-sectional household survey, 2014.

PubMed

Nkurunziza, Sandra; Meessen, Bruno; Van Geertruyden, Jean-Pierre; Korachais, Catherine

2017-07-25

Burundi is one of the poorest countries and is among the four countries with the highest prevalence of stunting (58%) among children aged less than 5 years. This situation undermines the economic growth of the country as undernutrition is strongly associated with less schooling and reduced economic productivity. Identifying the determinants of stunting and severe stunting may help policy-makers to direct the limited Burundian resources to the most vulnerable segments of the population, and thus make it more cost effective. This study aimed to identify predictors of stunting and severe stunting among children aged less than two years in Burundi. The sample is made up of 6199 children aged 6 to 23 months with complete anthropometric measurements from the baseline survey of an impact evaluation study of the Performance-Based financing (PBF) scheme applied to nutrition services in Burundi from 2015 to 2017. Binary and multivariable logistic regression analyses were used to examine stunting and severe stunting against a set of child, parental and household variables such as child's age or breastfeeding pattern, mother's age or knowledge of malnutrition, household size or socio-economic status. The prevalence of stunting and severe stunting were 53% [95%CI: 51.8-54.3] and 20.9% [95%CI: 19.9-22.0] respectively. Compared to children from 6-11 months, children of 12-17 months and 18-23 months had a higher risk of stunting (AdjOR:2.1; 95% CI: 1.8-2.4 and 3.2; 95% CI: 2.8-3.7). Other predictors for stunting were small babies (AdjOR=1.5; 95% CI: 1.3-1.7 for medium-size babies at birth and AdjOR=2.9; 95% CI: 2.4-3.6 for small-size babies at birth) and male children (AdjOR=1.5, 95% CI: 1.4-1.8). In addition, having no education for mothers (AdjOR=1.6; 95% CI: 1.2-2.1), incorrect mothers' child nutrition status assessment (AdjOR=3.3; 95% CI: 2.8-4), delivering at home (AdjOR=1.4; 95% CI: 1.2-1.6) were found to be predictors for stunting. More than to 2 under five children in the household (AdjOR=1.45; 95% CI: 1.1-1.9 for stunting and AdjOR= 1.5; 95% CI: 1.2-1.9 for severe stunting) and wealth were found to be predictors for both stunting and severe stunting. The factors associated with stunting were found to be applicable for severe stunting as well. Mother's education level, mother's knowledge about child nutrition status assessment and health facility delivery were predictors of child stunting. Our study confirms that stunting and severe stunting is in Burundi, as elsewhere, a multi-sectorial problem. Some determinants relate to the general development of Burundi: education of girls, poverty, and food security; will be addressed by a large array of actions. Some others relate to the health sector and its performance - we think in particular of the number of children under five in the household (birth spacing), the relationship with the health center and the knowledge of the mother on malnutrition. Our findings confirm that the Ministry of Health and its partners should strive for better performing and holistic nutrition services: they can contribute to better nutrition outcomes.

Assessing comorbidity and correlates of wasting and stunting among children in Somalia using cross-sectional household surveys: 2007 to 2010

PubMed Central

Kinyoki, Damaris K; Kandala, Ngianga-Bakwin; Manda, Samuel O; Krainski, Elias T; Fuglstad, Geir-Arne; Moloney, Grainne M; Berkley, James A; Noor, Abdisalan M

2016-01-01

Objective Wasting and stunting may occur together at the individual child level; however, their shared geographic distribution and correlates remain unexplored. Understanding shared and separate correlates may inform interventions. We aimed to assess the spatial codistribution of wasting, stunting and underweight and investigate their shared correlates among children aged 6–59 months in Somalia. Setting Cross-sectional nutritional assessments surveys were conducted using structured interviews among communities in Somalia biannually from 2007 to 2010. A two-stage cluster sampling methodology was used to select children aged 6–59 months from households across three livelihood zones (pastoral, agropastoral and riverine). Using these data and environmental covariates, we implemented a multivariate spatial technique to estimate the codistribution and divergence of the risks and correlates of wasting and stunting at the 1×1 km spatial resolution. Participants 73 778 children aged 6–59 months from 1066 survey clusters in Somalia. Results Observed pairwise child level empirical correlations were 0.30, 0.70 and 0.73 between weight-for-height and height-for-age; height-for-age and weight-for-age, and weight-for-height and weight-for-age, respectively. Access to foods with high protein content and vegetation cover, a proxy of rainfall or drought, were associated with lower risk of wasting and stunting. Age, gender, illness, access to carbohydrates and temperature were correlates of all three indicators. The spatial codistribution was highest between stunting and underweight with relative risk values ranging between 0.15 and 6.20, followed by wasting and underweight (range: 0.18–5.18) and lowest between wasting and stunting (range: 0.26–4.32). Conclusions The determinants of wasting and stunting are largely shared, but their correlation is relatively variable in space. Significant hotspots of different forms of malnutrition occurred in the South Central regions of the country. Although nutrition response in Somalia has traditionally focused on wasting rather than stunting, integrated programming and interventions can effectively target both conditions to alleviate common risk factors. PMID:26962034

Assessing comorbidity and correlates of wasting and stunting among children in Somalia using cross-sectional household surveys: 2007 to 2010.

PubMed

Kinyoki, Damaris K; Kandala, Ngianga-Bakwin; Manda, Samuel O; Krainski, Elias T; Fuglstad, Geir-Arne; Moloney, Grainne M; Berkley, James A; Noor, Abdisalan M

2016-03-09

Wasting and stunting may occur together at the individual child level; however, their shared geographic distribution and correlates remain unexplored. Understanding shared and separate correlates may inform interventions. We aimed to assess the spatial codistribution of wasting, stunting and underweight and investigate their shared correlates among children aged 6-59 months in Somalia. Cross-sectional nutritional assessments surveys were conducted using structured interviews among communities in Somalia biannually from 2007 to 2010. A two-stage cluster sampling methodology was used to select children aged 6-59 months from households across three livelihood zones (pastoral, agropastoral and riverine). Using these data and environmental covariates, we implemented a multivariate spatial technique to estimate the codistribution and divergence of the risks and correlates of wasting and stunting at the 1 × 1 km spatial resolution. 73,778 children aged 6-59 months from 1066 survey clusters in Somalia. Observed pairwise child level empirical correlations were 0.30, 0.70 and 0.73 between weight-for-height and height-for-age; height-for-age and weight-for-age, and weight-for-height and weight-for-age, respectively. Access to foods with high protein content and vegetation cover, a proxy of rainfall or drought, were associated with lower risk of wasting and stunting. Age, gender, illness, access to carbohydrates and temperature were correlates of all three indicators. The spatial codistribution was highest between stunting and underweight with relative risk values ranging between 0.15 and 6.20, followed by wasting and underweight (range: 0.18-5.18) and lowest between wasting and stunting (range: 0.26-4.32). The determinants of wasting and stunting are largely shared, but their correlation is relatively variable in space. Significant hotspots of different forms of malnutrition occurred in the South Central regions of the country. Although nutrition response in Somalia has traditionally focused on wasting rather than stunting, integrated programming and interventions can effectively target both conditions to alleviate common risk factors. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Vitamin D status is associated with underweight and stunting in children aged 6-36 months residing in the Ecuadorian Andes.

PubMed

Mokhtar, Rana R; Holick, Michael F; Sempértegui, Fernando; Griffiths, Jeffrey K; Estrella, Bertha; Moore, Lynn L; Fox, Matthew P; Hamer, Davidson H

2017-11-22

There is limited knowledge on vitamin D status of children residing in the Andes and its association with undernutrition. We evaluated the vitamin D status of children residing in a low socio-economic status (SES) setting in the Ecuadorian Andes and assessed the association between vitamin D status, stunting and underweight. We hypothesized that children who were underweight would have lower serum 25-hydroxyvitamin D (25(OH)D) levels and lower 25(OH)D levels would be associated with a higher risk of stunting. We conducted a cross-sectional secondary analysis of a randomized controlled trial, the Vitamin A, Zinc and Pneumonia study. Children had serum 25(OH)D concentrations measured. A sensitivity analysis was undertaken to determine a vitamin D cut-off specific for our endpoints. Associations between serum 25(OH)D and underweight (defined as weight-for-age Z-score≤-1) and stunting (defined as height-for-age Z-score≤-2) were assessed using multivariate logistic regression. Children residing in five low-SES peri-urban neighbourhoods near Quito, Ecuador. Children (n 516) aged 6-36 months. Mean serum 25(OH)D concentration was 58·0 (sd 17·7) nmol/l. Sensitivity analysis revealed an undernutrition-specific 25(OH)D cut-off of <42·5 nmol/l; 18·6 % of children had serum 25(OH)D<42·5 nmol/l. Children who were underweight were more likely to have serum 25(OH)D<42·5 nmol/l (adjusted OR (aOR)=2·0; 95 % CI 1·2, 3·3). Children with low serum 25(OH)D levels were more likely to be stunted (aOR=2·8; 95 % CI 1·6, 4·7). Low serum 25(OH)D levels were more common in underweight and stunted Ecuadorian children.

Effect of parental formal education on risk of child stunting in Indonesia and Bangladesh: a cross-sectional study.

PubMed

Semba, Richard D; de Pee, Saskia; Sun, Kai; Sari, Mayang; Akhter, Nasima; Bloem, Martin W

2008-01-26

Child stunting is associated with poor child development and increased mortality. Our aim was to determine the effect of length of maternal and paternal education on stunting in children under the age of 5 years. Data for indicators of child growth and of parental education and socioeconomic status were gathered from 590,570 families in Indonesia and 395,122 families in Bangladesh as part of major nutritional surveillance programmes. The prevalence of stunting in families in Indonesia was 33.2%, while that in Bangladesh was 50.7%. In Indonesia, greater maternal formal education led to a decrease of between 4.4% and 5% in the odds of child stunting (odds ratio per year 0.950, 95% CI 0.946-0.954 in rural settings; 0.956, 0.950-0.961 in urban settings); greater paternal formal education led to a decrease of 3% in the odds of child stunting (0.970, 0.967-0.974). In Bangladesh, greater maternal formal education led to a 4.6% decrease in the odds of child stunting (0.954, 0.951-0.957), while greater paternal formal education led to a decrease of between 2.9% and 5.4% in the odds of child stunting (0.971, 0.969-0.974 in rural settings; 0.946, 0.941-0.951 in urban settings). In Indonesia, high levels of maternal and paternal education were both associated with protective caregiving behaviours, including vitamin A capsule receipt, complete childhood immunisations, better sanitation, and use of iodised salt (all p<0.0001). Both maternal and paternal education are strong determinants of child stunting in families in Indonesia and Bangladesh.

Early-life Determinants of Stunted Adolescent Girls and Boys in Matlab, Bangladesh

PubMed Central

Bosch, Alinda M.; Baqui, Abdullah H.; van Ginneken, Jeroen K.

2008-01-01

This paper presents the results of a longitudinal study, conducted in Matlab, Bangladesh, that examined to what extent the level of stunting in adolescence can be predicted by nutritional status in early childhood and maternal height. A linked set of data collected from the same individuals at two moments in time, i.e. early childhood (1988–1989) and adolescence (2001), was analyzed. The study found that the odds of being stunted in adolescence could be explained by the combined effect of being stunted in childhood and having a mother whose height was less than 145 cm. Also, girls were more likely than boys to be stunted in childhood, whereas boys were more likely than girls to be stunted in adolescence. The latter is probably attributable to differences in the pace of maturation. In terms of policy and (reproductive health) programmes, it is important to recall that adolescent girls whose height and weight were subnormal (weight <45 kg and height <145 cm) might run an obstetric risk. Following these cut-off points, 83% and 23% of 16-year-old girls in this study would face obstetric risk, respectively, for weight and height if they marry and become pregnant soon. PMID:18686552

ERECTA, salicylic acid, abscisic acid, and jasmonic acid modulate quantitative disease resistance of Arabidopsis thaliana to Verticillium longisporum.

PubMed

Häffner, Eva; Karlovsky, Petr; Splivallo, Richard; Traczewska, Anna; Diederichsen, Elke

2014-04-01

Verticillium longisporum is a soil-borne vascular pathogen infecting cruciferous hosts such as oilseed rape. Quantitative disease resistance (QDR) is the major control means, but its molecular basis is poorly understood so far. Quantitative trait locus (QTL) mapping was performed using a new (Bur×Ler) recombinant inbred line (RIL) population of Arabidopsis thaliana. Phytohormone measurements and analyses in defined mutants and near-isogenic lines (NILs) were used to identify genes and signalling pathways that underlie different resistance QTL. QTL for resistance to V. longisporum-induced stunting, systemic colonization by the fungus and for V. longisporum-induced chlorosis were identified. Stunting resistance QTL were contributed by both parents. The strongest stunting resistance QTL was shown to be identical with Erecta. A functional Erecta pathway, which was present in Bur, conferred partial resistance to V. longisporum-induced stunting. Bur showed severe stunting susceptibility in winter. Three stunting resistance QTL of Ler origin, two co-localising with wall-associated kinase-like (Wakl)-genes, were detected in winter. Furthermore, Bur showed a much stronger induction of salicylic acid (SA) by V. longisporum than Ler. Systemic colonization was controlled independently of stunting. The vec1 QTL on chromosome 2 had the strongest effect on systemic colonization. The same chromosomal region controlled the level of abscisic acid (ABA) and jasmonic acid (JA) in response to V. longisporum: The level of ABA was higher in colonization-susceptible Ler than in colonization-resistant Bur after V. longisporum infection. JA was down-regulated in Bur after infection, but not in Ler. These differences were also demonstrated in NILs, varying only in the region containing vec1. All phytohormone responses were shown to be independent of Erecta. Signalling systems with a hitherto unknown role in the QDR of A. thaliana against V. longisporum were identified: Erecta mediated resistance against V. longisporum-induced stunting. Independent of Erecta, stunting was caused in a light-dependent manner with possible participation of SA and Wakl genes. ABA and JA showed a genotype-specific response that corresponded with systemic colonization by the fungus. Understanding the biological basis of phenotypic variation in A. thaliana with respect to V. longisporum resistance will provide new approaches for implementing durable resistance in cruciferous crops.

Recessive resistance to Cucurbit yellow stunting disorder virus in melon TGR 1551

USDA-ARS?s Scientific Manuscript database

Cucurbit yellow stunting disorder virus (CYSDV) reduces melon (Cucumis melo L.) fruit quality and yield in many parts of the world. Host plant resistance of melon to CYSDV is a high priority for sustainable melon production in affected production areas. High-level resistance to CYSDV exhibited by TG...

Impact of early and concurrent stunting on cognition.

PubMed

Crookston, Benjamin T; Dearden, Kirk A; Alder, Stephen C; Porucznik, Christina A; Stanford, Joseph B; Merrill, Ray M; Dickerson, Ty T; Penny, Mary E

2011-10-01

Undernutrition is associated with poor cognitive development, late entry into school, decreased years of schooling, reduced productivity and smaller adult stature. We use longitudinal data from 1674 Peruvian children participating in the Young Lives study to assess the relative impact of early stunting (stunted at 6-18 months of age) and concurrent stunting (stunted at 4.5-6 years of age) on cognitive ability. Anthropometric data were longitudinally collected for children at 6-18 months of age and 4.5-6 years of age at which time verbal and quantitative ability were also assessed. We estimate that an increase in concurrent height-for-age z-scores (HAZ) by one standard deviation was associated with an increase in a child's score on the Peabody Picture Vocabulary Test (PPVT) by 2.35 points [confidence interval (CI): 1.55-3.15] and a 0.16 point increase on the cognitive development assessment (CDA) (CI: 0.05-0.27). Furthermore, we report that the estimate for concurrent HAZ and PPVT is significantly higher than the estimate for early stunting and PPVT. We found no significant difference between early and concurrent estimates for HAZ and CDA. Children from older mothers, children whose mothers had higher education levels, children living in urban areas, children who attended pre-school, children with fewer siblings and children from wealthier backgrounds scored higher on both assessments. Cognitive skills of children entering school were associated with early stunting but the strongest association was found with concurrent stunting suggesting that interventions preventing linear growth faltering should not only focus on the under 2s but include children up to 5 years of age. © 2010 Blackwell Publishing Ltd.

Cauliflower is a new host of a subgroup 16SrVII-B phytoplasma associated with stunting disease

USDA-ARS?s Scientific Manuscript database

Cauliflower stunt has occurred with high levels of incidence and provoked significant yield reduction in Brazilian crops. Phytoplasmas belonging to the subgroups 16SrIII-J and 16SrXV-A were previously reported in association with the disease. In 2014, plants with typical symptoms of the disease were...

Individual and community levels of maternal autonomy and child undernutrition in India.

PubMed

Rajaram, Ramaprasad; Perkins, Jessica M; Joe, William; Subramanian, S V

2017-03-01

Investigate the relationship between maternal autonomy at multiple levels and the risk of child stunting, underweight, and wasting in India. Data were from a 2005-2006 nationally representative, cross-sectional sample of 51,555 children under 5 years from 29 states in India. Multilevel, multivariable, logistic regression analyses were used to estimate the odds of child stunting, underweight, and wasting in relation to maternal autonomy in healthcare, movement, and money at the individual level and community level, while adjusting for several child, maternal, and household factors. When only adjusting for child age and sex, children in communities with a high proportion of women with autonomy in healthcare, or movement, or money, separately, had a lower risk of being stunted, underweight, or wasted, separately. However, adjusting for other explanatory factors attenuated these relationships and made them statistically insignificant. Individual maternal autonomy in any of the three domains was not associated with any of the outcomes. The results suggest that caution should be taken when interpreting the direct relevance of maternal autonomy at both individual and community levels to measures of child undernutrition.

Interrelationship between growth and development in low and middle income countries.

PubMed

Martorell, Reynaldo; Nguyen, Phuong

2010-01-01

Early childhood growth failure is a significant public health problem in developing countries. We examine relationships between low birthweight and stunting with child development. Compared to children born with normal birthweight, low birth-weight children have substantially poorer cognitive and schooling outcomes later in life. Linear growth failure leading to stunting mostly occurs before age 2 years, with stunting in older children reflecting growth failure in early life. Many studies show that stunting is associated with poor mental and motor development in infants and with low scores in cognitive tests, increased frequency of behavioral problems and poor school achievement in older children. Very few studies have assessed the relative importance for development of prenatal vs. postnatal growth failure and even fewer have done so using appropriate statistical techniques. The limited evidence to date suggests growth during the first 2 years of life is more important than growth at any other time, including the prenatal period, for predicting later cognitive development, schooling and educational achievement. In conclusion, children in settings of poverty who experience growth failure prior to age 2 years have reduced potential to succeed in school and to be productive members of society. Copyright (c) 2010 S. Karger AG, Basel.

Stunting and soil-transmitted-helminth infections among school-age pupils in rural areas of southern China

PubMed Central

2010-01-01

Background Stunting and soil-transmitted helminth (STH) infections including ascariasis, trichuriasis and hookworm remain major public health problems in school-age pupils in developing countries. The objectives of this study were to determine the prevalence of stunting for children and its association with three major soil-transmitted helminths (STH) in rural areas of southern China. The study also aims to determine risk factors for stunting and to provide guidance on the prevention and control of stunting and STH infections for future studies in this field. Results A cross-sectional survey was carried out in the poor rural areas in Guangxi Autonomous Regional and Hainan Province where STH prevalence was higher between September and November 2009. Pupils were from 15 primary schools. All the school-age pupils aged between 9 and 12 years old (mean age 11.2 ± 3.2 years), from grades three to six took part in this study. Study contents include questionnaire surveys, physical examination and laboratory methods (stool checking for eggs of three major STH infections and haemoglobin determination was performed for the anaemia test). Finally 1031 school-age pupils took part in survey. The results showed that the overall prevalence of stunting (HAZ < 2SD) was 25.6%, based on the WHO Child Growth Standards (2007). Risk factors for stunting based on logistic regression analyses were: (1) STH moderate-to-heavy intensity infections (OR = 1.93;95%CI:1.19,3.11); (2) anaemia (OR = 3.26;95%CI: 2.02,5.27); (3) education level of mother (OR = 2.13; 95%CI: 1.39,3.25). The overall prevalence of major STH infections was 36.7%, STH moderate-to-heavy intensity infections was 16.7%. The overall prevalence of ascariasis, trichuriasis, hookworm and co-infection were 18.5%, 11.2%, 14.7% and 9.1% respectively. The prevalence of anaemic children (HB < 12 g/dl) was 13.1%. Conclusion The present study showed that stunting was highly prevalent among the study population and STH infection is one of the important risk factors for stunting, with moderate-to-heavy intensity infections being the main predictor of stunting. Hence, additional interventions measures such as to promote de-worming treatment, to enhance health education and to improve hygiene and sanitation in order to reduce stunting in this population, are needed throughout the primary school age group. PMID:20942948

Assessment of Nutritional Status of Infants Living in Arsenic-Contaminated Areas in Bangladesh and Its Association with Arsenic Exposure

PubMed Central

Milton, Abul Hasnat; Attia, John; Alauddin, Mohammad; McEvoy, Mark; McElduff, Patrick; Hussain, Sumaira; Akhter, Ayesha; Akter, Shahnaz; Islam, M. Munirul; Ahmed, AM Shamsir; Iyengar, Vasu; Islam, Md Rafiqul

2018-01-01

Data is scarce on early life exposure to arsenic and its association with malnutrition during infancy. This study followed the nutritional status of a cohort of 120 infants from birth to 9 months of age in an arsenic contaminated area in Bangladesh. Anthropometric data was collected at 3, 6 and 9 months of the infant’s age for nutritional assessment whereas arsenic exposure level was assessed via tube well drinking water arsenic concentration at the initiation of the study. Weight and height measurements were converted to Z-scores of weight for age (WAZ-underweight), height for age (HAZ-stunting), weight for height (WHZ-wasting) for children by comparing with WHO growth standard. Arsenic exposure levels were categorized as <50 μg/L and ≥50 μg/L. Stunting rates (<−2 SD) were 10% at 3 months and 44% at both 6 and 9 months. Wasting rates (<−2 SD) were 23.3% at 3 months and underweight rates (<−2 SD) were 25% and 10% at 3 and 6 months of age, respectively. There was a significant association of stunting with household drinking water arsenic exposure ≥50 μg/L at age of 9 months (p = 0.009). Except for stunting at 9 months of age, we did not find any significant changes in other nutritional indices over time or with levels of household arsenic exposure in this study. Our study suggests no association between household arsenic exposure and under-nutrition during infancy; with limiting factors being small sample size and short follow-up. Difference in stunting at 9 months by arsenic exposure at ≥50 μg/L might be a statistical incongruity. Further longitudinal studies are warranted to establish any association. PMID:29301293

[Coexistence of maternal overweight or obesity and stunted children in south-western Benin households].

PubMed

Dembélé, Bernard; Sossa Jérôme, Charles; Saizonou, Jacques; Makoutodé, Patrick Charles; Mongbo Adé, Virginie; Guedègbé Capo-Chichi, Justine; Dona Ouendo, Marius-Edgard

To determine the prevalence and determinants of coexistence of maternal overweight or obesity and stunted children (DBM / SCOM) in south-western Benin households. This cross-sectional study was carried out in June 2015 on 357 mother-child pairs randomly selected by a two-stage sampling technique in the city of Comè and its surroundings. Data on socio-economic factors, family, health care, dietary quality were collected by questionnaires, observation and documentary review. Anthropometric measurements were performed in mothers and children. A logistic regression analysis model was used to search for determinants of the coexistence of the two aspects of malnutrition. 19.3% of mothers were overweight and 5.7% were obese. 46% of children were stunted. The prevalence of DBM / SCOM was 11.5%. The main factors associated with DBM/SCOM were the child's age, the mother's occupation, ethnicity, social status and educational level, and the size, economic level, transportation means and food insecurity of the household. A high frequency of the coexistence of maternal overweight or obesity and stunting was observed in Comè households. Interventions based on the identified determinants are needed to act simultaneously on the double burden of malnutrition in Comè.

South Africa's nutritional transition: overweight, obesity, underweight and stunting in female primary school learners in rural KwaZulu-Natal, South Africa.

PubMed

Tathiah, N; Moodley, I; Mubaiwa, V; Denny, L; Taylor, M

2013-06-27

Malnutrition substantially impacts the health outcomes of children. Globally, the childhood prevalence of overweight and obesity has increased, while underweight and stunting (though decreasing) continues to pose a major public health challenge. In low- to middle-income countries, a mixed pattern of over- and undernutrition (nutritional transition) can exist in communities. To describe the prevalence of malnutrition among female learners in the Nongoma and Ceza districts in Zululand, KwaZulu-Natal (KZN). We performed a secondary analysis of anthropometric data collected during the 2011 HPV Vaccination Demonstration Project. School health teams, comprising trained nurses, measured the height (in cm) and weight (in kg) of 963 female learners in 31 primary schools. Internationally accepted standardised measures were used as cut-offs for defining overweight, obesity, underweight and stunting. We found evidence of both under- and overnutrition. Overall, 9% of female learners were overweight, 3.8% obese, 4% underweight and 9.2% stunted (using WHO/NCHS criteria). The highest levels of stunting were in the 11 - 12-year age groups, of underweight in the 10-year age group, of overweight and obesity in the 9 - 10-year age groups. Moreover, a proportion of underweight (17.4%), overweight (11.1%) and obese (22.9%) learners were also stunted. Our study describes the prevalence of overweight and obesity, wasting and stunting of female learners in KZN and suggests the presence of a nutritional transition in these rural communities; however, further studies are needed. Our findings emphasise the need for health promotion and education programs in schools.

Implications of stunting on morphology of freshwater fishes

USGS Publications Warehouse

Chizinski, C.J.; Pope, K.L.; Wilde, G.R.; Strauss, R.E.

2010-01-01

The purpose of this study was to assess morphological differences between stunted and non-stunted white perch Morone americana and green sunfish Lepomis cyanellus. Few female M. americana were captured; thus, morphological differences between adult males and juveniles were assessed for M. americana. Similarly, few immature (juvenile) L. cyanellus were captured for the stunted morphotype; thus, male and female morphological differences were assessed for L. cyanellus. Features of the head tended to be relatively larger in stunted fish of both species, whereas the mid-body tended to be relatively larger in non-stunted M. americana, but not in non-stunted L. cyanellus. Adult and juvenile morphology overlapped considerably in non-stunted M. americana, but there was a clear distinction between adult and juvenile morphology of stunted M. americana. There was little sexual dimorphism in shape in stunted L. cyanellus, whereas sexual dimorphism was evident in non-stunted L. cyanellus. It appears that selective forces imposed by predation and food limitation may contribute to morphological diversification between stunted and non-stunted fishes. ?? 2010 The Authors. Journal compilation ?? 2010 The Fisheries Society of the British Isles.

Effect of mother's education on child's nutritional status in the slums of Nairobi.

PubMed

Abuya, Benta A; Ciera, James; Kimani-Murage, Elizabeth

2012-06-21

Malnutrition continues to be a critical public health problem in sub-Saharan Africa. For example, in East Africa, 48 % of children under-five are stunted while 36 % are underweight. Poor health and poor nutrition are now more a characteristic of children living in the urban areas than of children in the rural areas. This is because the protective mechanism offered by the urban advantage in the past; that is, the health benefits that historically accrued to residents of cities as compared to residents in rural settings is being eroded due to increasing proportion of urban residents living in slum settings. This study sought to determine effect of mother's education on child nutritional status of children living in slum settings. Data are from a maternal and child health project nested within the Nairobi Urban Health and Demographic Surveillance System (NUHDSS). The study involves 5156 children aged 0-42 months. Data on nutritional status used were collected between October 2009 and January 2010. We used binomial and multiple logistic regression to estimate the effect of education in the univariable and multivariable models respectively. Results show that close to 40 % of children in the study are stunted. Maternal education is a strong predictor of child stunting with some minimal attenuation of the association by other factors at maternal, household and community level. Other factors including at child level: child birth weight and gender; maternal level: marital status, parity, pregnancy intentions, and health seeking behaviour; and household level: social economic status are also independently significantly associated with stunting. Overall, mothers' education persists as a strong predictor of child's nutritional status in urban slum settings, even after controlling for other factors. Given that stunting is a strong predictor of human capital, emphasis on girl-child education may contribute to breaking the poverty cycle in urban poor settings.

Effect of mother’s education on child’s nutritional status in the slums of Nairobi

PubMed Central

2012-01-01

Background Malnutrition continues to be a critical public health problem in sub-Saharan Africa. For example, in East Africa, 48 % of children under-five are stunted while 36 % are underweight. Poor health and poor nutrition are now more a characteristic of children living in the urban areas than of children in the rural areas. This is because the protective mechanism offered by the urban advantage in the past; that is, the health benefits that historically accrued to residents of cities as compared to residents in rural settings is being eroded due to increasing proportion of urban residents living in slum settings. This study sought to determine effect of mother’s education on child nutritional status of children living in slum settings. Methods Data are from a maternal and child health project nested within the Nairobi Urban Health and Demographic Surveillance System (NUHDSS). The study involves 5156 children aged 0–42 months. Data on nutritional status used were collected between October 2009 and January 2010. We used binomial and multiple logistic regression to estimate the effect of education in the univariable and multivariable models respectively. Results Results show that close to 40 % of children in the study are stunted. Maternal education is a strong predictor of child stunting with some minimal attenuation of the association by other factors at maternal, household and community level. Other factors including at child level: child birth weight and gender; maternal level: marital status, parity, pregnancy intentions, and health seeking behaviour; and household level: social economic status are also independently significantly associated with stunting. Conclusion Overall, mothers’ education persists as a strong predictor of child’s nutritional status in urban slum settings, even after controlling for other factors. Given that stunting is a strong predictor of human capital, emphasis on girl-child education may contribute to breaking the poverty cycle in urban poor settings. PMID:22721431

BMI, body fat and waist-to-height ratio of stunted v. non-stunted Indian children: a case-control study.

PubMed

Savanur, Mitravinda S; Ghugre, Padmini S

2016-06-01

To compare the BMI, body fat and waist-to-height ratio (WHtR) of stunted and non-stunted children following different growth trajectories from low socio-economic strata in Mumbai, India. Cross-sectional, case-control study. Weight, height, skinfold thicknesses and waist circumference were measured. Information regarding the duration of breast-feeding, age at initiation of complementary feeding and income was obtained. Birth weight was obtained from records. BMI, body fat, WHtR and change in weight sd were calculated. Children who were beneficiaries of anganwadis, Mumbai city, India. Three hundred and thirty children aged 2-4 years were selected in each of the stunted and non-stunted groups after matching for age and sex. After adjusting for birth weight, change in weight sd, duration of breast-feeding, age at complementary feeding initiation and income, stunted children had significantly higher body fat, WHtR and BMI than the non-stunted (P<0·01). The stunted and non-stunted children were classified based on their change in weight sd. Stunted children with no change in weight sd had higher mean body fat, BMI (P<0·01) and WHtR (P<0·05) than their non-stunted counterparts. In the catch-up growth group, stunted children had higher BMI and WHtR than the non-stunted (both P<0·001). In the catch-down growth group, stunted children had higher BMI than the non-stunted (P<0·001). Stunting was seen to increase the tendency of conserving body fat in young children. Such a tendency, if continued during later childhood and adolescence, can increase the risk of obesity and non-communicable diseases.

PREVALENCE AND DETERMINANTS OF STUNTING AMONG PRIMARY SCHOOL CHILDREN IN RURAL AND URBAN COMMUNITIES IN OBAFEMI OWODE LOCAL GOVERNMENT AREA, SOUTHWESTERN NIGERIA

PubMed Central

Adenuga, W.U.; Obembe, T.A.; Odebunmi, K.O.; Asuzu, M.C.

2017-01-01

Background: Studies on stunting in children have largely focused on the underfive, establishing it as a strong predictor of mortality in these children. Few studies have documented the prevalence or determinants of stunting among school children in southwestern Nigeria. The aim of the study was to determine the prevalence and predictors of stunting among selected primary school children in rural and urban communities of Obafemi Owode Local Government Area, Ogun State. Method: A cross-sectional study of rural and urban primary school children was conducted. An interviewer-administered questionnaire was used to collect information on respondents' and parents' socio-demographic characteristics. Stunting was defined as height-for-age less than two standard deviations from the median height-for-age of the standard World Health Organization reference population. Using EPI-INFO version 6.03, children were classified as stunted if z-scores of height-for-age were less than 2 standard deviations below the National Centre for Health statistics (NCHS)/WHO median. Height and weight were taken using a stadiometer and weighing scale respectively. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) Version 16.0 while predictors were determined using logistic regression at 95% level of significance. Results: A total of 1,160 primary school children were studied with 52.2% from rural schools. Males constituted 57.1% and 51.8% in the rural and urban school respectively. Prevalence of stunting among rural school children was 46.2%, and was significantly higher (p≤0.001) than among urban children at 33.8%. Younger children <10 years (OR: 0.088; 95CI: 0.052 - 0.150) and children between 11-12 years (OR: 0.534; 95CI: 0.322 - 0.886) were at a significantly lower risk of stunting both in rural schools compared to children >13 years. Conclusion: The prevalence of stunting was high especially among pupils from schools in the rural communities. This underscores the need for urgent feasible and effective nutrition programs for primary school children especially those in rural schools within the study area. PMID:28970765

A review of the evidence linking child stunting to economic outcomes.

PubMed

McGovern, Mark E; Krishna, Aditi; Aguayo, Victor M; Subramanian, S V

2017-08-01

To understand the full impact of stunting in childhood it is important to consider the long-run effects of undernutrition on the outcomes of adults who were affected in early life. Focusing on the costs of stunting provides a means of evaluating the economic case for investing in childhood nutrition. We review the literature on the association between stunting and undernutrition in childhood and economic outcomes in adulthood. At the national level, we also evaluate the evidence linking stunting to economic growth. Throughout, we consider randomized controlled trials (RCTs), quasi-experimental approaches and observational studies. Long-run evaluations of two randomized nutrition interventions indicate substantial returns to the programmes (a 25% and 46% increase in wages for those affected as children, respectively). Cost-benefit analyses of nutrition interventions using calibrated return estimates report a median return of 17.9:1 per child. Assessing the wage premium associated with adult height, we find that a 1-cm increase in stature is associated with a 4% increase in wages for men and a 6% increase in wages for women in our preferred set of studies which attempt to address unobserved confounding and measurement error. In contrast, the evidence on the association between economic growth and stunting is mixed. Countries with high rates of stunting, such as those in South Asia and sub-Saharan Africa, should scale up policies and programmes aiming to reduce child undernutrition as cost-beneficial investments that expand the economic opportunities of their children, better allowing them and their countries to reach their full potential. However, economic growth as a policy will only be effective at reducing the prevalence of stunting when increases in national income are directed at improving the diets of children, addressing gender inequalities and strengthening the status of women, improving sanitation and reducing poverty and inequities. © The Author 2017. Published by Oxford University Press on behalf of the International Epidemiological Association

A review of the evidence linking child stunting to economic outcomes

PubMed Central

McGovern, Mark E; Krishna, Aditi; Aguayo, Victor M; Subramanian, SV

2017-01-01

Abstract Background To understand the full impact of stunting in childhood it is important to consider the long-run effects of undernutrition on the outcomes of adults who were affected in early life. Focusing on the costs of stunting provides a means of evaluating the economic case for investing in childhood nutrition. Methods We review the literature on the association between stunting and undernutrition in childhood and economic outcomes in adulthood. At the national level, we also evaluate the evidence linking stunting to economic growth. Throughout, we consider randomized controlled trials (RCTs), quasi-experimental approaches and observational studies. Results Long-run evaluations of two randomized nutrition interventions indicate substantial returns to the programmes (a 25% and 46% increase in wages for those affected as children, respectively). Cost-benefit analyses of nutrition interventions using calibrated return estimates report a median return of 17.9:1 per child. Assessing the wage premium associated with adult height, we find that a 1-cm increase in stature is associated with a 4% increase in wages for men and a 6% increase in wages for women in our preferred set of studies which attempt to address unobserved confounding and measurement error. In contrast, the evidence on the association between economic growth and stunting is mixed. Conclusions Countries with high rates of stunting, such as those in South Asia and sub-Saharan Africa, should scale up policies and programmes aiming to reduce child undernutrition as cost-beneficial investments that expand the economic opportunities of their children, better allowing them and their countries to reach their full potential. However, economic growth as a policy will only be effective at reducing the prevalence of stunting when increases in national income are directed at improving the diets of children, addressing gender inequalities and strengthening the status of women, improving sanitation and reducing poverty and inequities. PMID:28379434

Forecasting the progress towards the target of Millennium Development Goal 1C in children under 5 years of age in Bangladesh.

PubMed

Hasan, Md Tanvir; Soares Magalhaes, Ricardo J; Williams, Gail M; Mamun, Abdullah A

2015-07-01

To estimate the average annual rates of reduction of stunting, underweight and wasting for the period 1996 to 2011, and to evaluate whether Bangladesh will be expected to achieve the target of Millennium Development Goal 1C of reducing the prevalence of underweight by half by 2015. We used five nationwide, cross-sectional, Demographic and Health Survey data sets to estimate prevalence of undernutrition defined by stunting, underweight and wasting among children under 5 years of age using the WHO child growth standards. We then computed the average annual rates of reduction of prevalence of undernutrition using the formula derived by UNICEF. Finally, we projected the prevalence of undernutrition for the year 2015 using the estimated average annual rates of reduction. Nationwide covering Bangladesh. Children under 5 years of age (n 28,941). The prevalence of stunting decreased by 18.8% (from 60.0% to 41.2%), underweight by 16.0% (from 52.2% to 36.2%) and wasting by 5.1% (from 20.6% to 15.5%) during 1996 to 2011. The overall average annual rates of reduction were 2.84%, 2.69 % and 2.47%, respectively, for stunting, underweight and wasting. We forecast that in 2015, the prevalence of stunting, underweight and wasting will be 36.7%, 32.5% and 14.0%, respectively, at the national level. The prevalence of undernutrition is likely to remain high in rural areas, in the Sylhet division and in the poorest wealth quintile. Bangladesh is likely to achieve the Millennium Development Goal 1C target of reducing the prevalence of underweight by half by 2015. However, it is falling behind in reducing stunting and further investment is needed to reduce individual, household and environmental determinants of stunting in Bangladesh.

Socio-economic inequalities in malnutrition among children and adolescents in Colombia: the role of individual-, household- and community-level characteristics.

PubMed

Garcia, Sandra; Sarmiento, Olga L; Forde, Ian; Velasco, Tatiana

2013-09-01

To examine socio-economic inequalities in malnutrition among Colombian children and adolescents, and to assess the contribution of individual-, household- and community-level factors to those inequalities. Cross-sectional data were used from two sources: 2005 Colombian Demographic and Health Survey and 2005 Colombian census. Malnutrition outcomes included stunting and overweight. Multilevel Poisson models were used to estimate the association between individual, household and contextual characteristics and malnutrition. Changes in prevalence ratios of the poorest quintile (v. richest) were compared to assess the contribution of different characteristics to inequalities in malnutrition. Population-based, representative of Colombia. Children and adolescents <18 years of age (n 30 779) from the Colombian Demographic and Health Survey. Children and adolescents living in the poorest households were close to five times more likely to be stunted, while those from the richest households were 1.3–2.8 times more likely than their poorest counterparts to be overweight. Care practices and household characteristics, particularly mother’s education, explained over one-third of socio-economic inequalities in stunting. The proportion explained by access to services was not negligible (between 6% and 14 %). Access to sanitation was significantly associated with a lower prevalence of stunting for all age groups. Between 14% and 32% of socio-economic disparities in overweight were explained by maternal and household characteristics. Mother’s overweight was positively associated with overweight of the child. Socio-economic inequalities in stunting and overweight coexist among children and adolescents in Colombia. Malnutrition inequalities are largely explained by household characteristics, suggesting the need for targeted interventions.

Association between growth stunting with dental development and skeletal maturation stage.

PubMed

Flores-Mir, Carlos; Mauricio, Franco Raul; Orellana, Maria Fernanda; Major, Paul William

2005-11-01

The aim of this study was to determine the influence of growth stunting on the maturation stage of the medium phalanx of the third finger (MP3) and the dental development of the left mandibular canine in 280 high school children (140 stunted and 140 normal controls; equally distributed by sex) between 9.5 and 16.5 years of age, from a representative Peruvian school. Periapical radiographs of the MP3 from the left hand were used to determine the skeletal maturity stage, according to an adaptation of the Hägg and Taranger method. Panoramic radiographs were used to determine the dental maturity stage of the lower left canine, according to Demirjian method. Stunting was determined by relating height and age, according to the World Health Organization recommendations. There was no statistically significant difference in the skeletal maturation stage (P = .134) and the dental development stage (P = .497) according to nutritional status, even when considering different age groups (P > .183). A high correlation (r = 0.85) was found between both maturity indicators regardless of the nutritional status (growth stunted, r = 0.855 and normal controls, r = 0.863) or sex (boys, r = 0.809 and girls, r = 0.892). When skeletal level was considered, correlations values were similar between advanced (r = 0.903) and average (r = 0.895) maturers but lower (r = 0.751) for delayed maturers. Growth stunting was not associated with dental development and skeletal maturity stages in Peruvian school children.

Social determinants of stunting in rural area of Wardha, Central India.

PubMed

Deshmukh, Pradeep R; Sinha, Nirmalya; Dongre, Amol R

2013-07-01

Stunting is a consequence of long term, cumulative inadequacies of health and nutrition. Health system uses underweight for growth monitoring for its simplicity. Lately there is renewed interest in stunting and especially severe acute malnutrition. Stunting is a relatively neglected indicator. It is therefore imperative to understand the causes of stunting early in infancy and childhood, so that preventive measures can be taken. Hence, the present study was undertaken to study the social determinants of stunting in rural Wardha. The present cross-sectional study was undertaken in three Primary Health Centres (PHCs) of Wardha district with total population of 88,187. The sample was drawn from three PHC areas by 30-cluster sampling technique. Stunting was defined using WHO Child Growth Standards for 'height-for-age'. 'Height-for-age' values below 2 standard deviations were considered as stunted while below 3 standard deviations were considered 'severe stunting'. Prevalence of stunting was observed to be 52.3% and severe stunting was 25.1%. The significant determinants of stunting were found to be age, father's education, fathers' occupation, low income, not receiving Vitamin-A supplement during last 6 months and having anaemia. Sex, caste, mother's education and mothers' occupation did not contribute significantly to the stunting. Low income and related factors such as father's education and his occupation are important determinant of the stunting. Father being the decision maker, his education is of importance. Vitamin-A supplementation and anaemia as surrogate indicators for access to health care also found out to be significant determinants of stunting.

Urbanicity Gradients Are Associated with the Household- and Individual-Level Double Burden of Malnutrition in Sub-Saharan Africa.

PubMed

Jones, Andrew D; Acharya, Yubraj; Galway, Lindsay P

2016-06-01

The nutrition transition is advancing throughout sub-Saharan Africa (SSA). However, the nutritional risk across urbanicity gradients associated with this transition is not clear. We aimed to determine 1) the extent to which overweight and anemia in women of childbearing age (WCBA) and stunting in preschool-age children (PSC) are spatially correlated within countries of SSA; and 2) the association of urbanicity with the individual-level nutritional double burden (i.e., concurrent overweight and anemia within an individual WCBA), the household-level double burden (i.e., overweight WCBA and stunted PSC in the same household), and the 3 components of these double burdens (i.e., overweight, anemia, and stunting). We used Demographic and Health Surveys (DHS) data for 30 countries in SSA from 2006-2012. We calculated overweight [body mass index (BMI; in kg/m(2)) ≥25] and anemia (hemoglobin concentration <120 g/L) in WCBA, and stunting in PSC aged 12-59 mo (height-for-age z score <-2). We used population density, measured using a high-resolution population distribution dataset, to define gradients of urbanicity. We used geolocated DHS data to calculate cluster-level mean population densities and the Moran's I statistic to assess spatial autocorrelation. Cluster-level BMI values and hemoglobin concentrations for WCBA were spatially correlated. The odds of overweight in WCBA were higher in periurban and urban areas than in rural areas (periurban, OR: 1.08; 95% CI: 1.01, 1.16; urban, OR: 1.26; 95% CI: 1.18, 1.36), as were the odds of stunting in PSC in periurban areas (OR: 1.13; 95% CI: 1.06, 1.22). The odds of both double burden conditions were higher in periurban and urban areas than in rural areas (individual-level-periurban, OR: 1.18; 95% CI: 1.05, 1.33; urban, OR: 1.43; 95% CI: 1.27, 1.61; household-level-periurban, OR: 1.24; 95% CI: 1.06, 1.44; urban, OR: 1.24; 95% CI: 1.06, 1.46). Urban and periurban areas in SSA may be particularly vulnerable to the nutritional double burden compared with rural areas. Clearly differentiating urban environments is important for assessing changing patterns of nutritional risk associated with the nutrition transition in SSA. © 2016 American Society for Nutrition.

Addressing Chronic Malnutrition through Multi-Sectoral, Sustainable Approaches: A Review of the Causes and Consequences

PubMed Central

Reinhardt, Kristina; Fanzo, Jessica

2014-01-01

Chronic malnutrition, including stunting, is an important example of a global challenge that spans multiple sectors, specifically health, agriculture, and the environment. The objective of this paper is to review current knowledge on the causes and consequences of chronic malnutrition and their relationship with multiple sectors. Understanding the causes includes approaching chronic malnutrition from the basic, underlying, and immediate levels. The causes reach from macro-level environmental influences to specific micronutrient intake. In order to effectively address stunting, it is important to understand the timing of stunting and the ability of individuals to catch up in terms of linear growth, cognitive ability, and immune function. The consequences of chronic malnutrition are transgenerational and they have an impact at the individual, community, and national level in the short- and long-term. There are still many gaps in knowledge regarding both the causes and consequences of chronic malnutrition, particularly when it comes to the interaction with agriculture and the environment, and understanding these gaps is important to addressing the burden of chronic malnutrition through evidence-based interventions. PMID:25988116

Association of Urban Slum Residency with Infant Mortality and Child Stunting in Low and Middle Income Countries

PubMed Central

Kyu, Hmwe Hmwe; Shannon, Harry S.; Georgiades, Katholiki; Boyle, Michael H.

2013-01-01

This study aimed to (i) examine the contextual influences of urban slum residency on infant mortality and child stunting over and above individual and household characteristics and (ii) identify factors that might modify any adverse effects. We obtained data from Demographic and Health Surveys conducted in 45 countries between 2000 and 2009. The respondents were women (15–49 years) and their children (0–59 months). Results showed that living in a slum neighborhood was associated with infant mortality (OR = 1.34, 95% CI = 1.15–1.57) irrespective of individual and household characteristics and this risk was attenuated among children born to women who had received antenatal care from a health professional (OR = 0.79, 95% CI = 0.63–0.99). Results also indicated that increasing child age exacerbated the risk for stunting associated with slum residency (OR = 1.19, 95% CI = 1.16–1.23). The findings suggest that improving material circumstances in urban slums at the neighborhood level as well as increasing antenatal care coverage among women living in these neighborhoods could help reduce infant mortality and stunted child growth. The cumulative impact of long-term exposure to slum neighborhoods on child stunting should be corroborated by future studies. PMID:24151612

Association of urban slum residency with infant mortality and child stunting in low and middle income countries.

PubMed

Kyu, Hmwe Hmwe; Shannon, Harry S; Georgiades, Katholiki; Boyle, Michael H

2013-01-01

This study aimed to (i) examine the contextual influences of urban slum residency on infant mortality and child stunting over and above individual and household characteristics and (ii) identify factors that might modify any adverse effects. We obtained data from Demographic and Health Surveys conducted in 45 countries between 2000 and 2009. The respondents were women (15-49 years) and their children (0-59 months). Results showed that living in a slum neighborhood was associated with infant mortality (OR = 1.34, 95% CI = 1.15-1.57) irrespective of individual and household characteristics and this risk was attenuated among children born to women who had received antenatal care from a health professional (OR = 0.79, 95% CI = 0.63-0.99). Results also indicated that increasing child age exacerbated the risk for stunting associated with slum residency (OR = 1.19, 95% CI = 1.16-1.23). The findings suggest that improving material circumstances in urban slums at the neighborhood level as well as increasing antenatal care coverage among women living in these neighborhoods could help reduce infant mortality and stunted child growth. The cumulative impact of long-term exposure to slum neighborhoods on child stunting should be corroborated by future studies.

Stunting and severe stunting among children under-5 years in Nigeria: A multilevel analysis.

PubMed

Akombi, Blessing Jaka; Agho, Kingsley Emwinyore; Hall, John Joseph; Merom, Dafna; Astell-Burt, Thomas; Renzaho, Andre M N

2017-01-13

Stunting has been identified as one of the major proximal risk factors for poor physical and mental development of children under-5 years. Stunting predominantly occurs in the first 1000 days of life (0-23 months) and continues to the age of five. This study examines factors associated with stunting and severe stunting among children under-5 years in Nigeria. The sample included 24,529 children aged 0-59 months from the 2013 Nigeria Demographic and Health Survey (NDHS). Height-for-age z-scores (HFAz), generated using the 2006 World Health Organisation (WHO) growth reference, were used to define stunting (HFAz < -2SD) and severe stunting (HFAz < -3SD). Multilevel logistic regression analyses that adjusted for cluster and survey weights were used to determine potential risk factors associated with stunting and severe stunting among children under-5 years in Nigeria. The prevalence of stunting and severe stunting were 29% [95% Confidence interval (Cl): 27.4, 30.8] and 16.4% [95%Cl: 15.1, 17.8], respectively for children aged 0-23 months, and 36.7% [95%Cl: 35.1, 38.3] and 21% [95%Cl: 19.7, 22.4], respectively for children aged 0-59 months. Multivariate analysis revealed that the most consistent significant risk factors for stunting and severe stunting among children aged 0-23 months and 0-59 months are: sex of child (male), mother's perceived birth size (small and average), household wealth index (poor and poorest households), duration of breastfeeding (more than 12 months), geopolitical zone (North East, North West, North Central) and children who were reported to having had diarrhoea in the 2 weeks prior to the survey [Adjusted odds ratio (AOR) for stunted children 0-23 months = 1.22 (95%Cl: 0.99, 1.49)];[AOR for stunted children 0-59 months = 1.31 (95%Cl: 1.16, 1.49)], [AOR for severely stunted children 0-23 months = 1.31 (95%Cl: 1.03, 1.67)]; [AOR for severely stunted children 0-59 months = 1.58 (95%Cl: 1.38, 1.82)]. In order to meet the post-2015 sustainable development goals, policy interventions to reduce stunting in Nigeria should focus on poverty alleviation as well as improving women's nutrition, child feeding practices and household sanitation.

Does Childhood Diarrhea Influence Cognition Beyond the Diarrhea-Stunting Pathway?

DTIC Science & Technology

2012-10-31

delayed careseeking [26,27]. In impoverished households maternal and paternal education levels are often low and children receive less stimulation during...Guatemala, maternal education was defined as the average number of years enrolled in school; whereas, in Brazil, maternal education was a categorical...Stunted (% ,22 LAZ) 86.5 67.5 24.3 32 Maternal education (mean years enrolled in school)a or % of mothers who had not completed primary schoolb 1.4a

[Research on the social determinants of malnutrition among children under the age of 5 in China].

PubMed

Man, S Lm; Guo, Y

2016-06-18

To understand the relationship between child malnutrition and social determinants among children under the age of 5 in China, and to provide evidence and useful information to help policy makers develop social policies to improve child nutritional status. Information of 2 434 children aged 0-5 was extracted from year 1991 to 2011 longitudinal survey data in the China Health and Nutrition Survey (CHNS) was extracted for analysis. Child underweight, child stunting, and child wasting were defined using World Health Organization Child Growth Standards for weight-for-age, height-for-age, and weight-for-height. Weight-for-age values, height-for-age values or weight-for-height values below 2 standard deviations were considered as underweight, stunting and wasting. World Health Organization igrowup software was used to calculate the prevalence of child underweight, child stunting, and child wasting. Multivariate Logistic regression model was used to analyze the relationship between child malnutrition and social determinants (household income, parents' educational level, living regions, and communities' urbanization level). The prevalence of child underweight and child stunting were decreased by 64.8% and 67.8%, respectively from 1991 to 2011, while the prevalence of child wasting had remained at a relatively low level (below 5%). The problem of child underweight and stunting had been significantly resolved in China. Female children had better outcomes than male children on improving nutritional status. Among all the non-socio-economic determinants of child malnutrition, children with low height mother and children had inadequate protein intake were both risk factors of malnutrition. The social determinants significantly associated to child malnutrition included: living in the western regions and central regions, living in low level urbanization communities, with low household incomes, and low maternal educational levels. In order to further decrease the prevalence of child malnutrition and alleviate the inequity of child health, we should pay more attention to the social determinants behind child malnutrition. Besides, social policies beneficial to child nutrition promotion need to be taken urgently, the important social policies suggested by the researchers included focusing on maternal and child dietary intake, improving household economic situation, improving maternal educational level, and balancing economic development and resource distribution between different regions in China.

Prevalence and determinants of stunting in under-five children in central Tanzania: remaining threats to achieving Millennium Development Goal 4.

PubMed

Semali, Innocent Antony; Tengia-Kessy, Anna; Mmbaga, Elia John; Leyna, Germana

2015-11-21

The Millennium Development Goal No 4 (MDG 4) requires countries to scale up interventions addressing malnutrition and other immediate determinants of burden of disease among children to reduce child mortality by two thirds by 2015, which is this year. Whereas globally some achievements have been registered, under-nourishment remains a significant problem in some developing countries such as Tanzania. This study set out to estimate the extent of stunting and its associated determinants to assess the progress made thus far towards achieving MDG 4 in Tanzania. A random sample of 678 households with under-five children was selected from two randomly selected wards of Kongwa district in Dodoma region, Tanzania. The WHO anthropometric calculator, which computes Z-scores using a reference population, was used to process the anthropometric measurement data taken from all the participants. Children with height for age Z-score of less than 2 were categorised as stunted and coded as 1 and the rest were coded as 0. Proportions of stunting were compared using the chi-square test to determine the association between stunting and the independent variables. Multivariate logistic regression analysis was carried out to determine the Adjusted Odds Ratio (AOR) of the independent determinants of stunting. The cut-off for significant association was set at p = 0.05. All these analyses used the STATA 12 software. About half (49.7 %) of the children were stunted. This stunting was associated with belonging to households where the head of family was young (<35 years) (AOR = 0.67, 95 % CI 0.47-0.96, p = 0.031), young age of the mothers (AOR = 1.54, 95 % CI 1.06-2.24, p = 0.023), and economic variables such as owning a cellular phone (AOR = 0.66, 96 % CI 0.46-0.94, p = 0.023). Stunting was highly prevalent in Kongwa district despite general improvements in child nutritional status at the national level. Household characteristics and economic status were found to play a major role in child health. In this regard, disaggregated analyses are therefore important in identifying resilient areas in need of concerted efforts for the MDG 4 to be achieved nationwide.

Childhood stunting: a global perspective

PubMed Central

Branca, Francesco

2016-01-01

Abstract Childhood stunting is the best overall indicator of children's well‐being and an accurate reflection of social inequalities. Stunting is the most prevalent form of child malnutrition with an estimated 161 million children worldwide in 2013 falling below −2 SD from the length‐for‐age/height‐for‐age World Health Organization Child Growth Standards median. Many more millions suffer from some degree of growth faltering as the entire length‐for‐age/height‐for‐age z‐score distribution is shifted to the left indicating that all children, and not only those falling below a specific cutoff, are affected. Despite global consensus on how to define and measure it, stunting often goes unrecognized in communities where short stature is the norm as linear growth is not routinely assessed in primary health care settings and it is difficult to visually recognize it. Growth faltering often begins in utero and continues for at least the first 2 years of post‐natal life. Linear growth failure serves as a marker of multiple pathological disorders associated with increased morbidity and mortality, loss of physical growth potential, reduced neurodevelopmental and cognitive function and an elevated risk of chronic disease in adulthood. The severe irreversible physical and neurocognitive damage that accompanies stunted growth poses a major threat to human development. Increased awareness of stunting's magnitude and devastating consequences has resulted in its being identified as a major global health priority and the focus of international attention at the highest levels with global targets set for 2025 and beyond. The challenge is to prevent linear growth failure while keeping child overweight and obesity at bay. PMID:27187907

Spatial heterogeneity and risk factors for stunting among children under age five in Ethiopia: A Bayesian geo-statistical model.

PubMed

Hagos, Seifu; Hailemariam, Damen; WoldeHanna, Tasew; Lindtjørn, Bernt

2017-01-01

Understanding the spatial distribution of stunting and underlying factors operating at meso-scale is of paramount importance for intervention designing and implementations. Yet, little is known about the spatial distribution of stunting and some discrepancies are documented on the relative importance of reported risk factors. Therefore, the present study aims at exploring the spatial distribution of stunting at meso- (district) scale, and evaluates the effect of spatial dependency on the identification of risk factors and their relative contribution to the occurrence of stunting and severe stunting in a rural area of Ethiopia. A community based cross sectional study was conducted to measure the occurrence of stunting and severe stunting among children aged 0-59 months. Additionally, we collected relevant information on anthropometric measures, dietary habits, parent and child-related demographic and socio-economic status. Latitude and longitude of surveyed households were also recorded. Local Anselin Moran's I was calculated to investigate the spatial variation of stunting prevalence and identify potential local pockets (hotspots) of high prevalence. Finally, we employed a Bayesian geo-statistical model, which accounted for spatial dependency structure in the data, to identify potential risk factors for stunting in the study area. Overall, the prevalence of stunting and severe stunting in the district was 43.7% [95%CI: 40.9, 46.4] and 21.3% [95%CI: 19.5, 23.3] respectively. We identified statistically significant clusters of high prevalence of stunting (hotspots) in the eastern part of the district and clusters of low prevalence (cold spots) in the western. We found out that the inclusion of spatial structure of the data into the Bayesian model has shown to improve the fit for stunting model. The Bayesian geo-statistical model indicated that the risk of stunting increased as the child's age increased (OR 4.74; 95% Bayesian credible interval [BCI]:3.35-6.58) and among boys (OR 1.28; 95%BCI; 1.12-1.45). However, maternal education and household food security were found to be protective against stunting and severe stunting. Stunting prevalence may vary across space at different scale. For this, it's important that nutrition studies and, more importantly, control interventions take into account this spatial heterogeneity in the distribution of nutritional deficits and their underlying associated factors. The findings of this study also indicated that interventions integrating household food insecurity in nutrition programs in the district might help to avert the burden of stunting.

Preventing environmental enteric dysfunction through improved water, sanitation and hygiene: an opportunity for stunting reduction in developing countries.

PubMed

Mbuya, Mduduzi N N; Humphrey, Jean H

2016-05-01

In 2011, one in every four (26%) children under 5 years of age worldwide was stunted. The realization that most stunting cannot be explained by poor diet or by diarrhoea, nor completely reversed by optimized diet and reduced diarrhoea has led to the hypothesis that a primary underlying cause of stunting is subclinical gut disease. Essentially, ingested microbes set in motion two overlapping and interacting pathways that result in linear growth impairment. Firstly, partial villous atrophy results in a reduced absorptive surface area and loss of digestive enzymes. This in turn results in maldigestion and malabsorption of much needed nutrients. Secondly, microbes and their products make the gut leaky, allowing luminal contents to translocate into systemic circulation. This creates a condition of chronic immune activation, which (i) diverts nutrient resources towards the metabolically expensive business of infection fighting rather than growth; (ii) suppresses the growth hormone-IGF axis and inhibits bone growth, leading to growth impairment; and (iii) causes further damage to the intestinal mucosa thereby exacerbating the problem. As such, the unhygienic environments in which infants and young children live and grow must contribute to, if not be the overriding cause of, this environmental enteric dysfunction. We suggest that a package of baby-WASH interventions (sanitation and water improvement, handwashing with soap, ensuring a clean play and infant feeding environment and food hygiene) that interrupt specific pathways through which feco-oral transmission occurs in the first two years of a child's life may be central to global stunting reduction efforts. © 2016 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.

The double burden of undernutrition and excess body weight in Ecuador.

PubMed

Freire, Wilma B; Silva-Jaramillo, Katherine M; Ramírez-Luzuriaga, María J; Belmont, Philippe; Waters, William F

2014-12-01

Ecuador's current nutrition policies have not taken adequate notice of the double burden of malnutrition and continue to focus on stunting and to a lesser extent on overweight, without addressing the simultaneous presence of undernutrition, micronutrient deficiencies, and overweight or obesity (OW/OB). The aim of this article was to describe the prevalence and distribution of undernutrition (stunting, anemia, and zinc deficiency), overweight, and obesity in Ecuador to explore the evolving double burden of malnutrition at the national, household, and individual levels and to discuss whether current public health policies are addressing the double burden. Data from the 2012 Ecuadorian National Health and Nutrition Survey (ENSANUT-ECU) was used to estimate the dual burden of malnutrition at the national, household, and individual levels in children <5 y old, school-aged children, and women of reproductive age. In 13.1% of households, mothers with excess body weight coexist with a stunted child <5 y old. Moreover, among households with overweight or obese mothers, 12.6% have an anemic child and 14% have a zinc-deficient child. At the individual levels, the coexistence of OW/OB and stunting, anemia, or zinc deficiency was found in 2.8%, 0.7%, and 8.4% of school-aged children, respectively. In addition, 8.9% and 32.6% of women aged 12-49 y have excess body weight and anemia or zinc deficiency, respectively. This article shows the coexistence of high rates of undernutrition and OW/OB at the individual, household, and national levels in Ecuador. Although integrated approaches to address the emerging double burden are required, public health policies to date have not responded adequately. © 2014 American Society for Nutrition.

Socioeconomic Inequality in Malnutrition in Under-5 Children in Iran: Evidence From the Multiple Indicator Demographic and Health Survey, 2010.

PubMed

Almasian Kia, Abdollah; Rezapour, Aziz; Khosravi, Ardeshir; Afzali Abarghouei, Vajiheh

2017-01-01

The aim of this study was to assess the socioeconomic inequality in malnutrition in under-5 children in Iran in order to help policymakers reduce such inequality. Data on 8443 under-5 children were extracted from the Iran Multiple Indicator Demographic and Health Survey. The wealth index was used as proxy for socioeconomic status. Socioeconomic inequality in stunting, underweight, and wasting was calculated using the concentration index. The concentration index was calculated for the whole sample, as well as for subcategories defined in terms of categories such as area of residence (urban and rural) and the sex of children. Stunting was observed to be more prevalent than underweight or wasting. The results of the concentration index at the national level, as well as in rural and urban areas and in terms of children's sex, showed that inequality in stunting and underweight was statistically significant and that children in the lower quintiles were more malnourished. The wasting index was not sensitive to socioeconomic status, and its concentration index value was not statistically significant. This study showed that it can be misleading to assess the mean levels of malnutrition at the national level without knowledge of the distribution of malnutrition among socioeconomic groups. Significant socioeconomic inequalities in stunting and underweight were observed at the national level and in both urban and rural areas. Regarding the influence of nutrition on the health and economic well-being of preschool-aged children, it is necessary for the government to focus on taking targeted measures to reduce malnutrition and to focus on poorer groups within society who bear a greater burden of malnutrition.

Socioeconomic Inequality in Malnutrition in Under-5 Children in Iran: Evidence From the Multiple Indicator Demographic and Health Survey, 2010

PubMed Central

2017-01-01

Objectives The aim of this study was to assess the socioeconomic inequality in malnutrition in under-5 children in Iran in order to help policymakers reduce such inequality. Methods Data on 8443 under-5 children were extracted from the Iran Multiple Indicator Demographic and Health Survey. The wealth index was used as proxy for socioeconomic status. Socioeconomic inequality in stunting, underweight, and wasting was calculated using the concentration index. The concentration index was calculated for the whole sample, as well as for subcategories defined in terms of categories such as area of residence (urban and rural) and the sex of children. Results Stunting was observed to be more prevalent than underweight or wasting. The results of the concentration index at the national level, as well as in rural and urban areas and in terms of children’s sex, showed that inequality in stunting and underweight was statistically significant and that children in the lower quintiles were more malnourished. The wasting index was not sensitive to socioeconomic status, and its concentration index value was not statistically significant. Conclusions This study showed that it can be misleading to assess the mean levels of malnutrition at the national level without knowledge of the distribution of malnutrition among socioeconomic groups. Significant socioeconomic inequalities in stunting and underweight were observed at the national level and in both urban and rural areas. Regarding the influence of nutrition on the health and economic well-being of preschool-aged children, it is necessary for the government to focus on taking targeted measures to reduce malnutrition and to focus on poorer groups within society who bear a greater burden of malnutrition. PMID:28605886

Suppression of cell wall-related genes associated with stunting of Oryza glaberrima infected with Rice tungro spherical virus

PubMed Central

Budot, Bernard O.; Encabo, Jaymee R.; Ambita, Israel Dave V.; Atienza-Grande, Genelou A.; Satoh, Kouji; Kondoh, Hiroaki; Ulat, Victor J.; Mauleon, Ramil; Kikuchi, Shoshi; Choi, Il-Ryong

2014-01-01

Rice tungro disease is a complex disease caused by the interaction between Rice tungro bacilliform virus and Rice tungro spherical virus (RTSV). RTSV alone does not cause recognizable symptoms in most Asian rice (Oryza sativa) plants, whereas some African rice (O. glaberrima) plants were found to become stunted by RTSV. Stunting of rice plants by virus infections usually accompanies the suppression of various cell wall-related genes. The expression of cell wall-related genes was examined in O. glaberrima and O. sativa infected with RTSV to see the relationship between the severity of stunting and the suppression of cell wall-related genes by RTSV. The heights of four accessions of O. glaberrima were found to decline by 14–34% at 28 days post-inoculation (dpi) with RTSV, whereas the height reduction of O. sativa plants by RTSV was not significant. RTSV accumulated more in O. glaberrima plants than in O. sativa plants, but the level of RTSV accumulation was not correlated with the degree of height reduction among the four accessions of O. glaberrima. Examination for expression of genes for cellulose synthase A5 (CESA5) and A6 (CESA6), cellulose synthase-like A9 (CSLA9) and C7, and α-expansin 1 (expansin 1) and 15 precursors in O. glaberrima and O. sativa plants between 7 and 28 dpi with RTSV showed that the genes such as those for CESA5, CESA6, CSLA9, and expansin 1were more significantly suppressed in stunted plants of O. glaberrima at 14 dpi with RTSV than in O. sativa, suggesting that stunting of O. glaberrima might be associated with these cell wall-related genes suppressed by RTSV. Examination for expression of these genes in O. sativa plants infected with other rice viruses in previous studies indicated that the suppression of the expansin 1 gene is likely to be a signature response commonly associated with virus-induced stunting of Oryza species. These results suggest that stunting of O. glaberrima by RTSV infection might be associated with the suppression of these cell wall-related genes at the early stage of infection with RTSV. PMID:24550897

A multilevel analysis of individual and community effect on chronic childhood malnutrition in rural Nigeria.

PubMed

Uthman, Olalekan A

2009-04-01

Protein energy malnutrition is the second most important cause of childhood morbidity and mortality in Nigeria after infections. The purpose of this article was to develop and test a model of childhood malnutrition that includes individual-level characteristics along with contextual characteristics defined at the community level. Multilevel logistic regression analysis. A total of 4007 children resident in 96 rural villages in Nigeria. Stunting: height-for-age that is less than the international reference value by >2 standard deviations (SDs). Independent of other factors, children born to underweight mothers were 1.32-times more likely to be stunted [adjusted odds ratio (aOR) 1.32; 95% confidence interval (CI) 1.07-1.64]. For each additional month of breastfeeding the odds of being stunted increased by 4% (aOR 1.04; 95% CI 1.03-1.06). Each SD increase in the household wealth index and maternal health-seeking behaviour index decreased the odds of being stunted by 16% (aOR 0.84; 95% CI 0.76-0.94) and 29% (aOR 0.71; 95% CI 0.60 -0.82), respectively. The study has provided evidence that both individual and community characteristics are important predictors of childhood malnutrition in rural Nigeria; and that scholars trying to understand variation in childhood malnutrition should pay attention to the characteristics of both children and place of residence.

Correlates of stunting among children in Ghana.

PubMed

Darteh, Eugene Kofuor Maafo; Acquah, Evelyn; Kumi-Kyereme, Akwasi

2014-05-26

Stunting, is a linear growth retardation, which results from inadequate intake of food over a long period of time that may be worsened by chronic illness. Over a long period of time, inadequate nutrition or its effects could result in stunting. This paper examines the correlates of stunting among children in Ghana using data from the 2008 Ghana Demographic and Health Survey (GDHS). The paper uses data from the children recode file of the 2008 Demographic and Health Survey (DHS), a nationally representative cross sectional survey conducted in Ghana. A total of 2379 children under five years who had valid anthropometric data were used for the study. Data on the stunting of children were collected by measuring the height of all children under six years of age. A measuring board produced by Shorr Productions was used to obtain the height of the children. Children under 2 years of age were measured lying down on the board while those above 2 years were measured standing. In the DHS data, a z-score is given for the child's height relative to the age. Both bi-variate and multi-variate statistics are used to examine the correlates of stunting. Stunting was common among males than females. Age of child was a significant determinant of stunting with the highest odd of stunting been among children aged 36-47 months. Region was significantly related to stunting. Children from the Eastern Region were more likely to be stunted than children from the Western Region which is the reference group (OR = 1.7 at p < 0.05). Number of children in household was significantly related to stunting. Children in households with 5-8 children were 1.3 times more likely to be stunted compared to those with 1-4 children (p < .05). Mother's age was a significant predictor of stunting with children whose mothers were aged 35-44 years being more likely to be stunted. Culturally appropriate interventions and policies should be put in place to minimise the effects of the distal, proximal and intermediate factors on stunting among under 5 children in Ghana.

[Trends of malnutrition in Mexican children under five years from 1988 to 2016: Analysis of five national surveys].

PubMed

Cuevas-Nasu, Lucía; Shamah-Levy, Teresa; Hernández-Cordero, Sonia L; González-Castell, L Dinorah; Méndez Gómez-Humarán, Ignacio; Ávila-Arcos, Marco A; Rivera-Dommarco, Juan A

2018-01-01

To study the magnitude, distribution and trends of undernutrition and overweight in Mexican children un¬der five years between 1988 and 2016. Underweight, wasting, stunting and overweight prevalences were calculated, at national, regional and rural/ urban locality levels in children under five years from the 1988, 1999, 2006, 2012 and 2016 national probabilistic surveys. Currently 3.9% suffer underweight, 1.9% wasting and 10% stunting. There was an decrease in stunting from 1988 to 2016 (26.9 vs 10.0%), in rural (43.1 vs 12.6%) and urban (22.5 vs 9.1%) localities and in South (38.6 vs 13.4%), Center (29.2 vs 8.4%) and Mexico City (13.6 vs 4.7%). In the North region the decrease was smaller (13.3 vs 11.4%). Overweight diminished from 9.7% to 5.8, mainly between 2012-2016. Stunting has continued its decline in Mexico, but high prevalences persist in some vulnerable groups. Overweight had an unexpected decline between 2012-2016.

The stunting syndrome in developing countries

PubMed Central

Prendergast, Andrew J; Humphrey, Jean H

2014-01-01

Linear growth failure is the most common form of undernutrition globally. With an estimated 165 million children below 5 years of age affected, stunting has been identified as a major public health priority, and there are ambitious targets to reduce the prevalence of stunting by 40% between 2010 and 2025. We view this condition as a ‘stunting syndrome’ in which multiple pathological changes marked by linear growth retardation in early life are associated with increased morbidity and mortality, reduced physical, neurodevelopmental and economic capacity and an elevated risk of metabolic disease into adulthood. Stunting is a cyclical process because women who were themselves stunted in childhood tend to have stunted offspring, creating an intergenerational cycle of poverty and reduced human capital that is difficult to break. In this review, the mechanisms underlying linear growth failure at different ages are described, the short-, medium- and long-term consequences of stunting are discussed, and the evidence for windows of opportunity during the life cycle to target interventions at the stunting syndrome are evaluated. PMID:25310000

The family as a determinant of stunting in children living in conditions of extreme poverty: a case-control study.

PubMed

Reyes, Hortensia; Pérez-Cuevas, Ricardo; Sandoval, Araceli; Castillo, Raúl; Santos, José Ignacio; Doubova, Svetlana V; Gutiérrez, Gonzalo

2004-11-30

Malnutrition in children can be a consequence of unfavourable socioeconomic conditions. However, some families maintain adequate nutritional status in their children despite living in poverty. The aim of this study was to ascertain whether family-related factors are determinants of stunting in young Mexican children living in extreme poverty, and whether these factors differ between rural or urban contexts. A case-control study was conducted in one rural and one urban extreme poverty level areas in Mexico. Cases comprised stunted children aged between 6 and 23 months. Controls were well-nourished children. Independent variables were defined in five dimensions: family characteristics; family income; household allocation of resources and family organisation; social networks; and child health care. Information was collected from 108 cases and 139 controls in the rural area and from 198 cases and 211 controls in the urban area. Statistical analysis was carried out separately for each area; unconditional multiple logistic regression analyses were performed to obtain the best explanatory model for stunting. In the rural area, a greater risk of stunting was associated with father's occupation as farmer and the presence of family networks for child care. The greatest protective effect was found in children cared for exclusively by their mothers. In the urban area, risk factors for stunting were father with unstable job, presence of small social networks, low rate of attendance to the Well Child Program activities, breast-feeding longer than six months, and two variables within the family characteristics dimension (longer duration of parents' union and migration from rural to urban area). This study suggests the influence of the family on the nutritional status of children under two years of age living in extreme poverty areas. Factors associated with stunting were different in rural and urban communities.Therefore, developing and implementing health programs to tackle malnutrition should take into account such differences that are consequence of the social, economic, and cultural contexts in which the family lives.

The prevalence and risk factors of stunting among primary school children in North Sumatera, Indonesia

NASA Astrophysics Data System (ADS)

Lestari, S.; Fujiati, I. I.; Keumalasari, D.; Daulay, M.

2018-03-01

Stunting in primary school-aged children is a kind of health and nutrition problem in Indonesia which has an impact on the human quality resources degradation. This research aimed to determine the stunting prevalence and the risk factors associated with stunting in primary school children in North Sumatra Province. This research is an analysis of cross-sectional approach. The total sampleis 400 children aged 8-13 years old were in the study from the Medan city and Langkat regency in July - October 2017. Data collected by using questionnaire and anthropometric assessment. Stunting (<-2 SD of height-for-age Z-score) were defined by using the World Health Organization reference 2007. Chi-square analysis and logistic regression were used toassess the association between risk factors and stunting. The prevalence of stunting in primary school children was 38.87%. The factors associated with stunting school children were theeducation of mother (OR=1.53), income (OR=2.27), work of mother (OR=1.39), energy intake (OR=2.66) and protein intake (OR=2.02). The dominant factor that influences stunting in school children was energy intake. The conclusion of this study is stunting prevalence in school children in NorthSumatra higher.

Lower waist circumference in mildly-stunted adolescents is associated with elevated insulin concentration.

PubMed

Clemente, Ana Paula Grotti; Santos, Carla Danusa da Luz; Martins, Vinicius J B; Albuquerque, Maria Paula; Fachim, Mariana B; Sawaya, Ana Lydia

2014-01-01

Augmented waist circumference (WC) is associated with non-communicable diseases and could represent a valuable marker in screening for metabolic dysfunctions in subjects with insufficient linear growth. The objective of the present study was to determine whether biochemical and hemodynamic parameters and waist circumference vary between mildly-stunted and non-stunted adolescents from impoverished communities of São Paulo, Brazil. The cross-sectional study involved 206 subjects, aged between 9 and 19 years and living in impoverished areas of São Paulo, Brazil. The sample population was divided according to height-for-age Z-score (HAZ) into stunted (-1 > HAZ ≥ -2) and non-stunted (HAZ ≥ -1) groups, and was sub-divided according to gender. Logistic regression analysis was employed to compare individuals with elevated (> 75th percentile) insulin concentrations. The receiver operating characteristic curves were constructed to determine WC cut-off points that could be used to identify stunted and non-stunted individuals with elevated insulin concentrations. WC cut-off points of 58.25cm and 67.2cm allowed for correct classification of 90.7% of stunted and 88.7% of non-stunted individuals in the studied population. While the sensitivity of the model was high for stunted and non-stunted subjects (98.8% and 97.2%, respectively), the specificity was modest (57.1% and 41.2%, respectively). The results presented herein suggest that an increase in plasma insulin is one of the primary metabolic modifications in stunted individuals, and that this alteration could be identified at a lower WC cut-off point than in non-stunted counterparts. Copyright © 2014 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Determinants of stunting and poor linear growth in children under 2 years of age in India: an in-depth analysis of Maharashtra's comprehensive nutrition survey.

PubMed

Aguayo, Víctor M; Nair, Rajilakshmi; Badgaiyan, Nina; Krishna, Vandana

2016-05-01

We use a representative sample of 2561 children 0-23 months old to identify the factors most significantly associated with child stunting in the state of Maharashtra, India. We find that 22.7% of children were stunted, with one-third (7.4%) of the stunted children severely stunted. Multivariate regression analyses indicate that children born with low birthweight had a 2.5-fold higher odds of being stunted [odds ratio (OR) 2.49; 95% confidence interval (CI) 1.96-3.27]; children 6-23 months old who were not fed a minimum number of times/day had a 63% higher odds of being stunted (OR 1.63; 95% CI 1.24-2.14); and lower consumption of eggs was associated with a two-fold increased odds of stunting in children 6-23 months old (OR 2.07; 95% CI 1.19-3.61); children whose mother's height was < 145 cm, had two-fold higher odds of being stunted (OR 2.04; 95% CI 1.46-2.81); lastly, children of households without access to improved sanitation had 88% higher odds of being severely stunted (OR 1.88; 95% CI 1.17-3.02). Attained linear growth (height-for-age z-score) was significantly lower in children from households without access to improved sanitation, children of mothers without access to electronic media, without decision making power regarding food or whose height was < 145 cm, children born with a low birthweight and children 6-23 months old who were not fed dairy products, fruits and vegetables. In Maharashtra children's birthweight and feeding practices, women's nutrition and status and household sanitation and poverty are the most significant predictors of stunting and poor linear growth in children under 2 years. Key messages One in five (22.7%) of children 0-23 months old in the state of Maharashtra were stunted, and one-third (7.4%) of the stunted children were severely stunted. Birthweight, child feeding, women's nutrition and household sanitation were the most significant predictors of stunting and poor linear growth in children under 2 years. Children born to mothers whose height was below 145 cm, had two-fold higher odds of being stunted; children born with a low birthweight had a 2.5-fold higher odds of being stunted. Low feeding frequency and low consumption of eggs, dairy products, fruits and vegetables were associated with stunting and poor linear growth in children 6-23 months old. Children of households without access to improved sanitation had 88% higher odds of being severely stunted. © 2016 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.

The use of biocultural data in interpreting sex differences in body proportions among rural Amazonians

PubMed Central

VERCELLOTTI, GIUSEPPE; PIPERATA, BARBARA A.

2012-01-01

Variation in height and body proportions is relatively well understood at the inter-population level, but less is known about intra-population variation. This study explores intra-population variation in body proportions among 172 (88 female; 84 male) adult rural Amazonians. We test the hypotheses that: 1) stunting is associated with changes in proportions and fatness; 2) the sexes express different proportions in response to similar environmental stress and 3) female growth is negatively affected by the costs of reproduction. We examined height, sitting height and total leg length in subsamples based on sex and nutritional status (stunted/non-stunted) in relation to biocultural factors including access to food and healthcare and female reproductive history parameters. Differences in proportions were examined using the Quick-Test (Tsutakawa and Hewett, 1977); correlation analyses were employed to detect associations between anthropometric data and body fatness, and female reproductive history parameters. We found significantly higher rates of stunting among females (X2=5.31; p=0.02; RR=1.4). Stunted individuals exhibited relatively shorter legs than non-stunted individuals (p=0.02), although this was not found in within-sex analyses. A significant negative correlation was found between leg length index and fatness (p<0.01). Lastly, females exhibited relatively shorter legs than males (p=0.0003) and, among females, height and leg length were significantly positively correlated with age-at-first-birth (p<0.02) suggesting that adolescent pregnancy may negatively affect growth in this population. Our findings provide insights for the study of intra-population variation in body proportions and highlight the importance of biocultural data in interpreting the pattern of variation observed in living and past populations. PMID:22120650

Prevalence and Determinants of Chronic Malnutrition among Preschool Children: A Cross-sectional Study in Dhaka City, Bangladesh

PubMed Central

Jesmin, Aklima; Yamamoto, Shelby Suzanne; Malik, Ahmad Azam

2011-01-01

Chronic malnutrition is one of the major causes of morbidity and mortality among preschool children and the future productivity of nations. To understand the prevalence of chronic malnutrition and to identify the factors affecting height-for-age z-score (HAZ) among preschool children, a cross-sectional study was conducted among 380 randomly-selected children aged less than five years in Dhaka city, Bangladesh. Results of analysis of this study data revealed that the prevalence of stunting among preschool children in Dhaka city was 39.5%, with 25% severely stunted and 14% moderately stunted (p<0.001). Results of bivariate analysis revealed that socioeconomic and demographic factors were most significantly associated with the stunting of children. Children were found to be well-nourished if their parents had a tertiary-level education or higher and if the mother held a job and had good knowledge of nutrition. Well-nourishment of the children were also associated with the height of mothers (above 148 cm), good family educational background, normal birthweight, greater frequency of food intake (more than six times/day), and fewer fever episodes in the last six months. Results of multivariate linear regression models showed that height of mothers, birthweight of children, education of fathers, knowledge of mothers on nutrition, and frequency of feeding were the most significant factors that had an independent and direct influence on the stunting of children. To achieve the Millennium Development Goal target of 34% malnutrition prevalence by 2015, it is important to have specific government intervention to focus on the causes that directly influence the stunting of children. PMID:22106755

Child, maternal and household-level correlates of nutritional status: a cross-sectional study among young Samoan children.

PubMed

Choy, Courtney C; Desai, Mayur M; Park, Jennifer J; Frame, Elizabeth A; Thompson, Avery A; Naseri, Take; Reupena, Muagututia S; Duckham, Rachel L; Deziel, Nicole C; Hawley, Nicola L

2017-05-01

Young children are particularly vulnerable to malnutrition as nutrition transition progresses. The present study aimed to document the prevalence, coexistence and correlates of nutritional status (stunting, overweight/obesity and anaemia) in Samoan children aged 24-59 months. A cross-sectional community-based survey. Height and weight were used to determine prevalence of stunting (height-for-age Z-score +2) based on WHO growth standards. Anaemia was determined using an AimStrip Hemoglobin test system (Hb <110 g/l). Ten villages on the Samoan island of Upolu. Mother-child pairs (n 305) recruited using convenience sampling. Moderate or severe stunting was apparent in 20·3 % of children, 16·1 % were overweight/obese and 34·1 % were anaemic. Among the overweight/obese children, 28·6 % were also stunted and 42·9 % anaemic, indicating dual burden of malnutrition. Stunting was significantly less likely among girls (OR=0·41; 95 % CI 0·21, 0·79, P<0·01) than boys. Overweight/obesity was associated with higher family socio-economic status and decreased sugar intake (OR per 10 g/d=0·89, 95 % CI 0·80, 0·99, P=0·032). The odds of anaemia decreased with age and anaemia was more likely in children with an anaemic mother (OR=2·20; 95 % CI 1·22, 3·98, P=0·007). No child, maternal or household characteristic was associated with more than one of the nutritional status outcomes, highlighting the need for condition-specific interventions in this age group. The observed prevalences of stunting, overweight/obesity and anaemia suggest that it is critical to invest in nutrition and develop health programmes targeting early childhood growth and development in Samoa.

The Relationship between Livestock Ownership and Child Stunting in Three Countries in Eastern Africa Using National Survey Data.

PubMed

Mosites, Emily M; Rabinowitz, Peter M; Thumbi, Samuel M; Montgomery, Joel M; Palmer, Guy H; May, Susanne; Rowhani-Rahbar, Ali; Neuhouser, Marian L; Walson, Judd L

2015-01-01

Livestock ownership has the potential to improve child nutrition through various mechanisms, although direct evaluations of household livestock and child stunting status are uncommon. We conducted an analysis of Demographic and Health Survey (DHS) datasets from Ethiopia (2011), Kenya (2008-2009), and Uganda (2010) among rural children under 5 years of age to compare stunting status across levels of livestock ownership. We classified livestock ownership by summing reported household numbers of goats, sheep, cattle and chickens, as well as calculating a weighted score to combine multiple species. The primary association was assessed separately by country using a log-binomial model adjusted for wealth and region, which was then stratified by child diarrheal illness, animal-source foods intake, sub-region, and wealth index. This analysis included n = 8079 children from Ethiopia, n = 3903 children from Kenya, and n = 1645 from Uganda. A ten-fold increase in household livestock ownership had significant association with lower stunting prevalence in Ethiopia (Prevalence Ratio [PR] 0.95, 95% CI 0.92-0.98) and Uganda (PR 0.87, 95% CI 0.79-0.97), but not Kenya (PR 1.01, 95% CI 0.96-1.07). The weighted livestock score was only marginally associated with stunting status. The findings varied slightly by region, but not by wealth, diarrheal disease, or animal-source food intake. This analysis suggested a slightly beneficial effect of household livestock ownership on child stunting prevalence. The small effect size observed may be related to limitations of the DHS dataset or the potentially complicated relationship between malnutrition and livestock ownership, including livestock health and productivity.

Predictors of stunting and thinness in post-menarcheal adolescent girls in rural Bangladesh.

PubMed

Rah, Jee H; Christian, Parul; Shamim, Abu Ahmed; Arju, Ummeh T; Labrique, Alain B; Rashid, Mahbubur

2009-12-01

To assess the nutritional status and risk factors of undernutrition in post-menarcheal girls in rural northern Bangladesh. Cross-sectional data on anthropometric measurements, dietary intake, work activity, morbidity and socio-economic status were collected from 12- to 19-year-old primigravidae (n 209) and never-pregnant adolescents (n 456) matched on age and time since menarche. Multiple regression analyses were conducted to determine predictors of stunting, thinness, upper-arm muscle (UAMZ) and fat area Z-scores (UAFZ) among the adolescent girls. A large proportion of adolescents (49 %) were stunted (height-for-age Z-score <-2) and underweight (40 %; weight-for-age Z-score <-2), but not thin (BMI-for-age <5th percentile; approximately 10 %). The mean (sd) UAMZ and UAFZ of the adolescent girls was -0.3 (0.64) and -0.9 (0.40), respectively. Lean mass increased whereas fat mass declined with age. Both stunting and thinness were positively associated with age and time since menarche (P < 0.05). Young age (12-14 years) and literacy were protective against stunting among pregnant adolescents (OR = 0.29, 95 % CI 0.09, 0.88 and OR = 0.50, 95 % CI 0.26, 0.96, respectively). Having symptoms of diarrhoea or dysentery (OR = 7.40, 95 % CI 1.43, 38.29) predicted thinness and was associated with lower UAMZ and UAFZ among never-pregnant girls (both P < 0.05). Performing light-to-moderate activities was protective against thinness among never-pregnant girls (OR = 0.43, 95 % CI 0.22, 0.82), whereas pregnant adolescents who performed high levels of strenuous activities had greater UAMZ (P < 0.05). Undernutrition was widespread among this post-menarcheal adolescent population. Younger and literate adolescents were less likely to be stunted, whereas thinness and body composition were associated with morbidity and work activity.

Impact of disasters on child stunting in Nepal

PubMed Central

Gaire, Surya; Delbiso, Tefera Darge; Pandey, Srijana; Guha-Sapir, Debarati

2016-01-01

Background Stunting is a major public health problem that results from inadequate nutritional intake over a long period of time. Disasters have major implications in poor and vulnerable children. The aim of this study was, therefore, to assess the impact of disasters on child stunting in Nepal. Method A sample consisting of 2,111 children aged 6–59 months was obtained from the 2011 Nepal Demographic and Health Survey. We used bivariate and multivariate analyses to examine moderate and severe stunting against disaster, controlling for all possible confounders. Result Out of the total study sample, 43% were stunted (17.1% severely and 25.9% moderately). The final model, after adjusting for confounders, showed that epidemics have no impact on child stunting (adjusted odds ratio [OR] =1.14, 95% confidence interval [CI]: 0.66, 1.97 and adjusted OR =1.04, 95% CI: 0.66, 1.65 for severe and moderate stunting, respectively). Floods have impact on child stunting (adjusted OR =0.57, 95% CI: 0.31, 0.96 and adjusted OR =0.66, 95% CI: 0.41, 0.94 for severe and moderate stunting, respectively). However, children aged 6–11 months, nonvaccinated children, children of working women, children who live in mountainous areas, and children from the poorest households were more likely to be moderately stunted. Similarly, children aged 36–47 months, Dalit and other ethnic groups, children from rural settings, and children from the poorest households were more likely to be severely stunted. Conclusion This article illustrates the need to rethink about child stunting in Nepal. This study suggests need for further research, integration of disaster data in the Nepal Demography Health Survey, educational interventions, public awareness, promotion of vaccination, and equity in health service delivery. PMID:27354834

Child stunting is associated with low circulating essential amino acids

USDA-ARS?s Scientific Manuscript database

Stunting affects about one-quarter of children under five worldwide. The pathogenesis of stunting is poorly understood. Nutritional interventions have had only modest effects in reducing stunting. We hypothesized that insufficiency in essential amino acids may be limiting the linear growth of childr...

Food habits of stunted and non-stunted white perch (Morone americana)

USGS Publications Warehouse

Gosch, N.J.C.; Stittie, J.R.; Pope, K.L.

2010-01-01

We studied food habits of white perch (Morone americana) from two populations with different stable states (stunted [Branched Oak Lake, Nebraska] and nonstunted [Pawnee Lake, Nebraska]) to determine if change in food habits of white perch is likely to occur in situations where a stunted white perch population is altered to a nonstunted state and vice versa. Three approaches were used to quantitatively describe seasonal (spring = March-May, summer = June-August, autumn = September-November) diets of white perch - 1) frequency of occurrence, 2) percentage of composition by volume, and 3) mean stomach fullness. White perch diets were dominated by cladocerans and dipterans in both reservoirs during all seasons. Fish egg predation was similar between reservoirs, and white perch rarely consumed fishes in either the stunted or the non-stunted population. Shifting a white perch population between stunted and non-stunted states will likely cause little or no change in food habits; fish in both states will primarily consume invertebrates.

Measuring Poverty in Southern India: A Comparison of Socio-Economic Scales Evaluated against Childhood Stunting.

PubMed

Kattula, Deepthi; Venugopal, Srinivasan; Velusamy, Vasanthakumar; Sarkar, Rajiv; Jiang, Victoria; S, Mahasampath Gowri; Henry, Ankita; Deosaran, Jordanna Devi; Muliyil, Jayaprakash; Kang, Gagandeep

2016-01-01

Socioeconomic status (SES) scales measure poverty, wealth and economic inequality in a population to guide appropriate economic and public health policies. Measurement of poverty and comparison of material deprivation across nations is a challenge. This study compared four SES scales which have been used locally and internationally and evaluated them against childhood stunting, used as an indicator of chronic deprivation, in urban southern India. A door-to-door survey collected information on socio-demographic indicators such as education, occupation, assets, income and living conditions in a semi-urban slum area in Vellore, Tamil Nadu in southern India. A total of 7925 households were categorized by four SES scales-Kuppuswamy scale, Below Poverty Line scale (BPL), the modified Kuppuswamy scale, and the multidimensional poverty index (MDPI) and the level of agreement compared between scales. Logistic regression was used to test the association of SES scales with stunting. The Kuppuswamy, BPL, MDPI and modified Kuppuswamy scales classified 7.1%, 1%, 5.5%, and 55.3% of families as low SES respectively, indicating conservative estimation of low SES by the BPL and MDPI scales in comparison with the modified Kuppuswamy scale, which had the highest sensitivity (89%). Children from low SES classified by all scales had higher odds of stunting, but the level of agreement between scales was very poor ranging from 1%-15%. There is great non-uniformity between existing SES scales and cautious interpretation of SES scales is needed in the context of social, cultural, and economic realities.

Prevalence and associated factors for stunting among 6-12 years old school age children from rural community of Humbo district, Southern Ethiopia.

PubMed

Bogale, Tesfahun Yonas; Bala, Elazar Tadesse; Tadesse, Minyahil; Asamoah, Benedict Oppong

2018-05-24

Stunting is one of the most serious and challenging public health problems in Ethiopia, which constitute a significant obstacle to achieving better child health outcomes. This study aimed to assess the prevalence and factors associated with stunting among 6-12 years old children in Humbo district, Southern Ethiopia. This was a cross-sectional study conducted among 633 children 6-12 years old living in Humbo district, Southern Ethiopia, from March to April, 2015. A multistage cluster sampling technique was used to select participants from households in eight Villages in the study area. Height was measured using standard methods and height for age Z-score was computed to assess stunting. EPI info version 3.5.4 was used for data entry, whereas Anthroplus software and SPSS version 20.0 were used for computation of height for age Z-scores and statistical analyses respectively. Simple and multiple logistic regression analyses were used to examine factors associated with stunting in the study sample, using 95% confidence limits (statistical significance set at p < 0.050). Prevalence of stunting was 57%, about, 3.5% were severely stunted, 27.3% moderately stunted and 26.4% mildly stunted, and the mean (SD) was - 1.1 (±1.2). About 7 (1.1%) boys and 15 (2.4%) girls were severely stunted. Age groups 10-12 years had significantly higher rate of stunting than others. Age (AOR = 1.7, 95% CI = 1.1-2.6), big family size (AOR = 4.6, 95% CI = 2.2-9.5) and field disposal of wastes (AOR = 2.7, 95% CI = 1.2-5.8) were factors significantly associated with stunting. This study exposed high rate of stunting among school age children. Stunting remains a noticeable attribute of rural school age children. Findings suggest the need to implement evidence-based school-aged rural children nutrition policy and strategies as well as need for intervention to improve domestic waste management system in the rural community.

Evolution of the biochemical profile of children treated or undergoing treatment for moderate or severe stunting: consequences of metabolic programming?

PubMed

Alves, Jullyana F R; Britto, Revilane P A; Ferreira, Haroldo S; Sawaya, Ana L; Florêncio, Telma M M T

2014-01-01

to evaluate changes in the biochemical profile of children treated or being treated for moderate or severe stunting in a nutrition recovery and education center. this was a retrospective longitudinal study of 263 children treated at this center between August of 2008 to August of 2011, aged 1 to 6 years, diagnosed with moderate (z-score of height-for-age [HAZ] < -2) or severe stunting (HAZ < -3). Data were collected on socioeconomic conditions, dietary habits, and biochemical changes, as well as height according to age. the nutritional intervention showed an increase in HAZ of children with moderate (0.51 ± 0.4, p = 0.001) and severe (0.91 ± 0.7, p = 0.001) stunting during the monitoring. Increased levels of insulin-like growth factor 1 (IGF-1) (initial: 71.7 ng/dL; final: 90.4 ng/dL; p = 0.01) were also observed, as well as a reduction in triglycerides (TG) in both severely (initial: 91.8mg/dL; final: 79.1mg/dL; p = 0.01) and in moderately malnourished children (initial: 109.2mg/dL; final 88.7mg/dL; p = 0.01), and a significant increase in high-density lipoprotein cholesterol HDL-C only in the third year of intervention (initial: 31.4mg/dL; final: 42.2mg/dL). The values of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) levels remained high throughout the treatment (initial: 165.1mg/dL; final: 163.5mg/dL and initial: 109.0mg/dL; final: 107.3mg/dL, respectively). the nutritional treatment for children with short stature was effective in reducing stunting and improving TG and HDL-C after three years of intervention. However, the levels of LDL-C and TC remained high even in treated children. It is therefore speculated that these changes may result from metabolic programming due to malnutrition. Copyright © 2014 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Malnutrition and xerophthalmia in rural communities of Ethiopia.

PubMed

Haidar, J; Demissie, T

1999-10-01

To determine the level of malnutrition and xerophthalmia in pre-school children. Non-randomised community based study. Four different administrative regions: Harari, Tigray, Southern Nation Nationalities and people region (SNNPR) and Oromiya, with different eco-zones, were studied from May to June 1996. Fifteen thousand and eighty seven children, aged between six and 71 months, examined for clinical symptoms and signs of xerophthalmia. Anthropometry and blood samples were taken from every 20 children (n = 634) of same age, for serum retinol and nutritional determination. INTERVENTION MEASURES: Disease targeted approach of vitamin A supplementation was employed in the regions. The overall prevalence rates of night blindness and Bitot's spots exceeded WHO cut-off point for xerophthalmia as a public health problem, with higher prevalence rates in males (53%) than females (26%). The proportion of children with deficient serum retinol concentrations (SRC), and Bitot's spot were observed to be higher in Oromiya and Harari regions followed by Tigray, than SNNPR administrative regions. Most of the affected children were aged between 36 and 72 months. The greatest low SRC was also observed in the same age group of children in all regions. There was higher prevalence rate of stunting (60.1%) than wasting (12.2%) with an additional (8.8%) of children both stunted and wasted. The proportion of stunted children was high in Tigray followed by Oromiya, SNNPR and Harari regions. The high level of stunting and Bitot's spot, together with the low level of serum retinol concentrations found in these regions, indicates the need to strengthen this intervention strategy further with universal vitamin A capsule distribution, nutrition education and promotion of horticulture activities.

Can wheat bran mitigate malnutrition and enteric pathogens?

USDA-ARS?s Scientific Manuscript database

Child malnutrition is a complex global problem, of which lack of food is only one component. Enteric pathogens and malnutrition work in a cyclic manner to depress a child’s intestinal immunity, while decreasing nutrient absorption. This cycle leads to stunting, wasting, and death. Often malnourished...

Replication protein A subunit 3 and the iron efficiency response in soybean

USDA-ARS?s Scientific Manuscript database

In soybean [Glycine max (L.) Merr.], iron deficiency results in interveinal chlorosis and decreased photosynthetic capacity, leading to stunting and yield loss. In this study, gene expression analyses investigated the role of soybean replication protein A (RPA) subunits during iron stress. Nine RP...

Catch-up growth and growth deficits: Nine-year annual panel child growth for native Amazonians in Bolivia

PubMed Central

Zhang, Rebecca; Undurraga, Eduardo A.; Zeng, Wu; Reyes-García, Victoria; Tanner, Susan; Leonard, William R.; Behrman, Jere R.; Godoy, Ricardo A.

2017-01-01

Background Childhood growth stunting is negatively associated with cognitive and health outcomes, claimed to be irreversible after age 2. Aim To estimate growth rates for children 2 ≤ age ≤ 7 who were stunted (sex-age standardized z-score [HAZ] <−2), marginally-stunted (−2≤ HAZ ≤ −1), or not-stunted (HAZ >−1) at baseline and tracked annually until age 11; frequency of movement among height categories; and variation in height predicted by early childhood height. Participants/methods We used a nine-year annual panel (2002–2010) from a native Amazonian society of horticulturalists-foragers (Tsimane’; n=174 girls; 179 boys at baseline) is used. We used descriptive statistics and random-effect regressions. Results We found some evidence of catch-up growth in HAZ but persistent height deficits. Children stunted at baseline improved 1 HAZ unit by age 11, and had higher annual growth rates than non-stunted children. Marginally-stunted boys had a 0.1 HAZ units higher annual growth rate than non-stunted boys. Despite some catch up, ~80% of marginally-stunted children at baseline remained marginally-stunted by age 11. The height deficit increased from age 2 to11. We found modest year-to-year movement between height categories. Conclusions The prevalence of growth faltering among the Tsimane’ has declined, but hurdles still substantially lock children into height categories. PMID:27251215

Disentangling the relative effects of bushmeat availability on human nutrition in central Africa.

PubMed

Fa, John E; Olivero, Jesús; Real, Raimundo; Farfán, Miguel A; Márquez, Ana L; Vargas, J Mario; Ziegler, Stefan; Wegmann, Martin; Brown, David; Margetts, Barrie; Nasi, Robert

2015-02-02

We studied links between human malnutrition and wild meat availability within the Rainforest Biotic Zone in central Africa. We distinguished two distinct hunted mammalian diversity distributions, one in the rainforest areas (Deep Rainforest Diversity, DRD) containing taxa of lower hunting sustainability, the other in the northern rainforest-savanna mosaic, with species of greater hunting potential (Marginal Rainforest Diversity, MRD). Wild meat availability, assessed by standing crop mammalian biomass, was greater in MRD than in DRD areas. Predicted bushmeat extraction was also higher in MRD areas. Despite this, stunting of children, a measure of human malnutrition, was greater in MRD areas. Structural equation modeling identified that, in MRD areas, mammal diversity fell away from urban areas, but proximity to these positively influenced higher stunting incidence. In DRD areas, remoteness and distance from dense human settlements and infrastructures explained lower stunting levels. Moreover, stunting was higher away from protected areas. Our results suggest that in MRD areas, forest wildlife rational use for better human nutrition is possible. By contrast, the relatively low human populations in DRD areas currently offer abundant opportunities for the continued protection of more vulnerable mammals and allow dietary needs of local populations to be met.

Disentangling the relative effects of bushmeat availability on human nutrition in central Africa

NASA Astrophysics Data System (ADS)

Fa, John E.; Olivero, Jesús; Real, Raimundo; Farfán, Miguel A.; Márquez, Ana L.; Vargas, J. Mario; Ziegler, Stefan; Wegmann, Martin; Brown, David; Margetts, Barrie; Nasi, Robert

2015-02-01

We studied links between human malnutrition and wild meat availability within the Rainforest Biotic Zone in central Africa. We distinguished two distinct hunted mammalian diversity distributions, one in the rainforest areas (Deep Rainforest Diversity, DRD) containing taxa of lower hunting sustainability, the other in the northern rainforest-savanna mosaic, with species of greater hunting potential (Marginal Rainforest Diversity, MRD). Wild meat availability, assessed by standing crop mammalian biomass, was greater in MRD than in DRD areas. Predicted bushmeat extraction was also higher in MRD areas. Despite this, stunting of children, a measure of human malnutrition, was greater in MRD areas. Structural equation modeling identified that, in MRD areas, mammal diversity fell away from urban areas, but proximity to these positively influenced higher stunting incidence. In DRD areas, remoteness and distance from dense human settlements and infrastructures explained lower stunting levels. Moreover, stunting was higher away from protected areas. Our results suggest that in MRD areas, forest wildlife rational use for better human nutrition is possible. By contrast, the relatively low human populations in DRD areas currently offer abundant opportunities for the continued protection of more vulnerable mammals and allow dietary needs of local populations to be met.

Children at risk for developmental delay can be recognised by stunting, being underweight, ill health, little maternal schooling or high gravidity.

PubMed

Abubakar, Amina; Holding, Penny; Van de Vijver, Fons J R; Newton, Charles; Van Baar, Anneloes

2010-06-01

To investigate markers of risk status that can be easily monitored in resource-limited settings for the identification of children in need of early developmental intervention. Eighty-five children in Kilifi, Kenya, aged between 2 and 10 months at recruitment, were involved in a 10-month follow-up. Data on developmental outcome were collected through parental report using a locally developed checklist. We tested for the unique and combined influence of little maternal schooling and higher gravidity, anthropometric status (being underweight and stunting) and poor health on the level of developmental achievement and the rate of acquisition of developmental milestones. A model with all five predictors showed a good fit to the data (chi(2)(21, N = 85) = 23.00, p = .33). Maternal schooling and gravidity and child's stunting were found to predict the rate of developmental achievements (beta = .24, beta = .31, and beta = .41, respectively). Being underweight, ill-health, stunting and gravidity predicted initial developmental status (beta = -.26, beta = -.27, beta = -.43, and beta = -.27). Slow rates of developmental achievement can be predicted using these easy-to-administer measures and the strongest relationship with risk was based on a combination of all measures.

Stunting is associated with poor outcomes in childhood pneumonia.

PubMed

Moschovis, Peter P; Addo-Yobo, Emmanuel O D; Banajeh, Salem; Chisaka, Noel; Christiani, David C; Hayden, Douglas; Jeena, Prakash; MacLeod, William B; Mino, Greta; Patel, Archana; Qazi, Shamim; Santosham, Mathuram; Thea, Donald M; Hibberd, Patricia L

2015-10-01

Stunting affects 26.7% of children worldwide, and little is known about its effects on the outcomes of childhood pneumonia. We evaluated the effect of stunting on the outcomes of pneumonia among children enrolled in two large clinical trials. We analysed data from two WHO and USAID-sponsored inpatient treatment trials, the Severe Pneumonia Evaluation Antimicrobial Research study (n = 958) and the Amoxicillin Penicillin Pneumonia International Study (n = 1702), which enrolled children aged 2-59 months across 16 sites in LMICs. We assessed the effect of stunting (height-for-age Z score < -2) on treatment outcome and time to resolution of hypoxaemic pneumonia. Among 2542 (96%) children with valid data for height, 28% were stunted and 12.8% failed treatment by 5 days. The failure rate among stunted patients was 16.0% vs. 11.5% among non-stunted patients [unadjusted RR = 1.24 (95% CI 1.08, 1.41); adjusted RR = 1.28 (95% CI 1.10, 1.48)]. An inverse relationship was observed between height and failure rates, even among non-stunted children. Among 845 patients with hypoxaemic pneumonia, stunting was associated with a lower probability of normalisation of respiratory rate [HR = 0.63 (95% CI 0.52, 0.75)] and oxygen saturation [HR = 0.74 (95% CI 0.61, 0.89)]. Stunting increases the risk of treatment failure and is associated with a longer course of recovery in children with pneumonia. Strategies to decrease stunting may decrease the burden of adverse outcomes in childhood pneumonia in low-resource settings. © 2015 John Wiley & Sons Ltd.

Orbital Light Curves of UU Aquarii in Stunted Outburst

NASA Astrophysics Data System (ADS)

Robertson, J. W.; Honeycutt, R. K.; Henden, A. A.; Campbell, R. T.

2018-02-01

Stunted outbursts are ∼0.ͫ6 eruptions, typically lasting 5–10 days, which are found in some novalike cataclysmic variables, including UU Aqr. The mechanism responsible for stunted outbursts is uncertain but is likely related to an accretion disk instability or to variations in the mass transfer rate. A campaign to monitor the eclipse light curves in UU Aqr has been conducted in order to detect any light curve distortions due to the appearance of a hot spot on the disk at the location of the impact point of the accretion stream. If stunted outbursts are due to a temporary mass transfer enhancement, then predictable deformations of the orbital light curve are expected to occur during such outbursts. This study used 156 eclipses on 135 nights during the years 2000–2012. During this interval, random samples found the system to be in stunted outbursts 4%–5% of the time, yielding ∼7 eclipses obtained during some stage of stunted outburst. About half of the eclipses obtained during stunted outbursts showed clear evidence for hot spot enhancement, providing strong evidence that the stunted outbursts in UU Aqr are associated with mass transfer variations. The other half of the eclipses during stunted outburst showed little or no evidence for hot spot enhancement. Furthermore, there were no systematic changes in the hot spot signature as stunted outbursts progressed. Therefore, we have tentatively attributed the changes in hot spot visibility during stunted outburst to random blobby accretion, which likely further modulates the strength of the accretion stream on orbital timescales.

Stunting is associated with poor outcomes in childhood pneumonia

PubMed Central

Moschovis, Peter P.; Addo-Yobo, Emmanuel O. D.; Banajeh, Salem; Chisaka, Noel; Christiani, David C.; Hayden, Douglas; Jeena, Prakash; MacLeod, William B.; Mino, Greta; Patel, Archana; Qazi, Shamim; Santosham, Mathuram; Thea, Donald M.; Hibberd, Patricia L.

2015-01-01

Objective Stunting affects 26.7% of children worldwide, and little is known about its effects on the outcomes of childhood pneumonia. We evaluated the effect of stunting on the outcomes of pneumonia among children enrolled in two large clinical trials. Methods We analyzed data from two WHO and USAID-sponsored inpatient treatment trials, the Severe Pneumonia Evaluation Antimicrobial Research study (n=958) and the Amoxicillin Penicillin Pneumonia International Study (n=1702), which enrolled children aged 2–59 months across 16 sites in LMICs. We assessed the effect of stunting (height-for-age Z score < −2) on treatment outcome and time to resolution of hypoxemic pneumonia. Results Among 2542 (96%) children with valid data for height, 28% were stunted and 12.8% failed treatment by 5 days. The failure rate among stunted patients was 16.0% vs. 11.5% among non-stunted patients (unadjusted RR = 1.24 [95% CI 1.08, 1.41]; adjusted RR = 1.28 [95% CI 1.10, 1.48]). An inverse relationship was observed between height and failure rates, even among non-stunted children. Among 845 patients with hypoxemic pneumonia, stunting was associated with a lower probability of normalization of respiratory rate (HR = 0.63 [95% CI 0.52, 0.75]) and oxygen saturation (HR = 0.74 [95% CI 0.61, 0.89]). Conclusions Stunting increases the risk of treatment failure and is associated with a longer course of recovery in children with pneumonia. Strategies to decrease stunting may decrease the burden of adverse outcomes in childhood pneumonia in low-resource settings. PMID:26083963

Environmental enteric dysfunction and growth failure/stunting in global child health

USDA-ARS?s Scientific Manuscript database

Approximately 25% of the world's children aged <5 years have stunted growth, which is associated with increased mortality, cognitive dysfunction, and loss of productivity. Reducing by 40% the number of stunted children is a global target for 2030. The pathogenesis of stunting is poorly understood. P...

Risk of poor development in young children in low-income and middle-income countries: an estimation and analysis at the global, regional, and country level

PubMed Central

Lu, Chunling; Black, Maureen M; Richter, Linda M

2018-01-01

Summary Background A 2007 study published in The Lancet estimated that approximately 219 million children aged younger than 5 years were exposed to stunting or extreme poverty in 2004. We updated the 2004 estimates with the use of improved data and methods and generated estimates for 2010. Methods We used country-level prevalence of stunting in children younger than 5 years based on the 2006 Growth Standards proposed by WHO and poverty ratios from the World Bank to estimate children who were either stunted or lived in extreme poverty for 141 low-income and middle-income countries in 2004 and 2010. To avoid counting the same children twice, we excluded children jointly exposed to stunting and extreme poverty from children living in extreme poverty. To examine the robustness of estimates, we also used moderate poverty measures. Findings The 2007 study underestimated children at risk of poor development. The estimated number of children exposed to the two risk factors in low-income and middle-income countries decreased from 279·1 million (95% CI 250·4 million–307·4 million) in 2004 to 249·4 million (209·3 million–292·6 million) in 2010; prevalence of children at risk fell from 51% (95% CI 46–56) to 43% (36–51). The decline occurred in all income groups and regions with south Asia experiencing the largest drop. Sub-Saharan Africa had the highest prevalence in both years. These findings were robust to variations in poverty measures. Interpretation Progress has been made in reducing the number of children exposed to stunting or poverty between 2004 and 2010, but this is still not enough. Scaling up of effective interventions targeting the most vulnerable children is urgently needed. Funding National Institutes of Health, Bill & Melinda Gates Foundation, Hilton Foundation, and WHO. PMID:27717632

Inadequate dietary intake is not the cause of stunting amongst young children living in an informal settlement in Gauteng and rural Limpopo Province in South Africa: the NutriGro study.

PubMed

Theron, M; Amissah, A; Kleynhans, I C; Albertse, E; MacIntyre, U E

2007-04-01

To measure dietary intakes of young children aged 12-24 months and to determine the impact of poor diets on stunting. A quantitative food-frequency questionnaire was adapted, tested and standardised. Trained enumerators conducted in-depth interviews with the mothers/caregivers of the children. Forty stunted children in urban informal settlements and 30 stunted children in rural areas were selected and pair-matched with controls. The data were captured on the Food Finder Program of the Medical Research Council. In both urban and rural areas, the diet of stunted and non-stunted groups did differ significantly and all diets were of poor nutritional quality. Diets in both areas resembled the recommended prudent diet, i.e. low in fat and high in carbohydrates. Poor quality diets were not the primary cause of stunting.

The Professional Development of School Principals

ERIC Educational Resources Information Center

Mathibe, Isaac

2007-01-01

Many schooling systems do not fulfil their mandates because of poor management and leadership. Similarly, the rigidity that one finds in schools does not only stunt schools' capacity to develop, but also leads to schools that are dysfunctional and unproductive. As a result, in countries where there is universal transformation, efficacious…

GESTATIONAL AND LACTATIONAL EXPOSURE TO PROPYLTHIOURACIL INDUCES HYPOTHYROIDISM AND IMPAIRS SYNAPTIC TRANSMISSION AND PLASTICITY IN AREA CA1 OF HIPPOCAMPUS.

EPA Science Inventory

Although severe developmental hypothyroidism leads to stunted growth, alterations in hippocampal structure, and impaired performance on a variety of behavioral learning tasks, the impact of milder forms of hypothyroidism has not been adequately assessed. Preliminary reports of ...

Zinc or albendazole attenuates the progression of environmental enteropathy a randomized controlled trial

USDA-ARS?s Scientific Manuscript database

Environmental enteropathy (EE) is a subclinical condition among children in the developing world, characterized by T-cell infiltration of the small-bowel mucosa and diffuse villous atrophy. EE leads to macronutrient and micronutrient malabsorption and stunting, with a resultant increased risk for in...

The family as a determinant of stunting in children living in conditions of extreme poverty: a case-control study

PubMed Central

Reyes, Hortensia; Pérez-Cuevas, Ricardo; Sandoval, Araceli; Castillo, Raúl; Santos, José Ignacio; Doubova, Svetlana V; Gutiérrez, Gonzalo

2004-01-01

Background Malnutrition in children can be a consequence of unfavourable socioeconomic conditions. However, some families maintain adequate nutritional status in their children despite living in poverty. The aim of this study was to ascertain whether family-related factors are determinants of stunting in young Mexican children living in extreme poverty, and whether these factors differ between rural or urban contexts. Methods A case-control study was conducted in one rural and one urban extreme poverty level areas in Mexico. Cases comprised stunted children aged between 6 and 23 months. Controls were well-nourished children. Independent variables were defined in five dimensions: family characteristics; family income; household allocation of resources and family organisation; social networks; and child health care. Information was collected from 108 cases and 139 controls in the rural area and from 198 cases and 211 controls in the urban area. Statistical analysis was carried out separately for each area; unconditional multiple logistic regression analyses were performed to obtain the best explanatory model for stunting. Results In the rural area, a greater risk of stunting was associated with father's occupation as farmer and the presence of family networks for child care. The greatest protective effect was found in children cared for exclusively by their mothers. In the urban area, risk factors for stunting were father with unstable job, presence of small social networks, low rate of attendance to the Well Child Program activities, breast-feeding longer than six months, and two variables within the family characteristics dimension (longer duration of parents' union and migration from rural to urban area). Conclusions This study suggests the influence of the family on the nutritional status of children under two years of age living in extreme poverty areas. Factors associated with stunting were different in rural and urban communities. Therefore, developing and implementing health programs to tackle malnutrition should take into account such differences that are consequence of the social, economic, and cultural contexts in which the family lives. PMID:15571622

Discovery of uncharacterized sugarcane viruses by next generation sequencing technology: the case of Ramu stunt

USDA-ARS?s Scientific Manuscript database

Ramu stunt disease of sugarcane was first reported in Papua New Guinea in the mid 1980's. The disease can reduce sugarcane yields significantly and causes severe stunting and mortality in highly susceptible cultivars. The causal agent of Ramu stunt has been investigated but its characterization has ...

Socio-economic determinants of severe and moderate stunting among under-five children of rural Bangladesh.

PubMed

Mostafa, Kamal S M

2011-04-01

Malnutrition among under-five children is a chronic problem in developing countries. This study explores the socio-economic determinants of severe and moderate stunting among under-five children of rural Bangladesh. The study used data from the 2007 Bangladesh Demographic and Health Survey. Cross-sectional and multinomial logistic regression analyses were used to assess the effect of the socio-demographic variables on moderate and severe stunting over normal among the children. Findings revealed that over two-fifths of the children were stunted, of which 26.3% were moderately stunted and 15.1% were severely stunted. The multivariate multinomial logistic regression analysis yielded significantly increased risk of severe stunting (OR=2.53, 95% CI=1.34-4.79) and moderate stunting (OR=2.37, 95% CI=1.47-3.83) over normal among children with a thinner mother. Region, father's education, toilet facilities, child's age, birth order of children and wealth index were also important determinants of children's nutritional status. Development and poverty alleviation programmes should focus on the disadvantaged rural segments of people to improve their nutritional status.

Child Stunting is Associated with Low Circulating Essential Amino Acids.

PubMed

Semba, Richard D; Shardell, Michelle; Sakr Ashour, Fayrouz A; Moaddel, Ruin; Trehan, Indi; Maleta, Kenneth M; Ordiz, M Isabel; Kraemer, Klaus; Khadeer, Mohammed A; Ferrucci, Luigi; Manary, Mark J

2016-04-01

Stunting affects about one-quarter of children under five worldwide. The pathogenesis of stunting is poorly understood. Nutritional interventions have had only modest effects in reducing stunting. We hypothesized that insufficiency in essential amino acids may be limiting the linear growth of children. We used a targeted metabolomics approach to measure serum amino acids, glycerophospholipids, sphingolipids, and other metabolites using liquid chromatography-tandem mass spectrometry in 313 children, aged 12-59months, from rural Malawi. Children underwent anthropometry. Sixty-two percent of the children were stunted. Children with stunting had lower serum concentrations of all nine essential amino acids (tryptophan, isoleucine, leucine, valine, methionine, threonine, histidine, phenylalanine, lysine) compared with nonstunted children (p<0.01). In addition, stunted children had significantly lower serum concentrations of conditionally essential amino acids (arginine, glycine, glutamine), non-essential amino acids (asparagine, glutamate, serine), and six different sphingolipids compared with nonstunted children. Stunting was also associated with alterations in serum glycerophospholipid concentrations. Our findings support the idea that children with a high risk of stunting may not be receiving an adequate dietary intake of essential amino acids and choline, an essential nutrient for the synthesis of sphingolipids and glycerophospholipids. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

What would it take to prevent stunted growth in children in sub-Saharan Africa?

PubMed

Lartey, Anna

2015-11-01

There is increasing agreement among the nutrition community about the use of length/height-for-age as the indicator to monitor the long-term impact of chronic nutritional deficiencies. Stunting, an indicator of linear growth failure, has both long- and short-term consequences affecting growth and development and adult work potential. The number of stunted children in sub-Saharan Africa is expected to increase by 2025 if the current trends remain. Stunting among African children peaks during the complementary feeding period, which coincides with the period when children are no longer on exclusive breastfeeding and infections are frequent. Addressing stunting has become the focus of global efforts. The World Health Assembly in 2012 set a 40 % reduction in the number of stunted children by 2025. To effectively address the issues of stunting in sub-Saharan Africa is it appropriate to examine the issue of what it takes. The WHO Multicentre Growth Reference Study (MGRS) conducted in several regions of the world, including Africa has lessons on what it would take to prevent in African children. The children in the MGRS had good socioeconomic background characteristics reflected by years of maternal education and availability of basic amenities, such as potable water and sanitary conditions. The prescription of exclusive breastfeeding, high-quality diversified diets and attention to care were critical factors contributing to healthy growth for the African children. Preventing stunting in sub-Saharan Africa is possible. It requires governments to put in place policies that would create the conducive environment needed. The complex and multiple causes of stunting offer the opportunity to address stunting in a multisectoral and within a food systems approach. The global resolve to make food systems deliver on healthy diet requires all stakeholders to work together to achieve the global goal of reducing stunting. This review highlights the key elements contributing to adequate growth in the Africa cohort of the WHO-MGRS and how these provide lessons for addressing stunting in children in sub-Saharan Africa.

Factors behind the success story of under-five stunting in Peru: a district ecological multilevel analysis.

PubMed

Huicho, Luis; Huayanay-Espinoza, Carlos A; Herrera-Perez, Eder; Segura, Eddy R; Niño de Guzman, Jessica; Rivera-Ch, María; Barros, Aluisio J D

2017-01-19

Stunting prevalence in children less than 5 years has remained stagnated in Peru from 1992 to 2007, with a rapid reduction thereafter. We aimed to assess the role of different predictors on stunting reduction over time and across departments, from 2000 to 2012. We used various secondary data sources to describe time trends of stunting and of possible predictors that included distal to proximal determinants. We determined a ranking of departments by annual change of stunting and of different predictors. To account for variation over time and across departments, we used an ecological hierarchical approach based on a multilevel mixed-effects regression model, considering stunting as the outcome. Our unit of analysis was one department-year. Stunting followed a decreasing trend in all departments, with differing slopes. The reduction pace was higher from 2007-2008 onwards. The departments with the highest annual stunting reduction were Cusco (-2.31%), Amazonas (-1.57%), Puno (-1.54%), Huanuco (-1.52%), and Ancash (-1.44). Those with the lowest reduction were Ica (-0.67%), Ucayali (-0.64%), Tumbes (-0.45%), Lima (-0.37%), and Tacna (-0.31%). Amazon and Andean departments, with the highest baseline poverty rates and concentrating the highest rural populations, showed the highest stunting reduction. In the multilevel analysis, when accounting for confounding, social determinants seemed to be the most important factors influencing annual stunting reduction, with significant variation between departments. Stunting reduction may be explained by the adoption of anti-poverty policies and sustained implementation of equitable crosscutting interventions, with focus on poorest areas. Inclusion of quality indicators for reproductive, maternal, neonatal and child health interventions may enable further analyses to show the influence of these factors. After a long stagnation period, Peru reduced dramatically its national and departmental stunting prevalence, thanks to a combination of social determinants and crosscutting factors. This experience offers useful lessons to other countries trying to improve their children's nutrition.

The financial burden of malnutrition in hospitalized pediatric patients under five years of age.

PubMed

Kittisakmontri, Kulnipa; Sukhosa, Onwaree

2016-10-01

Under-five children are a medically fragile group which is compromised by hospitalization. Malnutrition in those patients not only increases complications and mortality but also affects hospital resource utilization. Therefore, this study was conducted to clarify the impact of malnutrition on hospital expenditures. This prospective cohort study was performed at a tertiary hospital in Thailand. Under-five children who were admitted to general pediatric wards were included. Demographic data, the length of stay (LOS), and anthropometric measurements at admission were recorded. The classification of wasting and stunting were defined according to the World Health Organization (WHO) classification. Moreover, all hospital expenses were calculated directly based on the actual billing including the total hospital cost, cost of bed, enteral formula, medications, medical apparatus and procedures, nursing care, investigations and surgery. One-hundred and five patients with a mean age of 26.8 ± 1.8 months were included. The majority of them were males (61%) with the leading cause of infectious disease. According to the prevalence of malnutrition, the percentage of patients who had only stunting or wasting were 24.8% and 10.5%, respectively while 15.2% of all patients had both stunting and wasting. Regardless of stunting, the wasting patients had a significantly higher cost of bed, enteral formula, nursing care, and medical apparatus. Particularly, the highest costs of all expenditures including the total hospital cost were found in patients who were both stunted and wasting. Apart from the financial burdens, the wasting patients stayed longer in the hospital and the LOS also significantly correlated with the total hospital cost (r = 0.84, p = 0.01). The present study underscores the high prevalence of malnutrition in under-five pediatric patients. The malnourished patients, in particular the wasting group, had longer LOS and consequently had increased hospital expenses. Copyright © 2016 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

Should I fight or should I grow now? The role of cytokinins in plant growth and immunity and in the growth–defence trade-off

PubMed Central

Albrecht, Tessa

2017-01-01

Background Perception and activation of plant immunity require a remarkable level of signalling plasticity and control. In Arabidopsis and other plant species, constitutive defence activation leads to resistance to a broad spectrum of biotrophic pathogens, but also frequently to stunted growth and reduced seed set. Plant hormones are important integrators of the physiological responses that influence the outcome of plant–pathogen interactions. Scope We review the mechanisms by which the plant hormone cytokinin regulates both plant growth and response to pathogens, and how cytokinins may connect these two processes, ultimately affecting the growth trade-offs observed in plant immunity. PMID:27864225

Detection by next generation sequencing of a multi-segmented viral genome from sugarcane associated with Ramu stunt disease

USDA-ARS?s Scientific Manuscript database

Ramu stunt disease of sugarcane was first reported in Papua New Guinea in the mid 1980's. The disease can reduce sugarcane yields significantly and causes severe stunting and mortality in highly susceptible cultivars. The causal agent of Ramu stunt has been investigated but its characterization has ...

Measuring Poverty in Southern India: A Comparison of Socio-Economic Scales Evaluated against Childhood Stunting

PubMed Central

Kattula, Deepthi; Venugopal, Srinivasan; Velusamy, Vasanthakumar; Sarkar, Rajiv; Jiang, Victoria; S., Mahasampath Gowri; Henry, Ankita; Deosaran, Jordanna Devi; Muliyil, Jayaprakash; Kang, Gagandeep

2016-01-01

Introduction Socioeconomic status (SES) scales measure poverty, wealth and economic inequality in a population to guide appropriate economic and public health policies. Measurement of poverty and comparison of material deprivation across nations is a challenge. This study compared four SES scales which have been used locally and internationally and evaluated them against childhood stunting, used as an indicator of chronic deprivation, in urban southern India. Methods A door-to-door survey collected information on socio-demographic indicators such as education, occupation, assets, income and living conditions in a semi-urban slum area in Vellore, Tamil Nadu in southern India. A total of 7925 households were categorized by four SES scales—Kuppuswamy scale, Below Poverty Line scale (BPL), the modified Kuppuswamy scale, and the multidimensional poverty index (MDPI) and the level of agreement compared between scales. Logistic regression was used to test the association of SES scales with stunting. Findings The Kuppuswamy, BPL, MDPI and modified Kuppuswamy scales classified 7.1%, 1%, 5.5%, and 55.3% of families as low SES respectively, indicating conservative estimation of low SES by the BPL and MDPI scales in comparison with the modified Kuppuswamy scale, which had the highest sensitivity (89%). Children from low SES classified by all scales had higher odds of stunting, but the level of agreement between scales was very poor ranging from 1%-15%. Conclusion There is great non-uniformity between existing SES scales and cautious interpretation of SES scales is needed in the context of social, cultural, and economic realities. PMID:27490200

Mothers' autonomy and childhood stunting: evidence from semi-urban communities in Lao PDR.

PubMed

Kamiya, Yusuke; Nomura, Marika; Ogino, Hina; Yoshikawa, Kanako; Siengsounthone, Latsamy; Xangsayarath, Phonepadith

2018-05-22

Childhood stunting (height-for-age z-scores below - 2), a form of chronic undernutrition, remains a global health burden. Although a growing literature has examined the association between mothers' autonomy and childhood stunting, these studies have been limited to countries in South Asia or Sub-Saharan Africa where women have relatively lower social status than do men. Little research has analyzed the effect of mothers' autonomy on childhood stunting in Lao PDR, where women's social status is relatively high compared to that in other countries. We conducted a cross-sectional questionnaire and body scale measurement targeting 100 mothers and their 115 children (<5 years old) from semi-urban communities in Lao PDR, which is the country with the highest prevalence of childhood stunting in the Indochina region. As dimensions of women's autonomy, we measured self-esteem, self-efficacy, decision-making power, freedom of mobility, and control of money. We then analyzed how each dimension was associated with the likelihood of childhood stunting. The likelihood of childhood stunting was significantly lower if mothers had higher self-efficacy for health care (OR = 0.15, p = 0.007), self-esteem (OR = 0.11, p = 0.025), or control of money (OR = 0.11, p = 0.041). In contrast, mothers' decision-making power and freedom of mobility were not significantly associated with childhood stunting. We clarified which dimensions of women's autonomy were associated with childhood stunting in Lao PDR. A closer examination of mothers' autonomy will aid proper understanding of the determinants of childhood stunting.

Environmental predictors of stunting among children under-five in Somalia: cross-sectional studies from 2007 to 2010.

PubMed

Kinyoki, Damaris K; Berkley, James A; Moloney, Grainne M; Odundo, Elijah O; Kandala, Ngianga-Bakwin; Noor, Abdisalan M

2016-07-28

Stunting among children under five years old is associated with long-term effects on cognitive development, school achievement, economic productivity in adulthood and maternal reproductive outcomes. Accurate estimation of stunting and tools to forecast risk are key to planning interventions. We estimated the prevalence and distribution of stunting among children under five years in Somalia from 2007 to 2010 and explored the role of environmental covariates in its forecasting. Data from household nutritional surveys in Somalia from 2007 to 2010 with a total of 1,066 clusters covering 73,778 children were included. We developed a Bayesian hierarchical space-time model to forecast stunting by using the relationship between observed stunting and environmental covariates in the preceding years. We then applied the model coefficients to environmental covariates in subsequent years. To determine the accuracy of the forecasting, we compared this model with a model that used data from all the years with the corresponding environmental covariates. Rainfall (OR = 0.994, 95 % Credible interval (CrI): 0.993, 0.995) and vegetation cover (OR = 0.719, 95 % CrI: 0.603, 0.858) were significant in forecasting stunting. The difference in estimates of stunting using the two approaches was less than 3 % in all the regions for all forecast years. Stunting in Somalia is spatially and temporally heterogeneous. Rainfall and vegetation are major drivers of these variations. The use of environmental covariates for forecasting of stunting is a potentially useful and affordable tool for planning interventions to reduce the high burden of malnutrition in Somalia.

Determinants of stunting at 6, 12, 24 and 60 months and postnatal linear growth in Pakistani children.

PubMed

Saleemi, M A; Ashraf, R N; Mellander, L; Zaman, S

2001-11-01

A "nested" case-control design was used to identify cases from a longitudinally followed cohort of 1236 newborns registered during 1984-1987, living in three socioeconomically different areas. The children had a length <-2SDS (standard deviation scores) at 6, 12, 24 and 60 mo of age using the NCHS reference. The controls were matched for gender, area and month of birth. A logistic regression analysis was used for determining the risk factors for stunting at each age. Postnatal linear growth was also examined in these two groups of children and body size was compared with the NCHS reference and that of upper-middle-class children (n = 240). At 6 mo of age, prematurity and duration of breastfeeding showed a significant association with stunting. At 12 mo, maternal height, birthweight and stunting at 6 mo, while at 24 mo, stunting at 6, 12 and 18 mo were identified as important factors. At 60 mo, no other factors besides previous stunting could be identified. The mean height reached at 60 mo showed a deficit of 6 and 13 cm for the controls and the cases, respectively, compared to the NCHS reference. Twenty-eight percent of the children from the two poor areas who were stunted at 6 mo had improved by 60 mo of age. The risk factors for stunting varied at different ages, relating more to feeding at early ages and to previous stunting, predominantly at higher ages. The linear growth showed that faltering increased with age when cases and controls were treated separately. Recovery from stunting could also be demonstrated.

Prevalence and factors associated with stunting and excess weight in children aged 0-5 years from the Brazilian semi-arid region.

PubMed

Ramos, Clariana V; Dumith, Samuel C; César, Juraci A

2015-01-01

To analyze the prevalence of excess weight and low height, and identify associated factors among children younger than five years. Cross-census study. A total of 1,640 children from two municipalities in Piauí, Brazil were included. The prevalence of low height was 10.9% (95% CI: 9.3 to 12.4), inversely associated with mother's younger age and low level of education, lower socioeconomic status, mothers who had fewer than six prenatal consultations, and households that had more than one child younger than 5 years. Excess weight prevalence was 19.1% (95% CI: 17.2 to 21.0), and remained inversely associated with lower maternal age, low maternal education, and cesarean delivery. Stunting was greater in children aged between 12 and 23 months, while excess weight decreased with age. It is noteworthy that the stunting rate, although decreasing, is still high, while the prevalence of excess weight, even in this very poor area, already exceeds the expected percentage for a population with better socioeconomic level. Copyright © 2014 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Perspective: The potential role of essential amino acids and the mechanistic target of rapamycin complex 1 (mTORC1) pathway in the pathogenesis of child stunting

USDA-ARS?s Scientific Manuscript database

Stunting is the best summary measure of chronic malnutrition in children. Approximately one-quarter of children under age 5 worldwide are stunted. Lipid-based or micronutrient supplementation has little to no impact in reducing stunting, which suggests that other critical dietary nutrients are missi...

Risk factors for childhood malnutrition in Roma settlements in Serbia.

PubMed

Janevic, Teresa; Petrovic, Oliver; Bjelic, Ivana; Kubera, Amber

2010-08-22

Children living in Roma settlements in Central and Eastern Europe face extreme levels of social exclusion and poverty, but their health status has not been well studied. The objective of this study was to elucidate risk factors for malnutrition in children in Roma settlements in Serbia. Anthropometric and sociodemographic measures were obtained for 1192 Roma children under five living in Roma settlements from the 2005 Serbia Multiple Indicator Cluster Survey. Multiple logistic regression was used to relate family and child characteristics to the odds of stunting, wasting, and underweight. The prevalence of stunting, wasting, and underweight was 20.1%, 4.3%, and 8.0%, respectively. Nearly all of the children studied fell into the lowest quintile of wealth for the overall population of Serbia. Children in the lowest quintile of wealth were four times more likely to be stunted compared to those in the highest quintile, followed by those in the second lowest quintile (AOR = 2.1) and lastly by those in the middle quintile (AOR = 1.6). Children who were ever left in the care of an older child were almost twice as likely to stunted as those were not. Children living in urban settlements showed a clear disadvantage with close to three times the likelihood of being wasted compared to those living in rural areas. There was a suggestion that maternal, but not paternal, education was associated with stunting, and maternal literacy was significantly associated with wasting. Whether children were ever breastfed, immunized or had diarrhoeal episodes in the past two weeks did not show strong correlations to children malnutrition status in this Roma population. There exists a gradient relationship between household wealth and stunting even within impoverished settlements, indicating that among poor and marginalized populations socioeconomic inequities in child health should be addressed. Other areas on which to focus future research and public health intervention include maternal literacy, child endangerment practices, and urban settlements.

Risk factors for childhood malnutrition in Roma settlements in Serbia

PubMed Central

2010-01-01

Background Children living in Roma settlements in Central and Eastern Europe face extreme levels of social exclusion and poverty, but their health status has not been well studied. The objective of this study was to elucidate risk factors for malnutrition in children in Roma settlements in Serbia. Methods Anthropometric and sociodemographic measures were obtained for 1192 Roma children under five living in Roma settlements from the 2005 Serbia Multiple Indicator Cluster Survey. Multiple logistic regression was used to relate family and child characteristics to the odds of stunting, wasting, and underweight. Results The prevalence of stunting, wasting, and underweight was 20.1%, 4.3%, and 8.0%, respectively. Nearly all of the children studied fell into the lowest quintile of wealth for the overall population of Serbia. Children in the lowest quintile of wealth were four times more likely to be stunted compared to those in the highest quintile, followed by those in the second lowest quintile (AOR = 2.1) and lastly by those in the middle quintile (AOR = 1.6). Children who were ever left in the care of an older child were almost twice as likely to stunted as those were not. Children living in urban settlements showed a clear disadvantage with close to three times the likelihood of being wasted compared to those living in rural areas. There was a suggestion that maternal, but not paternal, education was associated with stunting, and maternal literacy was significantly associated with wasting. Whether children were ever breastfed, immunized or had diarrhoeal episodes in the past two weeks did not show strong correlations to children malnutrition status in this Roma population. Conclusions There exists a gradient relationship between household wealth and stunting even within impoverished settlements, indicating that among poor and marginalized populations socioeconomic inequities in child health should be addressed. Other areas on which to focus future research and public health intervention include maternal literacy, child endangerment practices, and urban settlements. PMID:20727212

Children at risk for developmental delay can be recognized by stunting, being underweight, ill health, little maternal schooling or high gravidity

PubMed Central

Abubakar, Amina; Holding, Penny; Van de Vijver, Fons J. R.; Newton, Charles; Van Baar, Anneloes

2010-01-01

Aims To investigate markers of risk status that can be easily monitored in resource limited settings for the identification of children in need of early developmental intervention. Methods Eighty-five children in Kilifi, Kenya, aged between 2–10 months at recruitment, were involved in a ten-month follow up. Data on developmental outcome were collected through parental report using a locally developed checklist. We tested for the unique and combined influence of little maternal schooling and higher gravidity, anthropometric status (being underweight and stunting) and poor health, on the level of developmental achievement and the rate of acquisition of developmental milestones. Results A model with all five predictors showed a good fit to the data (χ2(21, N = 85) = 23.00, p = .33). Maternal schooling and gravidity, and child’s stunting were found to predict the rate of developmental achievements (β = .24, β = .31, and β = .41, respectively). Being underweight, ill-health, stunting and gravidity predicted initial developmental status (β = −.26, β = −.27, β = −.43, and β = −.27). Conclusions Slow rates of developmental achievement can be predicted using these easy to administer measures and the strongest relationship with risk was based on a combination of all measures. PMID:19951363

Wasting and stunting--similarities and differences: policy and programmatic implications.

PubMed

Briend, André; Khara, Tanya; Dolan, Carmel

2015-03-01

Wasting and stunting are often presented as two separate forms of malnutrition requiring different interventions for prevention and/or treatment. These two forms of malnutrition, however, are closely related and often occur together in the same populations and often in the same children. Wasting and stunting are both associated with increased mortality, especially when both are present in the same child. A better understanding of the pathophysiology of these two different forms of malnutrition is needed to design efficient programs. A greatly reduced muscle mass is characteristic of severe wasting, but there is indirect evidence that it also occurs in stunting. A reduced muscle mass increases the risk of death during infections and also in many other different pathological situations. Reduced muscle mass may represent a common mechanism linking wasting and stunting with increased mortality. This suggests that to decrease malnutrition-related mortality, interventions should aim at preventing both wasting and stunting, which often share common causes. Also, this suggests that treatment interventions should focus on children who are both wasted and stunted and therefore have the greatest deficits in muscle mass, instead of focusing on one or the other form of malnutrition. Interventions should also focus on young infants and children, who have a low muscle mass in relation to body weight to start with. Using mid-upper-arm circumference (MUAC) to select children in need of treatment may represent a simple way to target young wasted and stunted children efficiently in situations where these two conditions are present. Wasting is also associated with decreased fat mass. A decreased fat mass is frequent but inconsistent in stunting. Fat secretes multiple hormones, including leptin, which may have a stimulating effect on the immune system. Depressed immunity resulting from low fat stores may also contribute to the increased mortality observed in wasting. This may represent another common mechanism linking wasting and stunting with increased mortality in situations where stunting is associated with reduced fat mass. Leptin may also have an effect on bone growth. This may explain why wasted children with low fat stores have reduced linear growth when their weight-for-height remains low. It may also explain the frequent association of stunting with previous episodes of wasting. Stunting, however, can occur in the absence of wasting and even in overweight children. Thus, food supplementation should be used with caution in populations where stunting is not associated with wasting and low fat stores.

Determinants of infant growth in Eastern Uganda: a community-based cross-sectional study.

PubMed

Engebretsen, Ingunn Marie Stadskleiv; Tylleskär, Thorkild; Wamani, Henry; Karamagi, Charles; Tumwine, James K

2008-12-22

Child under-nutrition is a leading factor underlying child mortality and morbidity in Sub-Saharan Africa. Several studies from Uganda have reported impaired growth, but there have been few if any community-based infant anthropometric studies from Eastern Uganda. The aim of this study was to describe current infant growth patterns using WHO Child Growth Standards and to determine the extent to which these patterns are associated with infant feeding practices, equity dimensions, morbidity and use of primary health care for the infants. A cross-sectional survey of infant feeding practices, socio-economic characteristics and anthropometric measurements was conducted in Mbale District, Eastern Uganda in 2003; 723 mother-infant (0-11 months) pairs were analysed. Infant anthropometric status was assessed using z-scores for weight-for-length (WLZ), length-for-age (LAZ) and weight-for-age (WAZ). Dependent dichotomous variables were constructed using WLZ < -2 (wasting) and LAZ < -2 (stunting) as cut-off values. A conceptual hierarchical framework was used as the basis for controlling for the explanatory factors in multivariate analysis. Household wealth was assessed using principal components analysis. The prevalences of wasting and stunting were 4.2% and 16.7%, respectively. Diarrhoea during the previous 14 days was associated with wasting in the crude analysis, but no factors were significantly associated with wasting in the adjusted analysis. The adjusted analysis for stunting showed associations with age and gender. Stunting was more prevalent among boys than girls, 58.7% versus 41.3%. Having brothers and/or sisters was a protective factor against stunting (OR 0.4, 95% CI 0.2-0.8), but replacement or mixed feeding was not (OR 2.7, 95% CI 1.0-7.1). Lowest household wealth was the most prominent factor associated with stunting with a more than three-fold increase in odds ratio (OR 3.5, 95% CI 1.6-7.8). This pattern was also seen when the mean LAZ was investigated across household wealth categories: the adjusted mean difference between the top and the bottom wealth categories was 0.58 z-scores, p < 0.001. Those who had received pre-lacteal feeds had lower adjusted mean WLZ than those who had not: difference 0.20 z-scores, p = 0.023. Sub-optimal infant feeding practices after birth, poor household wealth, age, gender and family size were associated with growth among Ugandan infants.

Stunting and the Prediction of Lung Volumes Among Tibetan Children and Adolescents at High Altitude

PubMed Central

Garruto, Ralph M.

2015-01-01

Abstract Weitz, Charles A., and Ralph M. Garruto. Stunting and the prediction of lung volumes among Tibetan children and adolescents at high altitude. High Alt Biol Med 16:306–317, 2015.—This study examines the extent to which stunting (height-for-age Z-scores ≤ −2) compromises the use of low altitude prediction equations to gauge the general increase in lung volumes during growth among high altitude populations. The forced vital capacity (FVC) and forced expiratory volume (FEV1) of 208 stunted and 365 non-stunted high-altitude Tibetan children and adolescents between the ages of 6 and 20 years are predicted using the Third National Health and Nutrition Examination Survey (NHANESIII) and the Global Lung Function Initiative (GLF) equations, and compared to observed lung volumes. Stunted Tibetan children show smaller positive deviations from both NHANESIII and GLF prediction equations at most ages than non-stunted children. Deviations from predictions do not correspond to differences in body proportions (sitting heights and chest circumferences relative to stature) between stunted and non-stunted children; but appear compatible with the effects of retarded growth and lung maturation that are likely to exist among stunted children. These results indicate that, before low altitude standards can be used to evaluate the effects of hypoxia, or before high altitude populations can be compared to any other group, it is necessary to assess the relative proportion of stunted children in the samples. If the proportion of stunted children in a high altitude population differs significantly from the proportion in the comparison group, lung function comparisons are unlikely to yield an accurate assessment of the hypoxia effect. The best solution to this problem is to (1) use stature and lung function standards based on the same low altitude population; and (2) assess the hypoxic effect by comparing observed and predicted values among high altitude children whose statures are most like those of children on whom the low altitude spirometric standard is based—preferably high altitude children with HAZ-scores ≥ −1. PMID:26397381

Factors associated with stunting in healthy children aged 5 years and less living in Bangui (RCA).

PubMed

Vonaesch, Pascale; Tondeur, Laura; Breurec, Sébastien; Bata, Petula; Nguyen, Liem Binh Luong; Frank, Thierry; Farra, Alain; Rafaï, Clotaire; Giles-Vernick, Tamara; Gody, Jean Chrysostome; Gouandjika-Vasilache, Ionela; Sansonetti, Philippe; Vray, Muriel

2017-01-01

Stunting remains a major public health concern worldwide. Although its global prevalence is slowly decreasing, the actual number of affected children is still rising in Sub-Saharan Africa. In the Central African Republic (CAR), about one third of all children below the age of five are stunted. Stunting is correlated with many long-term consequences, including poor cognitive development and a higher rate of morbidity and mortality, making stunting a major contributor to poverty. In CAR, little is known about the factors that contribute to stunting. This study aimed at analysing, in a cross-sectional study, the main factors associated with stunting in a group of 414 children recruited between December 2011 and November 2013, aged five years or less and living in Bangui. For all children, demographic, socio-economic and anthropometric data were recorded and asymptomatic enteropathogen carriage was assessed in stool samples using classical microbiological assays. The study group had a mean age of 14.2±10 months. Fifty-eight percent (292/414) were boys, and 36 percent (148/414) exhibited stunted growth. Of the stunted children, 51% (75/148) showed a moderate delay in linear growth for their age group [height-for-age z-score (HAZ) between -2 and -3 SD] while 49% (73/148) presented a severe delay (HAZ < -3). Factors significantly associated with stunting included gender (aOR: 1.67; 95% CI: 1.07; 2.62 for boys compared to girls) and age (aOR of 3.98 (95% CI: 2.45; 6.46) for toddlers and aOR 4.42 (95% CI: 2.36; 8.28) for children compared to infants). Most importantly, we identified being overweight [weight-for-height z-score (WHZ) > 2 SD; aOR: 3.21; 95% CI: 1.50; 6.90 of overweight compared to normal weight] as also being significantly associated with stunting. This is the first study showing that even in the poorest countries of the world there is an association of stunting with being overweight.

Stunting and the Prediction of Lung Volumes Among Tibetan Children and Adolescents at High Altitude.

PubMed

Weitz, Charles A; Garruto, Ralph M

2015-12-01

This study examines the extent to which stunting (height-for-age Z-scores ≤ -2) compromises the use of low altitude prediction equations to gauge the general increase in lung volumes during growth among high altitude populations. The forced vital capacity (FVC) and forced expiratory volume (FEV1) of 208 stunted and 365 non-stunted high-altitude Tibetan children and adolescents between the ages of 6 and 20 years are predicted using the Third National Health and Nutrition Examination Survey (NHANESIII) and the Global Lung Function Initiative (GLF) equations, and compared to observed lung volumes. Stunted Tibetan children show smaller positive deviations from both NHANESIII and GLF prediction equations at most ages than non-stunted children. Deviations from predictions do not correspond to differences in body proportions (sitting heights and chest circumferences relative to stature) between stunted and non-stunted children; but appear compatible with the effects of retarded growth and lung maturation that are likely to exist among stunted children. These results indicate that, before low altitude standards can be used to evaluate the effects of hypoxia, or before high altitude populations can be compared to any other group, it is necessary to assess the relative proportion of stunted children in the samples. If the proportion of stunted children in a high altitude population differs significantly from the proportion in the comparison group, lung function comparisons are unlikely to yield an accurate assessment of the hypoxia effect. The best solution to this problem is to (1) use stature and lung function standards based on the same low altitude population; and (2) assess the hypoxic effect by comparing observed and predicted values among high altitude children whose statures are most like those of children on whom the low altitude spirometric standard is based-preferably high altitude children with HAZ-scores ≥ -1.

Height and weight of urban preschool children in relation to their mothers' educational levels and employment status in Rasht City, northern Iran.

PubMed

Maddah, Mohsen; Mohtasham-Amiri, Zahra; Rashidi, Arash; Karandish, Majid

2007-01-01

This study determined the relationship between anthropometric status of 3-5-year-old urban children and theirs mothers' educational levels and employment status in Rasht City, northern Iran. A total of 1319 children (638 girls and 681 boys) at the ages of 3 and 6 years in all day-care centres in Rasht City were studied, using a cross-sectional design. Height and weight of the children were measured, and data on mothers' educational levels, employment status and duration of any breastfeeding were collected. Height for age, weight for age and weight for height of the children were compared with the National Center for Health Statistics (NCHS) reference population of the United States, and z-values 12 years of schooling, OR = 1.87; 95% CI: 1.08-2.4) had higher relative risk for underweight than children of mothers with an intermediate level of education (5-12 years of schooling). Children of mothers with college education were also more at risk for development of stunting (OR = 1.41; 95% CI: 1.14-4.22). In addition, children of employed mothers were more likely to be underweight (OR = 1.52; 95% CI: 1.05-2.31), stunted (OR = 2.42; 95% CI: 1.21-6.35) and wasted (OR = 3.35; 95% CI: 1.21-5.58) than children of non-employed mothers. The relative risk for undernutrition was higher in the children of both less and highly educated mothers compared with children of mothers with an intermediate level of education. Mothers' employment was also negatively related to nutritional status of these children in day-care centres in Rasht City.

Wasting and stunting are still prevalent in children with sickle cell anaemia in Lagos, Nigeria.

PubMed

Esezobor, Christopher I; Akintan, Patricia; Akinsulie, Adebola; Temiye, Edamisan; Adeyemo, Titilope

2016-05-04

Sickle cell anaemia (SCA) is associated with growth failure. However, recent reports indicate high rates of overweight or obesity among children with SCA in developed countries. It is unclear whether overweight or obesity is also common in children with SCA in developing countries. The objectives of the study were to determine the prevalence of overweight or obesity, wasting and stunting and identify predictors of wasting and stunting among children with SCA in Nigeria. Children with SCA attending a public-funded tertiary hospital clinic were studied. Weight, height, haemoglobin, haemoglobin fractions and white cell count were measured. Anthropometric values were converted to z scores and referenced to the WHO Child Growth Standards and WHO Reference 2007. The proportions with wasting, stunting and overweight or obesity were determined. Regression analysis was used to identify the predictors of wasting and stunting. Two hundred and thirty-three children [mean (±SD) age of 9.0 (±4.0) years, 60.9 % males] participated in the study. Wasting, stunting and overweight or obesity rates were 22.7 %, 11.6 % and 1.7 %, respectively. Boys and children from low socioeconomic class were 3.25 (1.45-7.29) and 2.42 (1.14-5.18) times more likely to be wasted respectively, while both wasting and stunting were more common with increasing age [adjusted OR of 1.33 (1.18-1.51) and 1.15 (1.01-1.32) respectively]. Sickle cell-related complications and intake of oral penicillin and hydroxyurea were not associated with wasting and stunting. Overweight or obesity is uncommon while wasting and stunting are still prevalent in children with SCA in Lagos. The strongest predictors of wasting and stunting were older age, male gender and low socioeconomic status.

Factors Influencing the Prevalence of Stunting Among Children Aged Below Five Years in Bangladesh.

PubMed

Sarma, Haribondhu; Khan, Jahidur Rahman; Asaduzzaman, Mohammad; Uddin, Fakhar; Tarannum, Sayeeda; Hasan, Md Mehedi; Rahman, Ahmed Shafiqur; Ahmed, Tahmeed

2017-09-01

Poor nutrition during childhood impedes physical and mental development of children, which propagate the vicious cycle of intergenerational under nutrition. This paper is aimed at understanding the determinants of stunting among children aged 0 to 59 months in Bangladesh. The study used Bangladesh Demographic and Health Survey 2011 data and a multistage stratified cluster-sampling design. Anthropometric data (for height and weight) were collected and analysis was limited to 7647 children. Multiple binary logistic regression analysis was performed to assess the association of stunting with potential socioeconomic and demographic factors. The prevalence of stunting has been found to be about 41% among children aged less than 60 months and higher in rural setting than in urban areas (43% vs 36%). Adjusted model revealed that several factors were influencing stunting. The children living in moderately food-insecure households had higher odds of becoming stunted (odds ratio [OR] = 1.27, 95% confidence interval [CI]: 1.05-1.54, P = .01) compared to the children living in food-secure households. The derived ORs of stunting for children delivered at institutions facilitated particularly by public (OR = 0.80, 95% CI: 0.67-0.96; P = .02) or private (OR = 0.81, 95% CI: 0.67-0.97; P = .02) sectors were less than for children delivered at home. Similarly, wealth index, exposure of mother to the mass media, age of child, size of child at birth, and parents' education were significantly associated with stunting. Moreover, the demographic characteristics and other indicators appeared to have significant influence in the prevalence of stunting. Public health programs are needed to avert the risk factors of stunting among children in Bangladesh.

A comparison of the socio-economic determinants of growth retardation in South African and Filipino infants.

PubMed

Jones, Laura L; Griffiths, Paula L; Adair, Linda S; Norris, Shane A; Richter, Linda M; Cameron, Noël

2008-12-01

To examine the association between household socio-economic status (SES) at birth and poor infant growth such as small for gestational age (SGA) and stunting across two different socio-cultural settings: South Africa and the Philippines. Data were from two longitudinal birth cohorts, the Birth to Twenty (Bt20) study in South Africa and the Cebu Longitudinal Health and Nutrition Survey (CLHNS) in the Philippines. Bt20 infants (n 2293 total; reduced to 758 (SGA), 450 (stunting 1 year) and 401 (stunting 2 years)) and CLHNS infants (n 2513 total; reduced to 2161 (SGA), 1820 (stunting 1 year) and 1710 (stunting 2 years)). CLHNS infants were significantly more likely to be born SGA (20.9 v. 11.7 %) and be stunted at 1 year (32.6 v. 8.7 %) and 2 years (48.9 v. 21.1 %) compared with Bt20 infants. Logistic regression analyses showed that SES (index) was a significant predictor of stunting at 1 and 2 years of age in the CLHNS cohort. SES (index or individual variables) was not a significant predictor of SGA in either cohort, or of stunting in the Bt20 cohort. Maternal education, ownership of a television and toilet facilities were all independent predictors of stunting in the CLHNS cohort. The social and economic milieu within the Philippines appears to place CLHNS infants at greater risk of being born SGA and being stunted compared with Bt20 infants. The present research highlights the importance of investigating the individual SES variables that predict infantile growth faltering, to identify the key areas for context-specific policy development and intervention.

The stunted child with an overweight mother as a growing public health concern in resource-poor environments: a case study from Guatemala.

PubMed

Doak, Colleen M; Campos Ponce, Maiza; Vossenaar, Marieke; Solomons, Noel W

2016-01-01

Overweight and obesity are emerging at alarming rates in low income women in many countries. Guatemala has the additional burden of a high prevalence of chronic under-nutrition (stunting) in children. The purpose of this paper is to explore the dual burden of infant and child (5-23 months) under-nutrition and maternal over-weight and obesity in the Western Highlands of Guatemala. Anthropometric measures were collected in 446 mother-infant dyads in a metropolitan population of mixed indigenous (Maya) and non-indigenous descent in the Western Highlands of Guatemala. Children were identified as stunted based on a height for age <-2 below the WHO reference median and maternal overweight/obesity defined as a BMI ≥25. Stunted children with an overweight/obese mother were compared to other children who were not stunted and/or who did not have an overweight/obese mother. The prevalences of stunting (38%) and maternal overweight/obesity (45%) were high, but just 17% of the mother and child pairs were dual burden. The socio-demographic characteristics of stunted children were not influenced by maternal overweight or obesity. Policies are needed to address under-nutrition as well as preventing obesity and obesity-related chronic disease risks of stunted children and their mothers.

Catch-up growth does not associate with cognitive development in Indian school-age children.

PubMed

Sokolovic, N; Selvam, S; Srinivasan, K; Thankachan, P; Kurpad, A V; Thomas, T

2014-01-01

Stunting is significantly associated with lifetime morbidity and poorer cognitive outcomes in children. Although several studies have examined the relationship between stunting, catch-up growth and cognitive performance in young populations, this relationship has not yet been explored in school-aged children. In this study, we used data from three different nutritional intervention studies conducted over a 4-year period on school-age children in Bangalore, India to assess these relationships. A battery of cognitive tests was conducted before each intervention to determine whether stunting status at baseline was related to cognitive performance across four separate domains, and repeated after a 6-month period to assess whether changes to stunting status is related to cognitive advancement. Results of independent t-tests showed that while stunted children had significantly poorer performance on short-term memory, retrieval ability and visuospatial ability tests (P=0.023, 0.026 and 0.028, respectively), there was no significant difference in the change in cognitive scores following nutritional interventions over a 6-month period between those who remained stunted and those who were no longer stunted (P>0.10). Evidently, stunting remains associated with cognitive ability in school-age children; however, the reversal of these effects in this age group may be quite difficult.

Can water, sanitation and hygiene help eliminate stunting? Current evidence and policy implications

PubMed Central

Cairncross, Sandy

2016-01-01

Abstract Stunting is a complex and enduring challenge with far‐reaching consequences for those affected and society as a whole. To accelerate progress in eliminating stunting, broader efforts are needed that reach beyond the nutrition sector to tackle the underlying determinants of undernutrition. There is growing interest in how water, sanitation and hygiene (WASH) interventions might support strategies to reduce stunting in high‐burden settings, such as South Asia and sub‐Saharan Africa. This review article considers two broad questions: (1) can WASH interventions make a significant contribution to reducing the global prevalence of childhood stunting, and (2) how can WASH interventions be delivered to optimize their effect on stunting and accelerate progress? The evidence reviewed suggests that poor WASH conditions have a significant detrimental effect on child growth and development resulting from sustained exposure to enteric pathogens but also due to wider social and economic mechanisms. Realizing the potential of WASH to reduce stunting requires a redoubling of efforts to achieve universal access to these services as envisaged under the Sustainable Development Goals. It may also require new or modified WASH strategies that go beyond the scope of traditional interventions to specifically address exposure pathways in the first 2 years of life when the process of stunting is concentrated. PMID:27187910

Inequality in malnutrition by maternal education levels in early childhood: the Prospective Cohort of Thai Children (PCTC).

PubMed

Hong, Seo Ah; Winichagoon, Pattanee; Mongkolchati, Aroonsri

2017-05-01

As tackling socioeconomic inequality in child malnutrition still remains one of the greatest challenges in developing countries, we examined maternal educational differences in malnutrition and the magnitude of its inequality among 4,198 children from the Prospective Cohort study of Thai Children (PCTC). Prevalence of stunting, underweight, and wasting from birth to 24 months was calculated using the new WHO growth chart. The Relative Index of Inequality (RII) was used to examine the magnitude and trend of inequality in malnutrition between maternal educational levels. The low education group had lower weight and height in most ages than the high education group. Faltering in height was observed in all education levels, but was most remarkable in the low education group. On the other hand, while upward trends for weight-for-age and weight-for-height across ages were observed in the high education group, a marked decline between 6 to 12 months was observed in the low education group. An increasing trend in inequality in The RII revealed an increasing trend in inequality in stunting, underweight, and wasting by maternal education levels was observed during infancy with an almost monotonic increase until 24 months, although the inequality in wasting decreased after 18 months of age. Inequality in malnutrition remarkably increased during infancy, and for stunting and underweight it remained until 24 months. These findings shed light on the extent of malnutrition inequality during the first 2 years of life and they suggest sustainable efforts must be established at the national level to tackle the malnutrition inequality in infancy.

Complete Nucleotide Sequence of Watermelon Chlorotic Stunt Virus Originating from Oman

PubMed Central

Khan, Akhtar J.; Akhtar, Sohail; Briddon, Rob W.; Ammara, Um; Al-Matrooshi, Abdulrahman M.; Mansoor, Shahid

2012-01-01

Watermelon chlorotic stunt virus (WmCSV) is a bipartite begomovirus (genus Begomovirus, family Geminiviridae) that causes economic losses to cucurbits, particularly watermelon, across the Middle East and North Africa. Recently squash (Cucurbita moschata) grown in an experimental field in Oman was found to display symptoms such as leaf curling, yellowing and stunting, typical of a begomovirus infection. Sequence analysis of the virus isolated from squash showed 97.6–99.9% nucleotide sequence identity to previously described WmCSV isolates for the DNA A component and 93–98% identity for the DNA B component. Agrobacterium-mediated inoculation to Nicotiana benthamiana resulted in the development of symptoms fifteen days post inoculation. This is the first bipartite begomovirus identified in Oman. Overall the Oman isolate showed the highest levels of sequence identity to a WmCSV isolate originating from Iran, which was confirmed by phylogenetic analysis. This suggests that WmCSV present in Oman has been introduced from Iran. The significance of this finding is discussed. PMID:22852046

Complete nucleotide sequence of watermelon chlorotic stunt virus originating from Oman.

PubMed

Khan, Akhtar J; Akhtar, Sohail; Briddon, Rob W; Ammara, Um; Al-Matrooshi, Abdulrahman M; Mansoor, Shahid

2012-07-01

Watermelon chlorotic stunt virus (WmCSV) is a bipartite begomovirus (genus Begomovirus, family Geminiviridae) that causes economic losses to cucurbits, particularly watermelon, across the Middle East and North Africa. Recently squash (Cucurbita moschata) grown in an experimental field in Oman was found to display symptoms such as leaf curling, yellowing and stunting, typical of a begomovirus infection. Sequence analysis of the virus isolated from squash showed 97.6-99.9% nucleotide sequence identity to previously described WmCSV isolates for the DNA A component and 93-98% identity for the DNA B component. Agrobacterium-mediated inoculation to Nicotiana benthamiana resulted in the development of symptoms fifteen days post inoculation. This is the first bipartite begomovirus identified in Oman. Overall the Oman isolate showed the highest levels of sequence identity to a WmCSV isolate originating from Iran, which was confirmed by phylogenetic analysis. This suggests that WmCSV present in Oman has been introduced from Iran. The significance of this finding is discussed.

The effect of predation on stunted and nonstunted white perch

USGS Publications Warehouse

Gosch, N.J.C.; Pierce, L.L.; Pope, K.L.

2010-01-01

Predation is widely regarded as a means to prevent or minimise the establishment of a stunted (high density of slow growing individuals) population. We investigated the effect of predation on two different white perch Morone americana populations (stunted and nonstunted) by examining the stomach contents of piscivorous fishes. White perch and gizzard shad dominated piscivore diets in Branched Oak Lake, whereas white perch dominated piscivore diets in Pawnee Lake. White perch consumed in the stunted population (Branched Oak Lake) were larger and older than white perch consumed in the nonstunted population (Pawnee Lake). Many of the consumed white perch in the stunted population were sexually mature and had the opportunity to spawn at least once. In contrast, all of the consumed white perch in the nonstunted population were sexually immature. Predation may have reinforced the stunting of white perch in Branched Oak Lake through removal of the largest, oldest individuals. ?? 2010 John Wiley & Sons A/S.

Risk of poor development in young children in low-income and middle-income countries: an estimation and analysis at the global, regional, and country level.

PubMed

Lu, Chunling; Black, Maureen M; Richter, Linda M

2016-12-01

A 2007 study published in The Lancet estimated that approximately 219 million children aged younger than 5 years were exposed to stunting or extreme poverty in 2004. We updated the 2004 estimates with the use of improved data and methods and generated estimates for 2010. We used country-level prevalence of stunting in children younger than 5 years based on the 2006 Growth Standards proposed by WHO and poverty ratios from the World Bank to estimate children who were either stunted or lived in extreme poverty for 141 low-income and middle-income countries in 2004 and 2010. To avoid counting the same children twice, we excluded children jointly exposed to stunting and extreme poverty from children living in extreme poverty. To examine the robustness of estimates, we also used moderate poverty measures. The 2007 study underestimated children at risk of poor development. The estimated number of children exposed to the two risk factors in low-income and middle-income countries decreased from 279·1 million (95% CI 250·4 million-307·4 million) in 2004 to 249·4 million (209·3 million-292·6 million) in 2010; prevalence of children at risk fell from 51% (95% CI 46-56) to 43% (36-51). The decline occurred in all income groups and regions with south Asia experiencing the largest drop. Sub-Saharan Africa had the highest prevalence in both years. These findings were robust to variations in poverty measures. Progress has been made in reducing the number of children exposed to stunting or poverty between 2004 and 2010, but this is still not enough. Scaling up of effective interventions targeting the most vulnerable children is urgently needed. National Institutes of Health, Bill & Melinda Gates Foundation, Hilton Foundation, and WHO. Copyright © 2016 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND license. Published by Elsevier Ltd.. All rights reserved.

Frequency of underweight and stunting among children entering school in a small urban locality and their association with academic performance.

PubMed

Ahmad, Mirza Sultan; Husain Zaidi, Syed Aizaz; Medhat, Naila; Farooq, Hadia; Ahmad, Danial; Nasir, Waqar

2018-01-01

To determine the frequency of underweight and stunting among the children entering first year of school and to assess its associated factors. This descriptive, analytical study was conducted at 5 schools of Rabwah, Pakistan, from August to September 2015, and comprised all students who got admission in the selected schools during the study period. Name, father's name, gender, weight, height, status of height, and weight on Z-score charts, and marks obtained in the test were recorded. SPSS 20 was used for statistical analysis. Of the 478 participants, 212(44.4%) were boys and 266(55.6%) were girls. The overall mean age was 66.6±5.966 months (range: 41-129 months). Overall, 53(11.1%) were underweight, 22(4.6%) were severely underweight, 55(11.5%) had stunting and 12(2.5%) had severe stunting. Median marks (Interquartile Range [IQR]) in admission test for obese, overweight, normal, underweight and severely underweight children were 76.3%(37.2-84.7), 65.9%, 66.7%(56.4-72.3), 64.6%(47-71), and 67%(55.3-78), respectively. Median marks (IQR) in admission test for tall, normal height, stunted and severe stunted children were 24.1%, 67%(57.3-73), 57%(31.1-67.8), and 62.6%(49.7-68.3), respectively. Children with stunting scored significantly fewer marks compared to children of normal height (p<0.05). Stunting and underweight were common problems among children starting school. Stunting was found to be associated with lower marks in admission test.

The effect of young children's faeces disposal practices on child growth: evidence from 34 countries.

PubMed

Bauza, Valerie; Guest, Jeremy S

2017-10-01

To characterize the relationship between child faeces disposal and child growth in low- and middle-income countries. We analysed caregiver responses and anthropometric data from Demographic and Health Surveys (2005-2014) for 202 614 children under five and 82 949 children under two to examine the association between child faeces disposal and child growth. Child faeces disposal in an improved toilet was associated with reduced stunting for children under five [adjusted prevalence ratio (aPR) = 0.90, 95% confidence interval (CI) 0.89-0.92] and a 0.12 increase in height-for-age z-score (HAZ; 95% CI: 0.10-0.15) among all households. Among households with improved sanitation access, practicing improved child faeces disposal was still associated with a decrease in stunting (aPR = 0.94, 95% CI: 0.91-0.96) and a 0.09 increase in HAZ (95% CI: 0.06-0.13). Improved child faeces disposal was also associated with reductions in underweight and wasting, and an increase in weight-for-age z-score (WAZ), but not an increase in weight-for-height z-score (WHZ). Community coverage level of improved child faeces disposal was also associated with stunting, with 75-100% coverage associated with the greatest reduction in stunting. Child faeces disposal in an unimproved toilet was associated with reductions in underweight and wasting, but not stunting. Improved child faeces disposal practices could achieve greater reductions in child undernutrition than improving toilet access alone. Additionally, the common classification of child faeces disposal as 'safe' regardless of the type of toilet used for disposal may underestimate the benefits of disposal in an improved toilet and overestimate the benefits of disposal in an unimproved toilet. © 2017 John Wiley & Sons Ltd.

Stunting Is Associated with Food Diversity while Wasting with Food Insecurity among Underfive Children in East and West Gojjam Zones of Amhara Region, Ethiopia.

PubMed

Motbainor, Achenef; Worku, Alemayehu; Kumie, Abera

2015-01-01

Food insecurity has detrimental effects in protecting child undernutrition.This study sought to determine the level of child undernutrition and its association with food insecurity. A community based comparative cross-sectional study design involving multistage sampling technique was implemented from 24th of May to 20th of July 2013. Using two population proportion formula, a total of 4110 randomly selected households were included in the study. Availability of the productive safety net programme was used for grouping the study areas. A multiple linear regression model was used to assess the association between food insecurity and child malnutrition. Clustering effects of localities were controlled during analysis. Stunting (37.5%), underweight (22.0%) and wasting (17.1%) were observed in East Gojjam zone, while 38.3% stunting, 22.5% underweight, and 18.6% wasting for the West Gojjam zone. Food insecurity was significantly associated with wasting (β = - 0.108, P < 0.05).Food diversity and number of meals the child ate per day significantly associated with stunting (β = 0.039, P < 0.01) and underweight (β = 0.035, P < 0.05) respectively. Residential area was the significant predictor of all indices. The magnitude of child undernutrition was found to be very high in the study areas. Food insecurity was the significant determinant of wasting. Food diversity and number of meals the child ate per day were the significant determinants of stunting and underweight respectively. Child nutrition intervention strategies should take into account food security, dietary diversity, and carefully specified with regard to residential locations. Addressing food insecurity is of paramount importance.

CDL description of the CDC 6600 stunt box

NASA Technical Reports Server (NTRS)

Hertzog, J. B.

1971-01-01

The CDC 6600 central memory control (stunt box) is described utilizing CDL (Computer Design Language), block diagrams, and text. The stunt box is a clearing house for all central memory references from the 6600 central and peripheral processors. Since memory requests can be issued simultaneously, the stunt box must be capable of assigning priorities to requests, of labeling requests so that the data will be distributed correctly, and of remembering rejected addresses due to memory conflicts.

Influence of socioeconomic status on the prevalence of stunted growth and obesity in prepubertal Indonesian children.

PubMed

Julia, M; van Weissenbruch, M M; de Waal, H A Delemarre-van; Surjono, A

2004-12-01

This cross-sectional study assesses the prevalence of stunting, overweight, and obesity in prepubertal children from different socioeconomic groups in Indonesia. Children from rural, poor urban, and nonpoor urban communities were studied (n = 3,010). The prevalences of stunting, wasting, overweight, and obesity were 19.3%, 5.0%, 2.7%, and 0.8%, respectively. The odds ratios (OR) for stunting, as compared with nonpoor urban children, were higher among rural children (2.92; 95% confidence interval [CI], 2.37-3.59) than among poor urban children (1.58; 95% CI, 1.18-2.13). The prevalence of wasting was not influenced by socioeconomic status. Both rural and poor urban children were significantly less likely to be overweight than were nonpoor urban children: in comparison with nonpoor urban children, the OR values were 0.19 (95% CI, 0.10-0.36) for rural and 0.13 (95% CI, 0.04-0.43) for poor urban children. Boys were more likely to be stunted or obese than girls: OR for stunting, 1.75 (95% CI, 1.44-2.12); OR for obesity, 4.07 (95% CI, 1.40-11.8). Stunted children were less likely than non-stunted children to be overweight: OR, 0.10 (95% CI, 0.03-0.43). In Indonesia, undernutrition is still related to poverty, whereas obesity is more related to prosperity.

Maternal and child undernutrition and overweight in low-income and middle-income countries.

PubMed

Black, Robert E; Victora, Cesar G; Walker, Susan P; Bhutta, Zulfiqar A; Christian, Parul; de Onis, Mercedes; Ezzati, Majid; Grantham-McGregor, Sally; Katz, Joanne; Martorell, Reynaldo; Uauy, Ricardo

2013-08-03

Maternal and child malnutrition in low-income and middle-income countries encompasses both undernutrition and a growing problem with overweight and obesity. Low body-mass index, indicative of maternal undernutrition, has declined somewhat in the past two decades but continues to be prevalent in Asia and Africa. Prevalence of maternal overweight has had a steady increase since 1980 and exceeds that of underweight in all regions. Prevalence of stunting of linear growth of children younger than 5 years has decreased during the past two decades, but is higher in south Asia and sub-Saharan Africa than elsewhere and globally affected at least 165 million children in 2011; wasting affected at least 52 million children. Deficiencies of vitamin A and zinc result in deaths; deficiencies of iodine and iron, together with stunting, can contribute to children not reaching their developmental potential. Maternal undernutrition contributes to fetal growth restriction, which increases the risk of neonatal deaths and, for survivors, of stunting by 2 years of age. Suboptimum breastfeeding results in an increased risk for mortality in the first 2 years of life. We estimate that undernutrition in the aggregate--including fetal growth restriction, stunting, wasting, and deficiencies of vitamin A and zinc along with suboptimum breastfeeding--is a cause of 3·1 million child deaths annually or 45% of all child deaths in 2011. Maternal overweight and obesity result in increased maternal morbidity and infant mortality. Childhood overweight is becoming an increasingly important contributor to adult obesity, diabetes, and non-communicable diseases. The high present and future disease burden caused by malnutrition in women of reproductive age, pregnancy, and children in the first 2 years of life should lead to interventions focused on these groups. Copyright © 2013 Elsevier Ltd. All rights reserved.

Secondary analysis of anthropometric data from a South African national food consumption survey, using different growth reference standards.

PubMed

Bosman, L; Herselman, M G; Kruger, H S; Labadarios, D

2011-11-01

The National Center for Health Statistics (NCHS) references were used to analyse anthropometric data from the 1999 National Food Consumption Survey (NFCS) of South Africa. Since then, however, The Centers for Disease Control and Prevention (CDC) 2000 reference and the World Health Organization (WHO) 2006 standards were released. It was anticipated that these reference and standards may lead to differences in the previous estimates of stunting, wasting, underweight and obesity in the study population. The aim was to compare the anthropometric status of children using the 1977 NCHS, the 2000 CDC growth references and the 2006 WHO standards. All children 12-60 months of age with a complete set of anthropometric data were included in the analyses. Data for 1,512 children were analysed with SAS 9.1 for Windows. A Z-score was calculated for each child for weight-for-age (W/A), weight-for-length/height (W/H), length/height-for-age (H/A) and body mass index (BMI)-for-age, using each of the three reference or standards for comparison. The prevalence of stunting, obesity and overweight were significantly higher and the prevalence of underweight and wasting were lower when using the WHO standards compared to the NCHS and the CDC references. The higher than previously established prevalence of stunting at 20.1% and combined overweight/obesity at 30% poses a challenge to South African policy makers to implement nutrition programmes to decrease the prevalence of both stunting and overweight. The 2006 WHO growth standard should be the standard used for assessment of growth of infants and children younger than 5 years in developing countries.

Prevalence and risk factors for stunting and severe stunting among under-fives in North Maluku province of Indonesia.

PubMed

Ramli; Agho, Kingsley E; Inder, Kerry J; Bowe, Steven J; Jacobs, Jennifer; Dibley, Michael J

2009-10-06

Adequate nutrition is needed to ensure optimum growth and development of infants and young children. Understanding of the risk factors for stunting and severe stunting among children aged less than five years in North Maluku province is important to guide Indonesian government public health planners to develop nutrition programs and interventions in a post conflict area. The purpose of the current study was to assess the prevalence of and the risk factors associated with stunting and severe stunting among children aged less than five years in North Maluku province of Indonesia. The health and nutritional status of children aged less than five years was assessed in North Maluku province of Indonesia in 2004 using a cross-sectional multi-stage survey conducted on 750 households from each of the four island groups in North Maluku province. A total of 2168 children aged 0-59 months were used in the analysis. Prevalence of stunting and severe stunting were 29% (95%CI: 26.0-32.2) and 14.1% (95%CI: 11.7-17.0) for children aged 0-23 months and 38.4% (95%CI: 35.9-41.0) and 18.4% (95%CI: 16.1-20.9) for children aged 0-59 months, respectively. After controlling for potential confounders, multivariate analysis revealed that the risk factors for stunted children were child's age in months, male sex and number of family meals per day (

Recovery from stunting and cognitive outcomes in young children: evidence from the South African Birth to Twenty Cohort Study.

PubMed

Casale, D; Desmond, C

2016-04-01

In this study we analyse the implications for cognitive function of recovery from stunting in early childhood. More specifically, we test whether children who met the definition for stunted at age 2, but not at age 5, perform better in cognitive tests than children who remain stunted over this period. The sample is drawn from the Birth to Twenty Cohort Study, a prospective data set of children born in 1990 in urban South Africa. The measure of cognitive function that we use is based on the Revised Denver Prescreening Developmental Questionnaire implemented when the children were age 5. We employ multivariate regression in the analysis to control for child-specific characteristics, socio-economic status, the home environment and caregiver inputs. We find that recovery from stunting is not uncommon among young children in our sample. However, children who recover from stunting by age 5 still perform significantly worse on cognitive tests than children who do not experience early malnutrition, and almost as poorly as children who remain stunted. These findings suggest that the timing of nutritional inputs in the early years is key in a child's cognitive development, with implications for school readiness and achievement.

Reduction in childhood malnutrition in Vietnam from 1990 to 2004.

PubMed

Khan, Nguyen Cong; Tuyen, Le Danh; Ngoc, Tran Xuan; Duong, Phan Hoai; Khoi, Ha Huy

2007-01-01

Reduction in childhood malnutrition in Vietnam between 1990 and 2004 was assessed using data from 5 national surveys. The prevalence of malnutrition, including stunting, declined significantly for underweight from 45% in 1990 to 26.6% in 2004. While the average reduction was 1.3% per year in the period from 1990 to 2000, it was 1.8% per year in the period from 2000 to 2004. The prevalence of stunting declined from 56.5% in 1990 to 30.7% in 2004, with an average reduction of 2% per year in the period from 1990 to 2000 and 1.5% per year in the period from 2000 to 2004. There were clear differences in the decrease in malnutrition prevalence between urban, rural and mountainous areas, the reduction being highest in the urban regions and lowest in the mountainous areas. Regression analysis showed that the nutrition status of the child is positively related to better household living conditions and to the educational level of the father, but not the mother. Stunting is higher in children whose parents are farmers and higher in households with more children. Stunting prevalence is lower in households with safe water access and hygienic toilets. In future , the dramatic reduction is childhood malnutrition as seen in the period 1990 to 2004 might not continue. More comprehensive apptoaches will be needed to lower childhood malnutrition in Vietnam further.

Malnutrition Status Among Under-5 Children in a Hill Community of Nepal.

PubMed

Gaurav, K; Poudel, I S; Bhattarai, S; Pradhan, P M S; Pokharel, P K

2014-01-01

Malnutrition, especially under nutrition puts children at increased risk of morbidity and mortality and remains a serious barrier in child growth, development and survival. This is a major public health problem among under- 5 children in Nepal particularly in rural areas. To assess the burden and contributing factors for malnutrition in hill community of Ilam district in eastern Nepal. A cross sectional study was conducted in rural hill communities of Ilam district, Nepal with a sample of 240 under- 5 children. Anthropometric measurements were used as per WHO guidelines to asses three nutritional status: Underweight, Stunting, and Wasting using descriptive statistics and chi square test was applied using SPSS 12.0 to assess social and predisposing factors. Seventeen percent of under- 5 children were moderately and 10.4 % were severely underweight. Similarly, 22.9%, and 17.5% were found to be moderately and severely stunted respectively. Less than 10% were found to be moderately and severely wasted. Older age group of children, education level of mother, not exclusive breast feeding practice had significant (p <0.05) effect on stunting. More than 50% children were affected with stunting, underweight and wasting at the same time. Significant proportion of under - 5 children were malnourished in the communities of the hilly areas. The study unveiled the importance of literacy and exclusive breast feeding for the prevention of malnutrition in under- 5 children.

Undernutrition and Its Correlates among Children of 3–9 Years of Age Residing in Slum Areas of Bhubaneswar, India

PubMed Central

Das, Sai Chandan

2014-01-01

Undernutrition among children is a major public health concern worldwide, more prevalent in Asia and Africa. It manifests itself in various forms such as wasting or stunting or underweight and retards physical and mental development, increases susceptibility to infection, and reduces educational attainment and productivity. The present study was undertaken to assess the level of wasting, stunting, and underweight and determine its associates among slum children of 3–9 years of age, residing in Bhubaneswar city, India. After obtaining informed consent, a total of 249 children from 249 households were studied and their parents/guardians were interviewed to collect all relevant information. 23.3%, 57.4%, and 45.4% of children were found to have wasting, stunting, and underweight, respectively. Variables like birth order of child, period of initiation of breastfeeding and mother's education were found to be strong predictors of wasting, whereas toilet facility in household and practice of drinking water storage were significantly associated with stunting among slum children as revealed in multiple regression analysis. Thus, a multipronged approach is needed such as giving priority to improve education for slum community especially for women, creating awareness regarding benefits of early initiation of breastfeeding, small family size, and proper storage of drinking water, and providing toilet facility in slum households which could improve the nutritional status of slum children. PMID:25580460

Undernutrition and its correlates among children of 3-9 years of age residing in slum areas of Bhubaneswar, India.

PubMed

Panigrahi, Ansuman; Das, Sai Chandan

2014-01-01

Undernutrition among children is a major public health concern worldwide, more prevalent in Asia and Africa. It manifests itself in various forms such as wasting or stunting or underweight and retards physical and mental development, increases susceptibility to infection, and reduces educational attainment and productivity. The present study was undertaken to assess the level of wasting, stunting, and underweight and determine its associates among slum children of 3-9 years of age, residing in Bhubaneswar city, India. After obtaining informed consent, a total of 249 children from 249 households were studied and their parents/guardians were interviewed to collect all relevant information. 23.3%, 57.4%, and 45.4% of children were found to have wasting, stunting, and underweight, respectively. Variables like birth order of child, period of initiation of breastfeeding and mother's education were found to be strong predictors of wasting, whereas toilet facility in household and practice of drinking water storage were significantly associated with stunting among slum children as revealed in multiple regression analysis. Thus, a multipronged approach is needed such as giving priority to improve education for slum community especially for women, creating awareness regarding benefits of early initiation of breastfeeding, small family size, and proper storage of drinking water, and providing toilet facility in slum households which could improve the nutritional status of slum children.

Stop stunting: improving child feeding, women's nutrition and household sanitation in South Asia.

PubMed

Aguayo, Víctor M; Menon, Purnima

2016-05-01

The latest available data indicate that 38% of South Asia's children aged 0-59 months are stunted. Such high prevalence combined with the region's large child population explain why South Asia bears about 40% of the global burden of stunting. Recent analyses indicate that the poor diets of children in the first years of life, the poor nutrition of women before and during pregnancy and the prevailing poor sanitation practices in households and communities are important drivers of stunting, most likely because of underlying conditions of women's status, food insecurity, poverty, and social inequalities. With this evidence in mind, UNICEF Regional Office for South Asia convened the Regional Conference: Stop Stunting: Improving Child Feeding, Women's Nutrition, and Household Sanitation in South Asia (New Delhi, November 10-12, 2014). The Conference provided a knowledge-for-action platform with three objectives: (1) share state-of-the-art research findings on the causes of child stunting and its consequences for child growth and development and the sustainable growth and development of nations; (2) discuss better practices and the cost and benefits of scaling up programmes to improve child feeding, women's nutrition, and household sanitation in South Asia; and (3) identify implications for sectoral and cross-sectoral policy, programme, advocacy and research to accelerate progress in reducing child stunting in South Asia. This overview paper summarizes the rationale for the focus on improving child feeding, women's nutrition, and household sanitation as priority areas for investment to prevent child stunting in South Asia. It builds on the invited papers presented at or developed as a follow on to the Stop Stunting Conference. © 2016 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.

Impact of contaminated household environment on stunting in children aged 12-59 months in Burkina Faso.

PubMed

Fregonese, Federica; Siekmans, Kendra; Kouanda, Seni; Druetz, Thomas; Ly, Antarou; Diabaté, Souleymane; Haddad, Slim

2017-04-01

Stunting affects 165 million children worldwide, with repercussions on their survival and development. A contaminated environment is likely to contribute to stunting: frequent faecal-oral transmission possibly causes environmental enteropathy, a chronic inflammatory disorder that may contribute to faltering growth in children. This study's objective was to assess the effect of contaminated environment on stunting in Burkina Faso, where stunting prevalence is persistently high. Panel study of children aged 1-5 years in Kaya. Household socioeconomic characteristics, food needs and sanitary conditions were measured once, and child growth every year (2011-2014). Using multiple correspondence analysis and 12 questions and observations on water, sanitation, hygiene behaviours, yard cleanliness and animal proximity, we constructed a 'contaminated environment' index as a proxy of faecal-oral transmission exposure. Analysis was performed using a generalised structural equation model (SEM), adjusting for repeat observations and hierarchical data. Stunting (<2 SD height-for-age) prevalence was 29% among 3121 children (median (IQR) age 36 (25-48) months). Environment contamination was widespread, particularly in rural and peri-urban areas, and was associated with stunting (prevalence ratio 1.30; p=0.008), controlling for sex, age, survey year, setting, mother's education, father's occupation, household food security and wealth. This association was significant for children of all ages (1-5 years) and settings. Lower contamination and higher food security had effects of comparable magnitude. Environment contamination can be at least as influential as nutritional components in the pathway to stunting. There is a rationale for including interventions to reduce environment contamination in stunting prevention programmes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

The rise in stunting in relation to avian influenza and food consumption patterns in Lower Egypt in comparison to Upper Egypt: results from 2005 and 2008 Demographic and Health Surveys.

PubMed

Kavle, Justine A; El-Zanaty, Fatma; Landry, Megan; Galloway, Rae

2015-03-25

A 2006 avian influenza (AI) outbreak resulted in mass removal of chickens in Lower Egypt, which decreased the household supply of poultry. Poultry, a key animal-source food, contains nutrients critical for child growth. This paper examines determinants of stunting between 2006 and 2008 in children 6 to 59 months of age within the context of the AI outbreak. The 2005 and 2008 nationally representative Egypt Demographic and Health Surveys (EDHS) were used to analyse anthropometric data from 7,794 children in 2005 and 6,091 children in 2008. Children, 6-59 months of age, with length for age Z-score < -2 S.D. were categorized as stunted. Predictors of stunting were examined by bivariate and multivariable analyses, focusing on Lower Egypt, where a rise in stunting occurred, and Upper Egypt, where stunting declined. Between 2005 and 2008, Upper Egypt experienced a significant decline in stunting (28.8 to 21.8%, P < 0.001). Lower Egypt experienced a significant rise in stunting (16.6 to 31.5%, P < 0.001), coinciding with the 2006 AI outbreak. In Lower Egypt (2008), households owning poultry were 41.7% less likely to have a stunted child [aOR 0.58; 95% CI (0.42, 0.81) P = 0.002], and 12-47 month old children were 2.12-2.34 times [95% CI (1.39 - 3.63) P ≤ 0.001] more likely to be stunted than 6-11 month old children. Older children were likely affected by AI, as these children were either in-utero or toddlers in 2006. In Upper Egypt, stunting peaked at 12-23 months [aOR 2.62, 95% CI (1.73-3.96), P < 0.001], with lowered risk (22-32%) of stunting in 24-47 month old children [aOR1.65, 95% 1.07-2.53, P = 0.022, 24-35 month old] and [aOR 1.57, 95% CI 1.01-2.43, P = 0.043 36-47 months old]. A two-fold increase in child consumption of sugary foods between 2005 and 2008 was found in Lower Egypt (24.5% versus 52.7%; P < .001). Decreased dietary diversity, reduced poultry consumption, substitution of nutritious foods with sugary foods paralleled a reduction in household raising of birds, following the AI outbreak in Lower Egypt and not Upper Egypt. Increased feeding of sugary foods due to fear of illness or greater penetration of these foods may be related to stunting. Advice on infant and young child feeding is needed to improve dietary intake and reduce sugary food consumption.

Are there changes in the nutritional status of children of Oportunidades families in rural Chiapas, Mexico? A cohort prospective study.

PubMed

García-Parra, Esmeralda; Ochoa-Díaz-López, Héctor; García-Miranda, Rosario; Moreno-Altamirano, Laura; Solís-Hernández, Roberto; Molina-Salazar, Raúl

2016-01-16

In Mexico, despite that the fact that several social programs have been implemented, chronic undernutrition is still a public health problem affecting 1.5 million children of <5 years. Chiapas ranks first in underweight and stunting at national level with a stunting prevalence of 31.4 % whereas for its rural population is 44.2 %. The purpose of this paper is to determine if the nutritional status of a cohort of children living in poor rural communities under Oportunidades has changed. We were interested in assessing the nutrition evolution of the children who were initially diagnosed as stunted and of those who were diagnosed as normal. Oportunidades is an anti-poverty program of the Mexican government consisting mainly in monetary transfers to the families living in alimentary poverty. A 9-year cohort prospective study was conducted with nutritional evaluations of 222 children. Anthropometric indices were constructed from measurements of weight, height, and age of the children whose nutritional status was classified following WHO standards. The results showed that although these children were Oportunidades beneficiaries for 9 years and their families improved their living conditions, children still had a high prevalence of stunting (40.1 %) and 69.6 % had not recovered yet. Children who were initially diagnosed with normal nutritional status and became stunted 2 years later had a higher risk (relative risk (RR) 5.69, 2.95-10.96) of continuing stunted at school age and adolescence. Oportunidades has not impacted, as expected, the nutritional status of the study population. These findings pose the question: Why has not the nutritional status of children improved, although the living conditions of their families have significantly improved? This might be the result of an adaptation process achieved through a decrease of growth velocity. It is important to make efforts to watch the growth of the children during their first 3 years of age, to focus on improving the diet of women at fertile age and pay special attention to environmental conditions to break the vicious cycle of malnutrition.

Systematic review of current efforts to quantify the impacts of climate change on undernutrition.

PubMed

Phalkey, Revati K; Aranda-Jan, Clara; Marx, Sabrina; Höfle, Bernhard; Sauerborn, Rainer

2015-08-18

Malnutrition is a challenge to the health and productivity of populations and is viewed as one of the five largest adverse health impacts of climate change. Nonetheless, systematic evidence quantifying these impacts is currently limited. Our aim was to assess the scientific evidence base for the impact of climate change on childhood undernutrition (particularly stunting) in subsistence farmers in low- and middle-income countries. A systematic review was conducted to identify peer-reviewed and gray full-text documents in English with no limits for year of publication or study design. Fifteen manuscripts were reviewed. Few studies use primary data to investigate the proportion of stunting that can be attributed to climate/weather variability. Although scattered and limited, current evidence suggests a significant but variable link between weather variables, e.g., rainfall, extreme weather events (floods/droughts), seasonality, and temperature, and childhood stunting at the household level (12 of 15 studies, 80%). In addition, we note that agricultural, socioeconomic, and demographic factors at the household and individual levels also play substantial roles in mediating the nutritional impacts. Comparable interdisciplinary studies based on primary data at a household level are urgently required to guide effective adaptation, particularly for rural subsistence farmers. Systemization of data collection at the global level is indispensable and urgent. We need to assimilate data from long-term, high-quality agricultural, environmental, socioeconomic, health, and demographic surveillance systems and develop robust statistical methods to establish and validate causal links, quantify impacts, and make reliable predictions that can guide evidence-based health interventions in the future.

Systematic review of current efforts to quantify the impacts of climate change on undernutrition

PubMed Central

Phalkey, Revati K.; Aranda-Jan, Clara; Marx, Sabrina; Höfle, Bernhard; Sauerborn, Rainer

2015-01-01

Malnutrition is a challenge to the health and productivity of populations and is viewed as one of the five largest adverse health impacts of climate change. Nonetheless, systematic evidence quantifying these impacts is currently limited. Our aim was to assess the scientific evidence base for the impact of climate change on childhood undernutrition (particularly stunting) in subsistence farmers in low- and middle-income countries. A systematic review was conducted to identify peer-reviewed and gray full-text documents in English with no limits for year of publication or study design. Fifteen manuscripts were reviewed. Few studies use primary data to investigate the proportion of stunting that can be attributed to climate/weather variability. Although scattered and limited, current evidence suggests a significant but variable link between weather variables, e.g., rainfall, extreme weather events (floods/droughts), seasonality, and temperature, and childhood stunting at the household level (12 of 15 studies, 80%). In addition, we note that agricultural, socioeconomic, and demographic factors at the household and individual levels also play substantial roles in mediating the nutritional impacts. Comparable interdisciplinary studies based on primary data at a household level are urgently required to guide effective adaptation, particularly for rural subsistence farmers. Systemization of data collection at the global level is indispensable and urgent. We need to assimilate data from long-term, high-quality agricultural, environmental, socioeconomic, health, and demographic surveillance systems and develop robust statistical methods to establish and validate causal links, quantify impacts, and make reliable predictions that can guide evidence-based health interventions in the future. PMID:26216952

Early life risk exposure and stunting in urban South African 2-year old children.

PubMed

Slemming, W; Kagura, J; Saloojee, H; Richter, L M

2017-06-01

Stunting is a measure of overall nutritional status and is a major public health concern because of its association with child mortality and morbidity and later adult performance. This study examined the effects of pregnancy events, birth characteristics and infant risk exposure on stunting at age 2 years. The study, established in 1990 in Soweto, an urban South African township, included 1098 mother-infant pairs enroled in the Birth to Twenty Plus longitudinal birth cohort study. In total, 22% of children were stunted at age 2 years, with males at greater risk than females [24.8 v. 19.4%, odds ratio (OR)=1.38; 95% confidence interval (CI): 1.03, 1.83]. In unadjusted analysis, male sex, household socio-economic status (SES), overcrowding, maternal age, maternal education, single motherhood, ethnicity, birth weight, gestational age and duration of infant breastfeeding were all significantly associated with stunting. In multivariable analysis, higher birth weight was protective against stunting for both sexes. Higher maternal education was protective for females only (adjusted odds ratio (AOR)=0.35; 95% CI: 0.14, 0.87), whereas wealthier household SES protected males (AOR for richest SES group=0.39; 95% CI: 0.16, 0.92). In this and other similar settings, current stunting prevention efforts focussing on primarily providing targeted proximal interventions, such as food supplements, risk undermining the critical importance of addressing key distal determinants of stunting such as SES and maternal education.

Parental IQ and cognitive development of malnourished Indonesian children.

PubMed

Webb, K E; Horton, N J; Katz, D L

2005-04-01

A cross-sectional study of children in West Kalimantan, Indonesia, was conducted to examine the relationship between malnutrition history, child IQ, school attendance, socioeconomic status, parental education and parental IQ. In unadjusted analyses, severely stunted children had significantly lower IQ scores than mild-moderately stunted children. This effect was significant when stunting, school attendance and parental education were included in multivariable models but was attenuated when parental IQ was included. Our research underscores the importance of accounting for parental IQ as a critical covariate when modeling the association between childhood stunting and IQ.

Biomass fuel use for household cooking in Swaziland: is there an association with anaemia and stunting in children aged 6-36 months?

PubMed

Machisa, Mercilene; Wichmann, Janine; Nyasulu, Peter S

2013-09-01

This study is the second to investigate the association between the use of biomass fuels (BMF) for household cooking and anaemia and stunting in children. Such fuels include coal, charcoal, wood, dung and crop residues. Data from the 2006-2007 Swaziland Demographic and Health Survey (a cross-sectional study design) were analysed. Childhood stunting was ascertained through age and height, and anaemia through haemoglobin measurement. The association between BMF use and health outcomes was determined in multinomial logistic regression analyses. Various confounders were considered in the analyses. A total of 1150 children aged 6-36 months were included in the statistical analyses, of these 596 (51.8%) and 317 (27.6%) were anaemic and stunted, respectively. BMF use was not significantly associated with childhood anaemia in univariate analysis. Independent risk factors for childhood anaemia were child's age, history of childhood diarrhoea and mother's anaemia status. No statistically significant association was observed between BMF use and childhood stunting, after adjusting for child's gender, age, birth weight and preceding birth interval. This study identified the need to prioritize childhood anaemia and stunting as health outcomes and the introduction of public health interventions in Swaziland. Further research is needed globally on the potential effects of BMF use on childhood anaemia and stunting.

Modelling the Ecological Comorbidity of Acute Respiratory Infection, Diarrhoea and Stunting among Children Under the Age of 5 Years in Somalia.

PubMed

Kinyoki, Damaris K; Manda, Samuel O; Moloney, Grainne M; Odundo, Elijah O; Berkley, James A; Noor, Abdisalan M; Kandala, Ngianga-Bakwin

2017-04-01

The aim of this study was to assess spatial co-occurrence of acute respiratory infections (ARI), diarrhoea and stunting among children of the age between 6 and 59 months in Somalia. Data were obtained from routine biannual nutrition surveys conducted by the Food and Agriculture Organization 2007-2010. A Bayesian hierarchical geostatistical shared component model was fitted to the residual spatial components of the three health conditions. Risk maps of the common spatial effects at 1×1 km resolution were derived. The empirical correlations of the enumeration area proportion were 0.37, 0.63 and 0.66 for ARI and stunting, diarrhoea and stunting and ARI and diarrhoea, respectively. Spatially, the posterior residual effects ranged 0.03-20.98, 0.16-6.37 and 0.08-9.66 for shared component between ARI and stunting, diarrhoea and stunting and ARI and diarrhoea, respectively. The analysis showed clearly that the spatial shared component between ARI, diarrhoea and stunting was higher in the southern part of the country. Interventions aimed at controlling and mitigating the adverse effects of these three childhood health conditions should focus on their common putative risk factors, particularly in the South in Somalia.

A Literature Review of the Effect of Malaria on Stunting.

PubMed

Jackson, Bianca D; Black, Robert E

2017-11-01

Background: The current version of the Lives Saved Tool (LiST) maternal and child health impact modeling software does not include an effect of malaria on stunting. Objective: This literature review was undertaken to determine whether such a causal link should be included in the LiST model. Methods: The PubMed, Embase, and Scopus databases were searched by using broad search terms. The searches returned a total of 4281 documents. Twelve studies from among the retrieved documents were included in the review according to the inclusion and exclusion criteria. Results: There was mixed evidence for an effect of malaria on stunting among longitudinal observational studies, and none of the randomized controlled trials of malaria interventions found an effect of the interventions on stunting. Conclusions: There is insufficient evidence to include malaria as a determinant of stunting or an effect of malaria interventions on stunting in the LiST model. The paucity and heterogeneity of the available literature were a major limitation. In addition, the studies included in the review consistently fulfilled their ethical responsibility to treat children under observation for malaria, which may have interfered with the natural history of the disease and prevented any observable effect on stunting or linear growth. © 2017 American Society for Nutrition.

Social and environmental determinants of child health in Mongolia across years of rapid economic growth: 2000-2010.

PubMed

Joshi, Nehal; Bolorhon, Bolormaa; Narula, Indermohan; Zhu, Shihua; Manaseki-Hollan, Semira

2017-10-30

To understand the effect of economic growth on health, we investigated the trend in socio-economic and regional determinants of child health in Mongolia. This Central Asian country had the fastest economic growth amongst low and middle-income countries (LMICs) from 2000 to 2010 and a healthcare system in transition. Data was from Mongolian multiple indicator cluster surveys (MICS) in 2000, 2005 and 2010. Child nutrition/growth was measured by height-for-age z-score (HAZ), weight-for-age z-score (WAZ), prevalence of stunted (HAZ < -2) and underweight (WAZ < -2) children. Access to health care was measured by prevalence of fully immunised children <5 years. Multivariate multi-level logistic mixed modelling was used to estimate the effect of socio-economic and environmental health determinants on each outcome in each year; 2000, 2005 and 2010. T-tests were used to measure significant change in HAZ and WAZ over the decade. Overall, from 2000 to 2010, there was a significant improvement (p < 0.001) in all three outcomes, but the effect of socio-economic factors increased on both stunting and weight. In 2000, region was a significant determinant: children living in three provinces were significantly more likely to be stunted and less likely to be immunised than Ulaanbaatar, but this was not significant by 2010. By 2010, none of the factors were significant determinants of immunisation in children. In 2000, economic status had no effect on stunting (OR = 0.91; 95%CI:0.49,1.66), however by 2010, children in the poorest economic quintile were 4 times more likely to be stunted than the richest (OR = 0.24; 95% CI:0.13,0.45; p < 0.001). The effect of maternal education on stunting prevalence continued over the 10 years, in both 2000 and 2010 children were twice as likely to be stunted if their mother had no education compared to university education (2000 OR = 0.45; 95% CI:0.28,0.73, p < 0.01,2010 OR =0.55; 95% CI:0.35,0.87, p < 0.05). Economic growth in Mongolia from 2000 to 2010 resulted in an increase in the effect of social determinants of child health; whilst focused policy improved access to immunisation. Children with less educated mothers and lower household incomes should be targeted in interventions to reduce health inequity.

Household sanitation and personal hygiene practices are associated with child stunting in rural India: a cross-sectional analysis of surveys

PubMed Central

Rah, Jee Hyun; Cronin, Aidan A; Badgaiyan, Bhupendra; Aguayo, Victor M; Coates, Suzanne; Ahmed, Sarah

2015-01-01

Objectives Increasing evidence suggests that water, sanitation and hygiene (WASH) practices affect linear growth in early childhood. We determined the association between household access to water, sanitation and personal hygiene practices with stunting among children aged 0–23 months in rural India. Setting India. Participants A total of 10 364, 34 639 and 1282 under-2s who participated in the 2005–2006 National Family Health Survey (NFHS-3), the 2011 Hunger and Malnutrition Survey (HUNGaMA) and the 2012 Comprehensive Nutrition Survey in Maharashtra (CNSM), respectively, were included in the analysis. Primary outcome measures The association between WASH indicators and child stunting was assessed using logistic regression models. Results The prevalence of stunting ranged from 25% to 50% across the three studies. Compared with open defecation, household access to toilet facility was associated with a 16–39% reduced odds of stunting among children aged 0–23 months, after adjusting for all potential confounders (NHFS-3 (OR=0.84, 95% CI 0.71 to 0.99); HUNGaMA (OR=0.84, 95% CI 0.78 to 0.91); CNSM (OR=0.61, 95% CI 0.44 to 0.85)). Household access to improved water supply or piped water was not in itself associated with stunting. The caregiver's self-reported practices of washing hands with soap before meals (OR=0.85, 95% CI 0.76 to 0.94) or after defecation (OR=0.86, 95% CI 0.80 to 0.93) were inversely associated with child stunting. However, the inverse association between reported personal hygiene practices and stunting was stronger among households with access to toilet facility or piped water (all interaction terms, p<0.05). Conclusions Improved conditions of sanitation and hygiene practices are associated with reduced prevalence of stunting in rural India. Policies and programming aiming to address child stunting should encompass WASH interventions, thus shifting the emphasis from nutrition-specific to nutrition-sensitive programming. Future randomised trials are warranted to validate the causal association. PMID:25678539

Household sanitation and personal hygiene practices are associated with child stunting in rural India: a cross-sectional analysis of surveys.

PubMed

Rah, Jee Hyun; Cronin, Aidan A; Badgaiyan, Bhupendra; Aguayo, Victor M; Coates, Suzanne; Ahmed, Sarah

2015-02-12

Increasing evidence suggests that water, sanitation and hygiene (WASH) practices affect linear growth in early childhood. We determined the association between household access to water, sanitation and personal hygiene practices with stunting among children aged 0-23 months in rural India. India. A total of 10 364, 34 639 and 1282 under-2s who participated in the 2005-2006 National Family Health Survey (NFHS-3), the 2011 Hunger and Malnutrition Survey (HUNGaMA) and the 2012 Comprehensive Nutrition Survey in Maharashtra (CNSM), respectively, were included in the analysis. The association between WASH indicators and child stunting was assessed using logistic regression models. The prevalence of stunting ranged from 25% to 50% across the three studies. Compared with open defecation, household access to toilet facility was associated with a 16-39% reduced odds of stunting among children aged 0-23 months, after adjusting for all potential confounders (NHFS-3 (OR=0.84, 95% CI 0.71 to 0.99); HUNGaMA (OR=0.84, 95% CI 0.78 to 0.91); CNSM (OR=0.61, 95% CI 0.44 to 0.85)). Household access to improved water supply or piped water was not in itself associated with stunting. The caregiver's self-reported practices of washing hands with soap before meals (OR=0.85, 95% CI 0.76 to 0.94) or after defecation (OR=0.86, 95% CI 0.80 to 0.93) were inversely associated with child stunting. However, the inverse association between reported personal hygiene practices and stunting was stronger among households with access to toilet facility or piped water (all interaction terms, p<0.05). Improved conditions of sanitation and hygiene practices are associated with reduced prevalence of stunting in rural India. Policies and programming aiming to address child stunting should encompass WASH interventions, thus shifting the emphasis from nutrition-specific to nutrition-sensitive programming. Future randomised trials are warranted to validate the causal association. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

[Micronutrient deficiencies and linear growth: a systematic review of observational studies].

PubMed

Pedraza, Dixis Figueroa; Rocha, Ana Carolina Dantas; Sales, Márcia Cristina

2013-11-01

This article seeks to evaluate the association of iron, vitamin A and zinc deficiencies with linear growth retardation. A systematic review of electronic databases in PubMed, LILACS and SciELO was conducted. Scientific papers published between January 1995 and March 2010 were selected, inserting the key words: (growth OR nutritional status) AND (child, preschool OR infant) AND (zinc AND iron AND vitamin A) OR (zinc AND iron) OR (zinc AND vitamin A) OR (iron AND vitamin A). Fourteen observational design studies were reviewed. In the cohort studies (two), one indicated a statistical association between iron levels and stunting; and the other revealed a statistical association between serum ferritin concentrations and an increase in height. Ten cross-sectional studies investigated the statistical association between micronutrient deficiencies and stunting, three of which resulted in an association with iron, two with vitamin A and none with zinc. Elucidation of the association between stunting and iron, vitamin A and zinc deficiencies involves difficulties of a biological nature and also related to the magnitude of these deficiencies, indicating the importance of a methodological standardization of the studies.

Key strategies to further reduce stunting in Southeast Asia: lessons from the ASEAN countries workshop.

PubMed

Bloem, Martin W; de Pee, Saskia; Hop, Le Thi; Khan, Nguyen Cong; Laillou, Arnaud; Minarto; Moench-Pfanner, Regina; Soekarjo, Damayanti; Soekirman; Solon, J Antonio; Theary, Chan; Wasantwisut, Emorn

2013-06-01

To further reduce stunting in Southeast Asia, a rapidly changing region, its main causes need to be identified. Assess the relationship between different causes of stunting and stunting prevalence over time in Southeast Asia. Review trends in mortality, stunting, economic development, and access to nutritious foods over time and among different subgroups in Southeast Asian countries. Between 1990-2011, mortality among under-five children declined from 69/1,000 to 29/1,000 live births. Although disease reduction, one of two direct causes of stunting, has played an important role which should be maintained, improvement in meeting nutrient requirements, the other direct cause, is necessary to reduce stunting further. This requires dietary diversity, which is affected by rapidly changing factors: economic development; urbanization, giving greater access to larger variety of foods, including processed and fortified foods; parental education; and modernizing food systems, with increased distance between food producers and consumers. Wealthier consumers are increasingly able to access a more nutritious diet, while poorer consumers need support to improve access, and may also still need better hygiene and sanitation. In order to accelerate stunting reduction in Southeast Asia, availability and access to nutritious foods should be increased by collaboration between private and public sectors, and the Association of Southeast Asian Nations (ASEAN) can play a facilitating role. The private sector can produce and market nutritious foods, while the public sector sets standards, promotes healthy food choices, and ensures access to nutritious foods for the poorest, e.g, through social safety net programs.

Determinants of reduced child stunting in Cambodia: analysis of pooled data from three demographic and health surveys.

PubMed

Ikeda, Nayu; Irie, Yuki; Shibuya, Kenji

2013-05-01

To assess how changes in socioeconomic and public health determinants may have contributed to the reduction in stunting prevalence seen among Cambodian children from 2000 to 2010. A nationally representative sample of 10 366 children younger than 5 years was obtained from pooled data of cross-sectional surveys conducted in Cambodia in 2000, 2005, and 2010. The authors used a multivariate hierarchical logistic model to examine the association between the prevalence of childhood stunting over time and certain determinants. They estimated those changes in the prevalence of stunting in 2010 that could have been achieved through further improvements in public health indicators. Child stunting was associated with the child's sex and age, type of birth, maternal height, maternal body mass index, previous birth intervals, number of household members, household wealth index score, access to improved sanitation facilities, presence of diarrhoea, parents' education, maternal tobacco use and mother's birth during the Khmer Rouge famine. The reduction in stunting prevalence during the past decade was attributable to improvements in household wealth, sanitation, parental education, birth spacing and maternal tobacco use. The prevalence of stunting would have been further reduced by scaling up the coverage of improved sanitation facilities, extending birth intervals, and eradicating maternal tobacco use. Child stunting in Cambodia has decreased owing to socioeconomic development and public health improvements. Effective policy interventions for sanitation, birth spacing and maternal tobacco use, as well as equitable economic growth and education, are the keys to further improvement in child nutrition.

Mosaic stunting in bareroot Pinus banksiana seedlings is unrelated to colonization by mycorrhizal fungi

Treesearch

Lynette R. Potvin; Martin F. Jurgensen; R. Kasten Dumroese; Dana L. Richter; Deborah S. Page-Dumroese

2014-01-01

Mosaic stunting, the occurrence of random patches of chlorotic seedlings with reduced shoot and diameter growth amidst more robust cohorts within bareroot nurseries, is classically associated with poor colonization by mycorrhizal fungi. We examined possible relationships among soil fertility, mycorrhizas, and random patches of mosaic stunting in bareroot Pinus...

Lactoferrin and lysozyme to reduce environmental enteric dysfunction and stunting in Malawian children: Study protocol for a randomized controlled trial

USDA-ARS?s Scientific Manuscript database

Chronic childhood malnutrition, as manifested by stunted linear growth, remains a persistent barrier to optimal child growth and societal development. Environmental enteric dysfunction (EED) is a significant underlying factor in the causal pathway to stunting, delayed cognitive development, and ulti...

Infant and fetal mortality among a high fertility and mortality population in the Bolivian Amazon

PubMed Central

Gurven, Michael

2012-01-01

Indigenous populations experience higher rates of poverty, disease and mortality than non-indigenous populations. To gauge current and future risks among Tsimane Amerindians of Bolivia, I assess mortality rates and growth early in life, and changes in risks due to modernization, based on demographic interviews conducted Sept. 2002–July 2005. Tsimane have high fertility (Total Fertility Rate = 9) and infant mortality (13%). Infections are the leading cause of infant death (55%). Infant mortality is greatest among women who are young, monolingual, space births close together, and live far from town. Infant mortality declined during the period 1990–2002, and a higher rate of reported miscarriages occurred during the 1950–1989 period. Infant deaths are more frequent among those born in the wet season. Infant stunting, underweight and wasting are common (34%, 15% and 12%, respectively) and greatest for low-weight mothers and high parity infants. Regression analysis of infant growth shows minimal regional differences in anthropometrics but greater stunting and underweight during the first two years of life. Males are more likely to be underweight, wasted, and spontaneously aborted. Whereas morbidity and stunting are prevalent in infancy, greater food availability later in life has not yet resulted in chronic diseases (e.g. hypertension, atherosclerosis and diabetes) in adulthood due to the relatively traditional Tsimane lifestyle. PMID:23092724

Reaching the global target to reduce stunting: an investment framework

PubMed Central

Shekar, Meera; D’Alimonte, Mary R; Rogers, Hilary E; Eberwein, Julia Dayton; Akuoku, Jon Kweku; Pereira, Audrey; Soe-Lin, Shan; Hecht, Robert

2017-01-01

Abstract Childhood stunting, being short for one’s age, has life-long consequences for health, human capital and economic growth. Being stunted in early childhood is associated with slower cognitive development, reduced schooling attainment and adult incomes decreased by 5–53%. The World Health Assembly has endorsed global nutrition targets including one to reduce the number of stunted children under five by 40% by 2025. The target has been included in the Sustainable Development Goals (SDG target 2.2). This paper estimates the cost of achieving this target and develops scenarios for generating the necessary financing. We focus on a key intervention package for stunting (KIPS) with strong evidence of effectiveness. Annual scale-up costs for the period of 2016–25 were estimated for a sample of 37 high burden countries and extrapolated to all low and middle income countries. The Lives Saved Tool was used to model the impact of the scale-up on stunting prevalence. We analysed data on KIPS budget allocations and expenditure by governments, donors and households to derive a global baseline financing estimate. We modelled two financing scenarios, a ‘business as usual’, which extends the current trends in domestic and international financing for nutrition through 2025, and another that proposes increases in financing from all sources under a set of burden-sharing rules. The 10-year financial need to scale up KIPS is US$49.5 billion. Under ‘business as usual’, this financial need is not met and the global stunting target is not reached. To reach the target, current financing will have to increase from US$2.6 billion to US$7.4 billion a year on average. Reaching the stunting target is feasible but will require large coordinated investments in KIPS and a supportive enabling environment. The example of HIV scale-up over 2001–11 is instructive in identifying the factors that could drive such a global response to childhood stunting. PMID:28453717

Associations of stunting in early childhood with cardiometabolic risk factors in adulthood

PubMed Central

Vianna, Carolina Avila; Gigante, Denise P.; Miranda, J. Jaime; Yudkin, John S.; Horta, Bernardo Lessa; Ong, Ken K.

2018-01-01

Early life stunting may have long-term effects on body composition, resulting in obesity-related comorbidities. We tested the hypothesis that individuals stunted in early childhood may be at higher cardiometabolic risk later in adulthood. 1753 men and 1781 women participating in the 1982 Pelotas (Brazil) birth cohort study had measurements of anthropometry, body composition, lipids, glucose, blood pressure, and other cardiometabolic traits at age 30 years. Early stunting was defined as height-for-age Z-score at age 2 years below -2 against the World Health Organization growth standards. Linear regression models were performed controlling for sex, maternal race/ethnicity, family income at birth, and birthweight. Analyses were stratified by sex when p-interaction<0.05. Stunted individuals were shorter (β = -0.71 s.d.; 95% CI: -0.78 to -0.64), had lower BMI (β = -0.14 s.d.; 95%CI: -0.25 to -0.03), fat mass (β = -0.28 s.d.; 95%CI: -0.38 to -0.17), SAFT (β = -0.16 s.d.; 95%CI: -0.26 to -0.06), systolic (β = -0.12 s.d.; 95%CI: -0.21 to -0.02) and diastolic blood pressure (β = -0.11 s.d.; 95%CI: -0.22 to -0.01), and higher VFT/SAFT ratio (β = 0.15 s.d.; 95%CI: 0.06 to 0.24), in comparison with non-stunted individuals. In addition, early stunting was associated with lower fat free mass in both men (β = -0.39 s.d.; 95%CI: -0.47 to -0.31) and women (β = -0.37 s.d.; 95%CI: -0.46 to -0.29) after adjustment for potential confounders. Our results suggest that early stunting has implications on attained height, body composition and blood pressure. The apparent tendency of stunted individuals to accumulate less fat-free mass and subcutaneous fat might predispose them towards increased metabolic risks in later life. PMID:29641597

A formulated double-stranded RNA diet for reducing Penaeus monodon densovirus infection in black tiger shrimp.

PubMed

Chimwai, Chaweewan; Tongboonsong, Punnee; Namramoon, Orathai; Panyim, Sakol; Attasart, Pongsopee

2016-02-01

Penaeus monodon densovirus (PmDNV) is one of the major causes of stunted shrimp in the aquaculture industry in Thailand. Significant reductions in levels of PmDNV as assessed by PCR analysis of shrimp hepatopancreas were seen in both prophylactic and curative experiments after feeding shrimp with a formulated diet containing mixed inactivated bacteria harboring dsRNAs corresponding to the PmDNV ns1 and vp genes. Significant reductions of approximately 88% (prophylactic) and 64% (curative) of PmDNV were observed, suggesting that this diet has a high potential for application in commercial aquaculture for reducing PmDNV associated stunted growth of shrimp. Copyright © 2016 Elsevier Inc. All rights reserved.

Risk Factors for Child Malnutrition in Bangladesh: A Multilevel Analysis of a Nationwide Population-Based Survey.

PubMed

Chowdhury, Mohammad Rocky Khan; Rahman, Mohammad Shafiur; Khan, Mohammad Mubarak Hossain; Mondal, Mohammad Nazrul Islam; Rahman, Mohammad Mosiur; Billah, Baki

2016-05-01

To identify the prevalence and risk factors of child malnutrition in Bangladesh. Data was extracted from the Bangladesh Demographic Health Survey (2011). The outcome measures were stunting, wasting, and underweight. χ(2) analysis was performed to find the association of outcome variables with selected factors. Multilevel logistic regression models with a random intercept at each of the household and community levels were used to identify the risk factors of stunting, wasting, and underweight. From the 2011 survey, 7568 children less than 5 years of age were included in the current analysis. The overall prevalence of stunting, wasting, and underweight was 41.3% (95% CI 39.0-42.9). The χ(2) test and multilevel logistic regression analysis showed that the variables age, sex, mother's body mass index, mother's educational status, father's educational status, place of residence, socioeconomic status, community status, religion, region of residence, and food security are significant factors of child malnutrition. Children with poor socioeconomic and community status were at higher risk of malnutrition. Children from food insecure families were more likely to be malnourished. Significant community- and household-level variations were found. The prevalence of child malnutrition is still high in Bangladesh, and the risk was assessed at several multilevel factors. Therefore, prevention of malnutrition should be given top priority as a major public health intervention. Copyright © 2016 Elsevier Inc. All rights reserved.

Wound-induced endogenous jasmonates stunt plant growth by inhibiting mitosis.

PubMed

Zhang, Yi; Turner, John G

2008-01-01

When plants are repeatedly injured their growth is stunted and the size of organs such as leaves is greatly reduced. The basis of this effect is not well-understood however, even though it reduces yield of crops injured by herbivory, and produces dramatic effects exemplified in ornamental bonsai plants. We have investigated the genetic and physiological basis of this "bonsai effect" by repeatedly wounding leaves of the model plant Arabidopsis. This treatment stunted growth by 50% and increased the endogenous content of jasmonate (JA), a growth inhibitor, by seven-fold. Significantly, repeated wounding did not stunt the growth of the leaves of mutants unable to synthesise JA, or unable to respond to JA including coi1, jai3, myc2, but not jar1. The stunted growth did not result from reduced cell size, but resulted instead from reduced cell number, and was associated with reduced expression of CycB1;2. Wounding caused systemic disappearance of constitutively expressed JAZ1::GUS. Wounding also activates plant immunity. We show that a gene, 12-oxo-phytodienoate reductase, which catalyses a step in JA biosynthesis, and which we confirm is not required for defence, is however required for wound-induced stunting. Our data suggest that intermediates in the JA biosynthetic pathway activate defence, but a primary function of wound-induced JA is to stunt growth through the suppression of mitosis.

Effectiveness of a stunting recovery program for children treated in a specialized center.

PubMed

Bueno, Nassib B; Lisboa, Catia B; Clemente, Ana G; Antunes, Renata T; Sawaya, Ana L; Florêncio, Telma T

2018-04-01

BackgroundStunting is still very prevalent in many poor and developing regions in the world. This study assessed the effectiveness of a stunting recovery program in children and its associated factors.MethodsThe retrospective study was conducted in a center of stunting recovery. There, children stayed in a day-hospital system (9 h per day; 5 days per week), and received five meals per day, providing 80% of their energetic daily needs. The main outcome was the stunting recovery rate (i.e., the child present a height-for-age index (HAZ) >-1.0 at the time of data collection). A total of 75 children treated for at least 24 months, aged between 6 and 48 months and with an HAZ <-2.0 at the time of admission were included.ResultsThe average treatment time was 41 months. About 18 children (24.0%) recovered from stunting. The variable "age at admission >24 months" (prevalence rate (PR)=0.39, 95% confidence interval (CI): 0.15-0.99; P=0.04) and the variable "Household crowding index" (PR=0.65, 95% CI: 0.44-0.95; P=0.03) were associated with the success of the treatment.ConclusionThe environmental conditions in which the children live in their households and late admission to the center negatively influenced the success of stunting recovery, even with an intensive treatment.

Early Childhood Stunting and Later Fine Motor Abilities

ERIC Educational Resources Information Center

Chang, Susan M.; Walker, Susan P.; Grantham-McGregor, Sally; Powell, Christine A.

2010-01-01

Aim: The aim of this study was to determine the effects of early childhood stunting (height for age 2SD or more below reference values) and interventions on fine motor abilities at 11 to 12 years, and the relationship between fine motor abilities and school achievement and intelligence. Method: A cohort of stunted children who had participated in…

First report of hop stunt viroid from sweet cherry with dapple apple fruit symptoms in China

USDA-ARS?s Scientific Manuscript database

Hop stunt viroid (HSVd), the type member of the genus Hostuviroid, family Pospiviroidae, was first described from hops with stunt disease in Japan. HSVd has a wide host range that includes hop, cucumber, citrus, grapevine, plum, pear, peach, apricot and almond and is the causal agent of serious dis...

Stunting in Children (0-59 Months): What Is the Current Trend in South Africa?

ERIC Educational Resources Information Center

Dukhi, Natisha; Sartorius, Benn; Taylor, Myra

2017-01-01

Background: Stunting continues to affect young children as a global nutritional disorder. The aim of our study was to assess the prevalence, associated risk factors and spatial clustering for stunting in a disadvantaged South African District. Methods: A community-based cross-sectional weighted survey of households was conducted in the iLembe…

First report of ratoon stunt of sugarcane caused by Leifsonia xyl. subsp. xyli in Pakistan

USDA-ARS?s Scientific Manuscript database

During a survey of the sugarcane crop in the area of Faisalabad, Sargodha and the Dera Ghazi Khan Division of the Punjab province of Pakistan from 2007 to 2010, symptoms consistent with ratoon stunting, including stunted growth and reddening of the vascular bundles at the nodal regions were observed...

Mosaic Stunting in jack pine seedlings in a northern Michigan bareroot nursery

Treesearch

Lynette Potvin; R. Kasten Dumroese; Martin F. Jurgensen; Dana Richter

2010-01-01

Mosaic, or patchy, stunting of bareroot conifer seedlings is thought to be caused by deficiencies of mycorrhizal fungi following fumigation, resulting in reduced nutrient uptake, particularly phosphorus. Mosaic stunting of jack pine (Pinus banksiana) seedlings was observed in 2005 at the USDA Forest Service JW Toumey Nursery in Watersmeet, MI. We initiated a study to...

Integrative taxonomy of the stunt nematodes of the genera Bitylenchus and Tylenchorhynchus (Nematoda, Telotylenchidae) with description of two new species and a molecular phylogeny

USDA-ARS?s Scientific Manuscript database

The genera Tylenchorhynchus Cobb, 1913 and Bitylenchus Filipjev, 1934 contain 104 and 29 valid species, respectively, of plant-parasitic nematodes collectively known as "stunt nematodes”. Stunt nematodes have a broad geographical distribution in several continents and some species damage agricultur...

Sociodemographic and geographical inequalities in under- and overnutrition among children and mothers in Bangladesh: a spatial modelling approach to a nationally representative survey.

PubMed

Mia, Mohammad Nahid; Rahman, M Shafiqur; Roy, Paritosh K

2018-05-02

To investigate the sociodemographic and geographical variation in under- and overnutrition prevalence among children and mothers. Data from the 2014 Bangladesh Demographic and Health Survey were analysed. Stunting and wasting for children and BMI<18·5 kg/m2 for mothers were considered as undernutrition; overweight was considered as overnutrition for both children and mothers. We estimated the prevalence and performed simple logistic regression analyses to assess the associations between outcome variables and predictors. Bayesian spatial models were applied to estimate region-level prevalence to identify the regions (districts) prone to under- and overnutrition.Settings/SubjectsChildren aged<5 years and their mothers aged 15-49 years in Bangladesh. A significant difference (P<0·001) was observed in both under- and overnutrition prevalence between poor and rich. A notable regional variation was also observed in under- and overnutrition prevalence. Stunting prevalence ranged from 20·3 % in Jessore to 56·2 % in Sunamgonj, wasting from 10·6 % in Dhaka to 19·2 % in Bhola, and overweight from 0·8 % in Shariatpur to 2·6 % in Dhaka. Of the sixty-four districts, twelve had prevalence of stunting and thirty-two districts had prevalence of wasting higher than the WHO critical threshold levels. Similarly, fifty-three districts had prevalence of maternal underweight higher than the national level. In contrast, the prevalence of overweight was comparatively high in the industrially equipped metropolitan districts. Observed sociodemographic and geographical inequalities imply slow progress in the overall improvement of both under- and overnutrition. Therefore, effective intervention programmes and policies need to be designed urgently targeting the grass-roots level of such regions.

Postinfancy growth, schooling, and cognitive achievement: Young Lives1234

PubMed Central

Schott, Whitney; Cueto, Santiago; Dearden, Kirk A; Engle, Patrice; Georgiadis, Andreas; Lundeen, Elizabeth A; Penny, Mary E; Stein, Aryeh D; Behrman, Jere R

2013-01-01

Background: Early life growth failure and resulting cognitive deficits are often assumed to be very difficult to reverse after infancy. Objective: We used data from Young Lives, which is an observational cohort of 8062 children in Ethiopia, India, Peru, and Vietnam, to determine whether changes in growth after infancy are associated with schooling and cognitive achievement at age 8 y. Design: We represented the growth by height-for-age z score at 1 y [HAZ(1)] and height-for-age z score at 8 y that was not predicted by the HAZ(1). We also characterized growth as recovered (stunted at age 1 y and not at age 8 y), faltered (not stunted at age 1 y and stunted at age 8 y), persistently stunted (stunted at ages 1 and 8 y), or never stunted (not stunted at ages 1 and 8 y). Outcome measures were assessed at age 8 y. Results: The HAZ(1) was inversely associated with overage for grade and positively associated with mathematics achievement, reading comprehension, and receptive vocabulary. Unpredicted growth from 1 to 8 y of age was also inversely associated with overage for grade (OR range across countries: 0.80–0.84) and positively associated with mathematics achievement (effect-size range: 0.05–0.10), reading comprehension (0.02–0.10), and receptive vocabulary (0.04–0.08). Children who recovered in linear growth had better outcomes than did children who were persistently stunted but were not generally different from children who experienced growth faltering. Conclusions: Improvements in child growth after early faltering might have significant benefits on schooling and cognitive achievement. Hence, although early interventions remain critical, interventions to improve the nutrition of preprimary and early primary school–age children also merit consideration. PMID:24067665

Postinfancy growth, schooling, and cognitive achievement: Young Lives.

PubMed

Crookston, Benjamin T; Schott, Whitney; Cueto, Santiago; Dearden, Kirk A; Engle, Patrice; Georgiadis, Andreas; Lundeen, Elizabeth A; Penny, Mary E; Stein, Aryeh D; Behrman, Jere R

2013-12-01

Early life growth failure and resulting cognitive deficits are often assumed to be very difficult to reverse after infancy. We used data from Young Lives, which is an observational cohort of 8062 children in Ethiopia, India, Peru, and Vietnam, to determine whether changes in growth after infancy are associated with schooling and cognitive achievement at age 8 y. We represented the growth by height-for-age z score at 1 y [HAZ(1)] and height-for-age z score at 8 y that was not predicted by the HAZ(1). We also characterized growth as recovered (stunted at age 1 y and not at age 8 y), faltered (not stunted at age 1 y and stunted at age 8 y), persistently stunted (stunted at ages 1 and 8 y), or never stunted (not stunted at ages 1 and 8 y). Outcome measures were assessed at age 8 y. The HAZ(1) was inversely associated with overage for grade and positively associated with mathematics achievement, reading comprehension, and receptive vocabulary. Unpredicted growth from 1 to 8 y of age was also inversely associated with overage for grade (OR range across countries: 0.80-0.84) and positively associated with mathematics achievement (effect-size range: 0.05-0.10), reading comprehension (0.02-0.10), and receptive vocabulary (0.04-0.08). Children who recovered in linear growth had better outcomes than did children who were persistently stunted but were not generally different from children who experienced growth faltering. Improvements in child growth after early faltering might have significant benefits on schooling and cognitive achievement. Hence, although early interventions remain critical, interventions to improve the nutrition of preprimary and early primary school-age children also merit consideration.

Association between maternal depression and child stunting in Northern Ghana: a cross-sectional study.

PubMed

Wemakor, Anthony; Mensah, Kofi Akohene

2016-08-24

Stunting indicates failure to attain genetic potential for height and is a well-documented indicator for poor growth. Depression is common in women of reproductive age and women's mental health problems may affect the growth of young children. We examined the association between maternal depression and stunting in mother-child pairs attending Child Welfare Clinic (CWC) in Northern Ghana. An analytical cross-sectional study was performed involving mothers (15-45 years) and their children (0-59 months) who attended CWC at Bilpeila Health Centre, Tamale, Ghana. Socio-demographic data were collected using a semi-structured questionnaire, maternal depression was measured using Centre for Epidemiological Studies Depression Screening Scale, and anthropometry was conducted on children following standard procedures. The association between maternal depression and child stunting was examined in logistic regression adjusting for potential confounders. Prevalence rates of child stunting and maternal depression were estimated at 16.1 and 27.8 % respectively in Northern Ghana. Mothers with depression when compared with those without depression tended to be younger, be currently unmarried, belong to the poorest household wealth tertile, and were more likely to have low birth weight babies, so these characteristics were adjusted for. In an adjusted multivariate logistic regression model, children of depressed mothers were almost three times more likely to be stunted compared to children of non-depressed mothers (Adjusted OR = 2.48, 95 % CI 1.29-4.77, p = 0.0011). There is a high prevalence of depression among mothers in Northern Ghana which is associated with child stunting. Further studies are needed to identify the determinants of maternal depression and to examine its association with child stunting to inform nutrition programming.

Household dietary diversity and child stunting in East Java, Indonesia.

PubMed

Mahmudiono, Trias; Sumarmi, Sri; Rosenkranz, Richard R

2017-03-01

More than one-quarter of under-five children in the developing world are stunted, and those with poor nutrient intake are at risk of irreversible cognitive impairment. The purpose of this study was to determine the relationship between dietary diversity and child stunting in an Indonesian context. Dietary diversity was assessed using a maternal-reported checklist of 12 food groups, summed as a Household Dietary Diversity Score. Stunting was defined as <=-2.0 height-for-age z-score by WHO-Anthro 2005. Trained interviewers administered the household dietary diversity questionnaire to 768 households with children aged <5 years in East Java, Indonesia. Logistic regression models were constructed to test the association between dietary diversity and child stunting. The prevalence of child stunting was 39.4%, and the percentage of households consuming food groups high in protein and calcium, like dairy products (41%), and meat/poultry, (65%) was lower compared with other food groups. The unadjusted model revealed that higher dietary diversity scores were associated with lower likelihood of child stunting (OR=0.89; 95% CI=0.80-0.98). This relationship remained significant after adjustment for family size, maternal literacy, food expenditure, breastfeeding, energy, and protein intake (OR=0.89; 95% CI=0.80-0.99). The dietary diversity score was moderate, with consumption of dairy products and meat/poultry lowest among 12 food groups. Hence, population interventions should focus on promoting food groups currently lacking in maternal and child diet, including those rich in growth-promoting nutrients like dairy, meat/poultry. These results, from an Indonesian context, confirm the widely observed protective relationship between dietary diversity and child stunting.

ETHNICITY AND INCOME IMPACT ON BMI AND STATURE OF SCHOOL CHILDREN LIVING IN URBAN SOUTHERN MEXICO.

PubMed

Mendez, Nina; Barrera-Pérez, The Late Mario; Palma-Solis, Marco; Zavala-Castro, Jorge; Dickinson, Federico; Azcorra, Hugo; Prelip, Michael

2016-03-01

Obesity affects quality of life and increases the risk of morbidity and mortality. Mexico, a middle-income country, has a high prevalence of overweight and obesity among urban children. Merida is the most populated and growing city in southern Mexico with a mixed Mayan and non-Maya population. Local urbanization and access to industrialized foods have impacted the eating habits and physical activity of children, increasing the risk of overweight and obesity. This study aimed to contribute to the existing literature on the global prevalence of overweight and obesity and examined the association of parental income, ethnicity and nutritional status with body mass index (BMI) and height in primary school children in Merida. The heights and weights of 3243 children aged 6-12 from sixteen randomly selected schools in the city were collected between April and December 2012. Multinomial logistic regression models were used to examine differences in the prevalence of BMI and height categories (based on WHO reference values) by ethnicity and income levels. Of the total students, 1648 (50.9%) were overweight or obese. Stunting was found in 227 children (7%), while 755 (23.3%) were defined as having short stature. Combined stunting and overweight/obesity was found in 301 students (9.3%) and twelve (0.4%) were classified as stunted and of low weight. Having two Mayan surnames was inversely associated with having adequate height (OR=0.69, p<0.05) and the presence of two Maya surnames in children increased the odds of short stature and stunting. Children from lower income families had twice the odds of being stunted and obese. Overweight, obesity and short stature were frequent among the studied children. A significant proportion of Meridan children could face an increased risk of developing cardiovascular disease and its associated negative economic and social outcomes unless healthier habits are adopted. Action is needed to reduce the prevalence of obesity among southern Mexican families of all ethnic groups, particularly those of lower income.

Does living in an urban environment confer advantages for childhood nutritional status? Analysis of disparities in nutritional status by wealth and residence in Angola, Central African Republic and Senegal.

PubMed

Kennedy, Gina; Nantel, Guy; Brouwer, Inge D; Kok, Frans J

2006-04-01

The purpose of this paper is to examine the relationship between childhood undernutrition and poverty in urban and rural areas. Anthropometric and socio-economic data from Multiple Indicator Cluster Surveys in Angola-Secured Territory (Angola ST), Central African Republic and Senegal were used in this analysis. The population considered in this study is children 0-59 months, whose records include complete anthropometric data on height, weight, age, gender, socio-economic level and urban or rural area of residence. In addition to simple urban/rural comparisons, the population was stratified using a wealth index based on living conditions and asset ownership to compare the prevalence, mean Z-score and odds ratios for stunting and wasting. In all cases, when using a simple urban/rural comparison, the prevalence of stunting was significantly higher in rural areas. However, when the urban and rural populations were stratified using a measure of wealth, the differences in prevalence of stunting and underweight in urban and rural areas of Angola ST, Central African Republic and Senegal disappeared. Poor children in these urban areas were just as likely to be stunted or underweight as poor children living in rural areas. The odds ratio of stunting in the poorest compared with the richest quintile was 3.4, 3.2 and 1.5 in Angola ST, Senegal and Central African Republic, respectively. This paper demonstrates that simple urban/rural comparisons mask wide disparities in subgroups according to wealth. There is a strong relationship between poverty and chronic undernutrition in both urban and rural areas; this relationship does not change simply by living in an urban environment. However, urban and rural living conditions and lifestyles differ, and it is important to consider these differences when designing programmes and policies to address undernutrition.

Polyparasite Helminth Infections and Their Association to Anaemia and Undernutrition in Northern Rwanda

PubMed Central

Mupfasoni, Denise; Karibushi, Blaise; Koukounari, Artemis; Ruberanziza, Eugene; Kaberuka, Teddy; Kramer, Michael H.; Mukabayire, Odette; Kabera, Michee; Nizeyimana, Vianney; Deville, Marie-Alice; Ruxin, Josh; Webster, Joanne P.; Fenwick, Alan

2009-01-01

Background Intestinal schistosomiasis and soil-transmitted helminth (STH) infections constitute major public health problems in many parts of sub-Saharan Africa. In this study we examined the functional significance of such polyparasite infections in anemia and undernutrition in Rwandan individuals. Methods Three polyparasite infection profiles were defined, in addition to a reference profile that consisted of either no infections or low-intensity infection with only one of the focal parasite species. Logistic regression models were applied to data of 1,605 individuals from 6 schools in 2 districts of the Northern Province before chemotherapeutic treatment in order to correctly identify individuals who were at higher odds of being anaemic and/or undernourished. Findings Stunted relative to nonstunted, and males compared to females, were found to be at higher odds of being anaemic independently of polyparasite infection profile. The odds of being wasted were 2-fold greater for children with concurrent infection of at least 2 parasites at M+ intensity compared to those children with the reference profile. Males compared to females and anaemic compared to nonanaemic children were significantly more likely to be stunted. None of the three polyparasite infection profiles were found to have significant effects on stunting. Conclusion The present data suggest that the levels of polyparasitism, and infection intensities in the Rwandan individuals examined here may be lower as compared to other recent similar epidemiological studies in different regions across sub-Saharan Africa. Neither the odds of anaemia nor the odds of stunting were found to be significantly different in the three-polyparasite infection profiles. However, the odds of wasting were higher in those children with at least two parasites at M+ intensity compared to those children with the reference profile. Nevertheless, despite the low morbidity levels indicated in the population under study here, we recommend sustainable efforts for the deworming of affected populations to be continued in order to support the economic development of the country. PMID:19753110

Fecal total iron concentration is inversely associated with fecal Lactobacillus in preschool children.

PubMed

Kalipatnapu, Sasank; Kuppuswamy, Sivaraman; Venugopal, Giriprasad; Kaliaperumal, Venkatesh; Ramadass, Balamurugan

2017-08-01

Iron deficiency is associated with stunting and poor performance in children. Oral iron supplementation is widely promoted to correct iron deficiency. However, excess iron may be toxic to beneficial luminal gut bacteria and could support growth of pathobionts. The aim of this study is to analyze the fecal total iron concentration and fecal Lactobacillus levels in a cohort of stunted and normal children. The study was undertaken in two different locations. One of them is a rural area, and the other is a semi-urban-slum area; both areas are located in the Vellore district of Tamilnadu state. Twenty children (10 stunted and 10 normal growth) aged 2 to 5 years from each area were recruited. Both groups were nearly identical demographically. Fecal samples were collected. Fecal total iron was estimated, and fecal DNA was extracted and subjected to 16S rDNA-targeted real-time PCR to determine the relative predominance of Lactobacillus and Escherichia coli. The fecal total iron concentration in rural children (3656 μg/g wet wt. of feces) was significantly higher when compared with semi-urban-slum children (114.9 μg/g wet wt. of feces, P < 0.005). Inversely, fecal Lactobacillus in rural children (median 3.18 × 10 -3 relative difference compared with total bacteria) was significantly lower when compared with semi-urban-slum children (median 59.33 × 10 -3 , p < 0.005). There was no significant change observed between normal and stunted children. E. coli levels remained unaffected. The present study documents an inverse relationship between fecal iron concentration and fecal Lactobacillus concentration in children belonging to two different localities independent of their nutritional status. © 2017 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

Low serum omega-3 and omega-6 polyunsaturated fatty acids and other metabolites are associated with poor linear growth in young children from rural Malawi

USDA-ARS?s Scientific Manuscript database

Stunting affects ~25% of children <5 y of age and is associated with impaired cognitive and motor development and increased morbidity and mortality. The pathogenesis of stunting is poorly understood. The purpose of this study was to identify altered metabolic pathways associated with child stunting...

A combined intervention of zinc, multiple micronutrients, and albendazole does not ameliorate environmental enteric dysfunction or stunting in rural Malawian children in a double-blind randomized controlled trial

USDA-ARS?s Scientific Manuscript database

Environmental enteric dysfunction (EED) and linear growth stunting affect many rural agrarian children in the developing world and contribute to the persistently high rates of stunting that are observed worldwide. Effective interventions to consistently ameliorate EED are lacking. We tested whether ...

Micronutrients in the treatment of stunting and moderate malnutrition.

PubMed

Penny, Mary Edith

2012-01-01

Linear growth retardation or stunting may occur with or without low weight-for-age, but in both cases stunted or moderately malnourished children are deficient in micronutrients. Pregnancy and the first 2 years are critical periods. Dietary deficiency of zinc, iron, calcium, and vitamin A are especially common and often occur together. Zinc is essential for adequate growth, and supplements have been shown to increase intrauterine femur length and to prevent stunting. However, in general, supplements which provide a mixture of micronutrients have been more successful in preventing stunting and are simpler to take and distribute. Multiple micronutrients together with energy and macronutrients are also needed for the management of moderate malnutrition. Multiple micronutrients may be delivered as medicinal-like supplements, but may also be combined with food, for instance in milk drinks, in fortified dried cereal mixes used to supplement complementary foods or in lipid nutrition supplements. The latter also provide essential fats necessary for growth. Micronutrient powders for home fortification are effective in preventing anemia, but present combinations do not prevent stunting. Improving the diets of infant and young children is also possible, and increased intake of animal source foods can improve growth. Copyright © 2012 S. Karger AG, Basel.

Malaria increased the risk of stunting and wasting among young children in Ethiopia: Results of a cohort study.

PubMed

Gari, Taye; Loha, Eskindir; Deressa, Wakgari; Solomon, Tarekegn; Lindtjørn, Bernt

2018-01-01

Given the high prevalence of malnutrition in a malaria-endemic setting, improving nutritional status could serve as a tool to prevent malaria. However, the relationship between the two conditions remains unclear. Therefore, this study assessed the association between under-nutrition and malaria among a cohort of children aged 6 to 59 months old. Two cohorts of children were followed for 89 weeks in a rural Rift Valley area of Ethiopia. In the first approach (malaria-malnutrition), a cohort of 2,330 non-stunted and 4,204 non-wasted children were included to assess under-nutrition (outcome) based on their previous malaria status (exposure). In the second approach (malnutrition-malaria), a cohort of 4,468 children were followed-up to measure malaria (outcome), taking under-nutrition as an exposure. A weekly home visit was carried out to identify malaria cases. Four anthropometry surveys were conducted, and generalized estimating equation (GEE) method was used to measure the association between undernutrition and malaria. The prevalence of stunting was 44.9% in December 2014, 51.5% in August 2015, 50.7% in December 2015 and 48.1% in August 2016. We observed 103 cases with 118 episodes of malaria, 684 new stunting and 239 new wasting cases. The incidence rate per 10,000 weeks of observation was 3.8 for malaria, 50.4 for stunting and 8.2 for wasting. Children with malaria infection, [Adjusted Odds Ratio (AOR) = 1.9; 95% Confidence Interval (CI), 1.2-2.9)] and younger age (AOR = 1.3; 95% CI, 1.1-1.5) were more likely to be stunted. Furthermore, children with malaria infection (AOR = 8.5; 95% CI, 5.0-14.5) and young age group (AOR = 1.6; 95% CI, 1.2-2.1) were more likely to be wasted. However, stunting and wasting were not risk factors of subsequent malaria illness. Malaria infection was a risk factor for stunting and wasting, but stunting or wasting was not associated with subsequent malaria illness. As our study shows that malaria is a risk factor for stunting and wasting, a close follow-up of the nutritional status of such children may be needed. PACT R2014 11000 882128 (8 September 2014).

Malaria increased the risk of stunting and wasting among young children in Ethiopia: Results of a cohort study

PubMed Central

Loha, Eskindir; Deressa, Wakgari; Solomon, Tarekegn; Lindtjørn, Bernt

2018-01-01

Introduction Given the high prevalence of malnutrition in a malaria-endemic setting, improving nutritional status could serve as a tool to prevent malaria. However, the relationship between the two conditions remains unclear. Therefore, this study assessed the association between under-nutrition and malaria among a cohort of children aged 6 to 59 months old. Methods Two cohorts of children were followed for 89 weeks in a rural Rift Valley area of Ethiopia. In the first approach (malaria-malnutrition), a cohort of 2,330 non-stunted and 4,204 non-wasted children were included to assess under-nutrition (outcome) based on their previous malaria status (exposure). In the second approach (malnutrition–malaria), a cohort of 4,468 children were followed-up to measure malaria (outcome), taking under-nutrition as an exposure. A weekly home visit was carried out to identify malaria cases. Four anthropometry surveys were conducted, and generalized estimating equation (GEE) method was used to measure the association between undernutrition and malaria. Results The prevalence of stunting was 44.9% in December 2014, 51.5% in August 2015, 50.7% in December 2015 and 48.1% in August 2016. We observed 103 cases with 118 episodes of malaria, 684 new stunting and 239 new wasting cases. The incidence rate per 10,000 weeks of observation was 3.8 for malaria, 50.4 for stunting and 8.2 for wasting. Children with malaria infection, [Adjusted Odds Ratio (AOR) = 1.9; 95% Confidence Interval (CI), 1.2–2.9)] and younger age (AOR = 1.3; 95% CI, 1.1–1.5) were more likely to be stunted. Furthermore, children with malaria infection (AOR = 8.5; 95% CI, 5.0–14.5) and young age group (AOR = 1.6; 95% CI, 1.2–2.1) were more likely to be wasted. However, stunting and wasting were not risk factors of subsequent malaria illness. Conclusions Malaria infection was a risk factor for stunting and wasting, but stunting or wasting was not associated with subsequent malaria illness. As our study shows that malaria is a risk factor for stunting and wasting, a close follow-up of the nutritional status of such children may be needed. Trial registration PACT R2014 11000 882128 (8 September 2014). PMID:29324840

Association of enteric parasitic infections with intestinal inflammation and permeability in asymptomatic infants of São Tomé Island.

PubMed

Garzón, Marisol; Pereira-da-Silva, Luis; Seixas, Jorge; Papoila, Ana Luísa; Alves, Marta; Ferreira, Filipa; Reis, Ana

2017-05-01

The cumulative effect of repeated asymptomatic enteric infections on intestinal barrier is not fully understood in infants. We aimed to evaluate the association between previous enteric parasitic infections and intestinal inflammation and permeability at 24-months of age, in asymptomatic infants of São Tomé Island. A subset of infants from a birth cohort, with intestinal parasite evaluations in at least four points of assessment, was eligible. Intestinal inflammatory response and permeability were assessed using fecal S100A12 and alpha-1-antitrypsin (A1AT), respectively. The cutoff <-1SD for weight-for-length and length-for-age was used to define wasting and stunting. Multivariable linear regression analysis explored if cumulative enteric parasitic infections explained variability of fecal biomarkers, after adjusting for potential confounders. Eighty infants were included. Giardia duodenalis and soil-transmitted helminths (STH) were the most frequent parasites. The median (interquartile range) levels were 2.87 μg/g (2.41-3.92) for S100A12 and 165.1 μg/g (66.0-275.6) for A1AT. Weak evidence of association was found between S100A12 levels and G. duodenalis (p = 0.080) and STH infections (p = 0.089), and between A1AT levels and parasitic infection of any etiology (p = 0.089), at 24-months of age. Significant associations between A1AT levels and wasting (p = 0.006) and stunting (p = 0.044) were found. Previous parasitic infections were not associated with fecal biomarkers at 24 months of age. To summarize, previous asymptomatic parasitic infections showed no association with intestinal barrier dysfunction. Notwithstanding, a tendency toward increased levels of the inflammatory biomarker was observed for current G. duodenalis and STH infections, and increased levels of the permeability biomarker were significantly associated with stunting and wasting.

Stunting at 24 Months Is Not Related to Incidence of Overweight through Young Adulthood in an Urban South African Birth Cohort.

PubMed

Hanson, Sara K; Munthali, Richard J; Lundeen, Elizabeth A; Richter, Linda M; Norris, Shane A; Stein, Aryeh D

2018-05-15

The role that childhood stunting plays in the development of overweight and obesity later in life is not well understood, particularly in adolescence and young adulthood, because most studies have only followed up through midchildhood. The objective of this study was to examine the relation between stunting and age-specific patterns of overweight and obesity incidence from early childhood to young adulthood in the context of a country in the process of the nutrition transition while these children were growing up. We analyzed data from 895 participants in the Birth-to-Twenty Plus Cohort (Bt20+), an urban South African birth cohort initiated in 1990. Anthropometric data were collected at multiple ages and participants were included if they provided height at age 24 mo and ≥1 measure of body mass index [BMI; weight (kg)/height (m)2] in each of the following time periods: 4-8 y, 11-12 y, 13-15 y, 16-18 y, and 22-24 y. We defined stunting at age 24 mo as height-for-age z score <2 and overweight as BMI z score (BMIZ) >1 in childhood (4-8 y) and adolescence (11-12 y, 13-15 y, and 16-18 y) and BMI ≥25 in young adulthood (22-24 y). We compared BMI, BMIZ, and the prevalence of overweight by stunting status, stratified by sex. Our sample was 93% black and 51% female. The prevalence of stunting at 24 mo was 26% in males and 19% in females. In young adulthood, the prevalence of overweight and obesity was 15.5% (males) and 47.5% (females). Among both males and females, neither mean BMI nor a combined measure of overweight and obesity in any subsequent period differed by stunting status at 24 mo (P ≥ 0.05). Stunting at 24 mo was not related to the risk of overweight or obesity in this cohort. Stunting may not be an important contributor to the increasing obesity rates in urban South Africa.

Major dietary patterns in relation to stunting among children in Tehran, Iran.

PubMed

Esfarjani, Fatemeh; Roustaee, Roshanak; Mohammadi-Nasrabadi, Fatemeh; Esmaillzadeh, Ahmad

2013-06-01

To the best of our knowledge, no information is available to link major dietary patterns to stunting during childhood, although dietary patterns are associated with chronic diseases. This study was conducted to determine the relationship between major dietary patterns and stunting in the first grade pupils of Tehran in 2009. In this case-control study, 86 stunted children (defined as height-for-age of less than the 5th percentile of CDC2000 cutoff points) were enrolled from among 3,147 first grade pupils of Tehran, selected using a multistage cluster random-sampling method. Participants for the control group (n=308) were selected randomly from non-stunted children (height-for-age more than the 5th percentile of CDC2000 cutoff points), after matching for age, sex, and area of residence. Dietary data were collected using two 24-hour dietary recalls through face-to-face interview with mothers. Factor analysis was used for identifying major dietary patterns. Mean consumption of dairy products (308 +/- 167 vs 382 +/- 232 g/day, p < 0.05), dried fruits and nuts (2.5819 vs 7.15 +/- 26 g/day, p < 0.05) were significantly lower among stunted children than those in the control group. Three major dietary patterns were identified: 'traditional dietary pattern' that was dominated by bread, potato, fats, eggs, flavours, vegetables other than leafy ones, sugar, drinks, and fast food; 'mixed dietary pattern' that was dominated by leafy vegetables, fast foods, nuts, fats, cereals other than bread, fruits, legumes, visceral meats, sugars, eggs, and vegetables other than leafy vegetables; and 'carbohydrate-protein pattern' that was dominated by sweets and desserts, poultry, dairy, fruits, legumes, and visceral meats. No significant relationships were found between traditional and mixed dietary patterns and stunting. Individuals in the third quartile of carbohydrate-protein dietary pattern were less likely to be stunted compared to those in the bottom quartile (OR: 0.31, 95% CI 0.13-0.78, p < 0.05). Adherence to dietary patterns high in protein (e.g. dairy, legumes, and meat products) and carbohydrates (e.g. fruits, sweets, and desserts) might be associated with reduced odds of being stunted among children.

The prevalence of overweight, obesity and stunting in school children aged 6-19 years in Beijing, China.

PubMed

Wu, Huahong; Li, Hui; Zong, Xinnan

2016-11-01

Childhood/adolescent obesity and stunting are associated with heightened risk of metabolic syndrome. Understanding the prevalence and patterns of stunting, the emergence of overweight/obesity in children and adolescents and the concomitant risk for metabolic syndrome is of critical importance for public health policy. To investigate the prevalence of overweight, obesity and stunting in school children and adolescents aged 6-19 years in Beijing and to compare the differences in screening rates by national and international references. School children aged 6-19 years in Xuanwu, Haidian and Fangshan district were selected. Overweight and obesity in the children was screened for using the International Obesity Task-force (IOTF) and Chinese standards. Stunting was defined as height-for-age Z-score (HAZ) less than -2 using the 2009 Chinese standards and 2007 WHO reference. A total of 99 482 children were included in this survey. The prevalences of overweight and obesity are 17.7% and 14.4% in the Chinese standard, but they are 18.1% and 8.6% in the IOTF standard; there were significant differences between the prevalences of these two standards (p < 0.01). The prevalences of overweight/obesity in boys are all significantly higher than that of girls in every age-group (p < 0.05). Overall there was stunting in 2630 children and adolescents (2.6%) according to the Chinese standards, with 2.8% in boys, higher than the 2.5% of girls (p < 0.01). According to WHO standards, there was stunting in 1201 children and adolescents (1.2%) with 1.1% in boys and 1.3% in girls (p < 0.05). The prevalence of stunting in urban areas was 1.3%, which is significantly lower than that of suburban areas, at 3.9% (p < 0.01). The prevalence of overweight/obesity in children and adolescents aged 6-19 years in Beijing was close to western countries, which should be highly valued when considering public health policies and the problem of growth stunting should not be ignored.

Reaching the global target to reduce stunting: an investment framework.

PubMed

Shekar, Meera; Kakietek, Jakub; D'Alimonte, Mary R; Rogers, Hilary E; Eberwein, Julia Dayton; Akuoku, Jon Kweku; Pereira, Audrey; Soe-Lin, Shan; Hecht, Robert

2017-06-01

Childhood stunting, being short for one's age, has life-long consequences for health, human capital and economic growth. Being stunted in early childhood is associated with slower cognitive development, reduced schooling attainment and adult incomes decreased by 5-53%. The World Health Assembly has endorsed global nutrition targets including one to reduce the number of stunted children under five by 40% by 2025. The target has been included in the Sustainable Development Goals (SDG target 2.2). This paper estimates the cost of achieving this target and develops scenarios for generating the necessary financing. We focus on a key intervention package for stunting (KIPS) with strong evidence of effectiveness. Annual scale-up costs for the period of 2016-25 were estimated for a sample of 37 high burden countries and extrapolated to all low and middle income countries. The Lives Saved Tool was used to model the impact of the scale-up on stunting prevalence. We analysed data on KIPS budget allocations and expenditure by governments, donors and households to derive a global baseline financing estimate. We modelled two financing scenarios, a 'business as usual', which extends the current trends in domestic and international financing for nutrition through 2025, and another that proposes increases in financing from all sources under a set of burden-sharing rules. The 10-year financial need to scale up KIPS is US$49.5 billion. Under 'business as usual', this financial need is not met and the global stunting target is not reached. To reach the target, current financing will have to increase from US$2.6 billion to US$7.4 billion a year on average. Reaching the stunting target is feasible but will require large coordinated investments in KIPS and a supportive enabling environment. The example of HIV scale-up over 2001-11 is instructive in identifying the factors that could drive such a global response to childhood stunting. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

A mixed methods study to assess the effectiveness of food-based interventions to prevent stunting among children under-five years in Districts Thatta and Sujawal, Sindh Province, Pakistan: study protocol.

PubMed

Kureishy, Sumra; Khan, Gul Nawaz; Arrif, Shabina; Ashraf, Khizar; Cespedes, Angela; Habib, Muhammad Atif; Hussain, Imtiaz; Ullah, Asmat; Turab, Ali; Ahmed, Imran; Zaidi, Shehla; Soofi, Sajid Bashir

2017-01-05

Maternal and child malnutrition is widely prevalent in low and middle income countries. In Pakistan, widespread food insecurity and malnutrition are the main contributors to poor health, low survival rates and the loss of human capital development. The nutritional status trends among children exhibit a continuous deteriorating with rates of malnutrition exceeding the WHO critical threshold. With the high prevalence of maternal and child malnutrition, it is important to identify effective preventative approaches, especially for reducing stunting in children under-five years of age. The primary aim of this study is to assess the effectiveness of food-based interventions to prevent stunting in children under-five years. A mixed methods study design will be conducted to evaluate the effectiveness of food-based interventions to prevent stunting among children under-five years in districts Thatta and Sujawal, Sindh Province, Pakistan. The study will include cross sectional surveys, a community-based cluster randomized controlled trial and a process evaluation. The study participants will be pregnant women, lactating mothers and children under-five years. The cross-sectional surveys will be conducted with 7360 study participants at baseline and endline. For the randomized control trial, 5000 participants will be recruited and followed monthly for compliance of food-based supplements, dietary diversity, pregnancy outcomes, and maternal and child morbidity and mortality. Anthropometric measurements and hemoglobin levels will be measured at baseline, quarterly and at endline. The interventions will consist of locally produced lipid-based nutrient supplement (Wawamum) for children 6-23 months, micronutrient powders for children 24-59 months, and wheat soya blends for pregnant and lactating mothers. Government lady health workers will deliver interventions to participants. The effectiveness of the project will be measured in terms of the impact of the proposed interventions on stunting, nutritional status, micronutrient deficiencies, and other key indicators of the participants. The process evaluation will assess the acceptability, feasibility and potential barriers of project implementation through focus group discussions, key informant interviews and household surveys. Data analysis will be conducted using STATA version 12. There is considerable evidence on the effectiveness of food-based interventions in managing stunting in developing countries. However, these studies do not account for the local environmental factors and widespread nutrient deficiencies in Pakistan. These studies are often conducted in controlled environments, where the results cannot be generalized to programs operating under field conditions. The findings of this study will provide sufficient evidence to develop policies and programs aimed to prevent stunting in children 6-59 months and to improve maternal and child health and growth outcomes in poor resource settings. NCT02422953 . Registered on April 15, 2015.

Is economic growth associated with reduction in child undernutrition in India?

PubMed

Subramanyam, Malavika A; Kawachi, Ichiro; Berkman, Lisa F; Subramanian, S V

2011-03-01

Economic growth is widely perceived as a major policy instrument in reducing childhood undernutrition in India. We assessed the association between changes in state per capita income and the risk of undernutrition among children in India. Data for this analysis came from three cross-sectional waves of the National Family Health Survey (NFHS) conducted in 1992-93, 1998-99, and 2005-06 in India. The sample sizes in the three waves were 33,816, 30,383, and 28,876 children, respectively. After excluding observations missing on the child anthropometric measures and the independent variables included in the study, the analytic sample size was 28,066, 26,121, and 23,139, respectively, with a pooled sample size of 77,326 children. The proportion of missing data was 12%-20%. The outcomes were underweight, stunting, and wasting, defined as more than two standard deviations below the World Health Organization-determined median scores by age and gender. We also examined severe underweight, severe stunting, and severe wasting. The main exposure of interest was per capita income at the state level at each survey period measured as per capita net state domestic product measured in 2008 prices. We estimated fixed and random effects logistic models that accounted for the clustering of the data. In models that did not account for survey-period effects, there appeared to be an inverse association between state economic growth and risk of undernutrition among children. However, in models accounting for data structure related to repeated cross-sectional design through survey period effects, state economic growth was not associated with the risk of underweight (OR 1.01, 95% CI 0.98, 1.04), stunting (OR 1.02, 95% CI 0.99, 1.05), and wasting (OR 0.99, 95% CI 0.96, 1.02). Adjustment for demographic and socioeconomic covariates did not alter these estimates. Similar patterns were observed for severe undernutrition outcomes. We failed to find consistent evidence that economic growth leads to reduction in childhood undernutrition in India. Direct investments in appropriate health interventions may be necessary to reduce childhood undernutrition in India. Please see later in the article for the Editors' Summary.

Factors Associated with Stunting among Children Aged 0 to 59 Months from the Central Region of Mozambique.

PubMed

Cruz, Loida M García; Azpeitia, Gloria González; Súarez, Desiderio Reyes; Rodríguez, Alfredo Santana; Ferrer, Juan Francisco Loro; Serra-Majem, Lluis

2017-05-12

The objective of this study was to identify the major socio-demographic, health, and environmental determinants of stunting among children aged 0-59 months from the Tete province (Mozambique) and offering useful information for future healthcare strategies and interventions. A case-control study was conducted among 282 (162 boys; 120 girls) children under five years of age from the central region of Mozambique between 1 May and 3 June 2014. Children with stunting (HAZ < -2 SD according to the WHO Child Growth Standards in 2006) were considered as cases and those who had a Z -score < -2 SD were considered as controls. We collected data related to mothers and children and their environment, and they were assessed in two groups to find a possible association. The software used for data analysis was the SPSS ® (version, 21.0) using descriptive statistics, t -test, ANOVA, chi-square analyses, bivariate comparisons, and stepwise multiple logistic regression analysis. The results showed that birth weight, mother's educational status, maternal occupation, living in a rural area, family size, number of children under five years of age in the household, cooking with charcoal, inhabiting wooden or straw housing or housing without proper floors, overall duration of breastfeeding as well as duration of exclusive breastfeeding, and time of initiation of complementary feeding were significantly related to stunting. Thus, appropriate nutritional intervention programmes considering these determinants and the dissemination of knowledge at the population level related to undernutrition are necessary to ameliorate the children´s nutritional status.

Factors Associated with Stunting among Children Aged 0 to 59 Months from the Central Region of Mozambique

PubMed Central

García Cruz, Loida María; González Azpeitia, Gloria; Reyes Súarez, Desiderio; Santana Rodríguez, Alfredo; Loro Ferrer, Juan Francisco; Serra-Majem, Lluis

2017-01-01

The objective of this study was to identify the major socio-demographic, health, and environmental determinants of stunting among children aged 0–59 months from the Tete province (Mozambique) and offering useful information for future healthcare strategies and interventions. A case-control study was conducted among 282 (162 boys; 120 girls) children under five years of age from the central region of Mozambique between 1 May and 3 June 2014. Children with stunting (HAZ < −2 SD according to the WHO Child Growth Standards in 2006) were considered as cases and those who had a Z-score < −2 SD were considered as controls. We collected data related to mothers and children and their environment, and they were assessed in two groups to find a possible association. The software used for data analysis was the SPSS® (version, 21.0) using descriptive statistics, t-test, ANOVA, chi-square analyses, bivariate comparisons, and stepwise multiple logistic regression analysis. The results showed that birth weight, mother’s educational status, maternal occupation, living in a rural area, family size, number of children under five years of age in the household, cooking with charcoal, inhabiting wooden or straw housing or housing without proper floors, overall duration of breastfeeding as well as duration of exclusive breastfeeding, and time of initiation of complementary feeding were significantly related to stunting. Thus, appropriate nutritional intervention programmes considering these determinants and the dissemination of knowledge at the population level related to undernutrition are necessary to ameliorate the children´s nutritional status. PMID:28498315

Anthropometric Characterization of Impaired Fetal Growth: Risk Factors for and Prognosis of Newborns With Stunting or Wasting.

PubMed

Victora, Cesar G; Villar, José; Barros, Fernando C; Ismail, Leila Cheikh; Chumlea, Cameron; Papageorghiou, Aris T; Bertino, Enrico; Ohuma, Eric O; Lambert, Ann; Carvalho, Maria; Jaffer, Yasmin A; Altman, Douglas G; Noble, Julia A; Gravett, Michael G; Purwar, Manorama; Frederick, Ihunnaya O; Pang, Ruyan; Bhutta, Zulfiqar A; Kennedy, Stephen H

2015-07-01

Stunting (short length for age) and wasting (low body mass index [BMI] for age) are widely used to assess child nutrition. In contrast, newborns tend to be assessed solely based on their weight. To use recent international standards for newborn size by gestational age to assess how stunted and wasted newborns differ in terms of risk factors and prognoses. A cross-sectional study with follow-up until hospital discharge was conducted at urban sites in Brazil, China, India, Italy, Kenya, Oman, England, and the United States that are participating in the INTERGROWTH-21st Project. The study was conducted from April 27, 2009, to March 2, 2014, and the final dataset for analyses was locked on March 19, 2014. Sociodemographic and behavioral maternal risk factors, previous pregnancy history, and maternal and fetal conditions during pregnancy were investigated as risk factors for stunting and wasting. Anthropometry at birth was used to predict for neonatal prognosis. Newborn stunting and wasting were defined as birth length and BMI for gestational age below the third centiles of the INTERGROWTH-21st standards. Prognosis was assessed through mortality before hospital discharge, admission to neonatal intensive care units, and newborn complications. From the 60 206 singleton live births during the study period, we selected all newborns between 33 weeks' and 42 weeks 6 days' gestation at birth (51 200 [85%]) with reliable ultrasound dating. Stunting affected 3.8% and wasting 3.4% of all newborns; both conditions were present in 0.7% of the sample. Of the 26 conditions studied, five were more strongly associated with stunting than with wasting (reported as odds ratios [OR]; 95% CI): short maternal height (6.7; 5.1-9.0), younger maternal age (0.7; 0.5-0.9), smoking (2.8; 2.3-3.3), illicit drug use (2.3; 1.5-3.6), and clinically suspected intrauterine growth restriction (5.2; 4.5-6.0). Wasting was more strongly related than stunting with 4 newborn outcomes (neonatal intensive care stay, 6.7 [5.5-8.1]; respiratory distress syndrome, 4.0 [3.3-4.9]; transient tachypnea, 2.1 [1.5-2.9]; and no oral feeding for >24 hours, 5.0 [3.9-6.5]). Maternal gestational diabetes mellitus was protective against wasting (0.6; 0.5-0.8) but not against stunting (0.9; 0.7-1.1). Although newborn stunting and wasting share some common determinants, they are distinct phenotypes with their own risk factors and neonatal prognoses. To be consistent with the literature on infant and child nutrition, newborns should be classified using the 2 phenotypes of stunting and wasting. The distinction will help to prioritize preventive interventions and focus the management of fetal undernutrition.

Childhood overweight and obesity among Kenyan pre-school children: association with maternal and early child nutritional factors.

PubMed

Gewa, Constance A

2010-04-01

To report on the prevalence of overweight and obesity among pre-school children in Kenya and examine the associations between childhood overweight and selected maternal and child-related factors. Demographic Health Survey data, multistage stratified cluster sampling methodology. Rural and urban areas of Kenya. A total of 1495 children between the ages of 3 and 5 years in Kenya. Over 30 % of the children were stunted, approximately 16 % were underweight, 4 % were wasted, approximately 18 % were overweight and 4 % were obese; 8 % were both overweight/obese and stunted. Maternal overweight and obesity, higher levels of maternal education, being a large or very large child at birth, and being stunted were each associated with higher odds of overweight and obesity among Kenyan children. Older children and large household size were each associated with lower odds of overweight and obesity among Kenyan children. The analysis demonstrates the presence of under- and overnutrition among Kenyan pre-school children and the importance of focusing on expanding efforts to prevent and treat malnutrition within this population. It also identifies some of the modifiable factors that can be targeted in these efforts.

Risk factors for wasting and stunting among children in Metro Cebu, Philippines.

PubMed

Ricci, J A; Becker, S

1996-06-01

Risk factors for wasting and stunting were examined in a longitudinal study of 18 544 children younger than 30 mo in Metro Cebu, Philippines. Measures of household demographic and socioeconomic characteristics, maternal characteristics and behavior, and child biological variables were analyzed cross-sectionally in six child age-residence strata by using logistic regression. Our results support biological and epidemiologic evidence that wasting and stunting represent different processes of malnutrition. They also indicate that the principal risk factors for stunting and wasting in infants < 6 mo of age were either maternal behaviors or child biological characteristics under maternal control, eg, breast-feeding status and birth weight. After 6 mo of age, household socioeconomic characteristics emerged with behavioral and biological variables as important determinants of malnutrition, eg, father's education and presence of a television and/or radio. Household socioeconomic status influenced the risk of stunting earlier in rural than in urban barangays. Implications of the results for interventions are discussed.

Frequency and determinants of malnutrition in children aged between 6 to 59 months in district Tharparkar, a rural area of Sindh.

PubMed

Ahsan, Shahid; Mansoori, Naveed; Mohiuddin, Syed Maqsood; Mubeen, Syed Muhammad; Saleem, Rubab; Irfanullah, Muhammad

2017-09-01

To assess the nutritional status of children living in Tharparkar. This cross-sectional study was conducted in four villages of Tharparkar district of Sindh, Pakistan, in 2014, and comprised children aged between 6 and 59 months. Data was collected from mothers and anthropometry of children was done using standard techniques. Nutritional status was assessed by using age- and sex-specific World Health Organisation standard charts for underweight, stunting and wasting. Data was analysed using SPSS 16. Of the 304 children assessed, 117(38.5%) were stunted, 58(19.1 %) were wasted and 101(33.2 %) were underweight with no gender discrimination. Under-nutrition was particularly observed in the second year of life. Statistically significant factors associated with stunting were illiteracy of mother, family size of >5 members, pregnancy>4 times, child mortality in last 6 months, absence of breastfeeding and no history of child vaccination(p<0.05 each). Logistic regression revealed family size of <5 members, pregnancy ?4 times, breastfeeding and vaccination were protective factors for stunting (p<0.05 each). Mortality of a child in the last 6 months in the family was 3 times more likely to have a stunted child. Stunting was the most common type of under-nutrition with no sex discrimination.

Are stunted young Indonesian children more likely to be overweight, thin, or have high blood pressure in adolescence?

PubMed

Rachmi, Cut Novianti; Agho, Kingsley Emwinyore; Li, Mu; Baur, Louise Alison

2017-01-01

To determine whether stunted young children are at greater risk of (1) overweight/obesity or thinness, and (2) high blood pressure (HBP) in adolescence. A secondary data analysis using the Indonesian Family Life Survey waves 1 (1993) to 4 (2007). We generated a 14-year follow-up cohort (1993-2007) and two 7-year cohorts (1993-2000 and 2000-2007) of children aged 2.0-4.9 years. Stunting (HAZ < -2), thinness (BMIZ < -2), and overweight/obesity (BMIZ > +1) were determined based upon the WHO Child Growth Standards. HBP (>90th percentile) was interpreted using the 4th Report on the Diagnosis of HBP in Children and Adolescents. 765, 1083, and 1589 children were included in the 14-year cohort, and the two 7-year cohort analyses, respectively. In the 7-year cohorts, early life stunting was inversely associated with overweight/obesity (prevalence ratio 0.32 and 0.38, respectively; P < 0.05), but no significant association was found with the 14-year cohort. There was no significant association between childhood stunting and thinness at adolescence or in the odds/likelihood of having high systolic or diastolic blood pressure. We found no association between early life stunting and overweight/obesity, thinness and HBP in adolescence.

The co-occurrence of anaemia and stunting in young children.

PubMed

Gosdin, Lucas; Martorell, Reynaldo; Bartolini, Rosario M; Mehta, Rukshan; Srikantiah, Sridhar; Young, Melissa F

2018-02-22

Anaemia and stunting are prevalent nutritional problems among children of low-income countries that have profound effects on development, morbidity, and mortality. Many use a single conceptual framework to identify the basic determinants of these and other forms of malnutrition. One would expect that problems with matching underlying determinants should co-occur in affected individuals to a greater degree than by chance. In 2 populations of children-ages 6-18 months in Bihar, India, (n = 5,664) and 6-36 months in Lambayeque, Peru (n = 688)-we measured the frequency of the co-occurrence of anaemia and stunting. We compared this value with the value expected by chance, the product of the prevalence of anaemia and stunting, using a chi-square test. We also built logistic regression models for each condition. The frequency of co-occurrence in the Indian population was 21.5%, and in the Peruvian population, it was 30.4%, which are similar to frequencies expected by chance, 21.3% (p = .97) and 31.5% (p = .85). In Peru, anaemia was associated with age and consumption of treated water. Stunting was associated with age, sex, dietary diversity, hand washing, language spoken, and wealth. In India, anaemia was associated with age, sex, caste, dietary diversity, and household hunger. Stunting was associated with age, sex, caste, wealth, and maternal illiteracy. Despite some basic shared factors, anaemia and stunting are more independent than commonly assumed. Interventions that target children based on 1 condition may miss children with the other form of malnutrition. © 2018 John Wiley & Sons Ltd.

Effect of number of rooms and sibs on nutritional status among rural Bengalee preschool children from eastern India.

PubMed

Biswas, Sadaruddin; Bose, Kaushik

2011-12-01

In developing countries including rural India, undernutrition among preschool children is one of the main barriers of the national development. However, there exists scanty information on the prevalence of underweight and stunting and their socio-demographic predictors among preschool children in India and West Bengal. The aim of the present study was to investigate the prevalence of underweight and stunting and the impact of two socio-demographic indicators, namely number of living rooms (NLR) and number of sibs (NS), on them among 1-5 year old Bengalee rural preschool children of Integrated Child Development Services (ICDS) Centres. This cross sectional study was undertaken at 30 randomly selected ICDS centre of Chapra Block, Nadia District, West Bengal, India. A total of 673 children, aged 1-5 years were studied. The overall (age and sex combined) rates of underweight and stunting were 54.40% and 39.20%, respectively. NLR was significantly associated with the prevalence of underweight (chi2 = 4.34, df = 1, p < 0.05) and stunting (chi2 = 8.98, df = 1, p < 0.01) among girls. Similarly, NS had a significant association with prevalence of underweight (chi2 = 10.29, df = 1, p < 0.001) and stunting (chi2 = 5.42, df = 1, p < 0.05) among girls. Girls with < 2 NLR had significant higher risk of being underweight (OR = 1.64, C.I = 1.30-2.62) or stunted (OR=2.23, C.I = 1.31-3.80) than those with > or = 2 NLR. Moreover, girls with > or = 3 NS had significant higher rate of underweight (OR = 2.03, CI = 1.32-3.146) or stunting (OR = 1.69, C.I = 1.09-2.63) than those with < 3 sibs. Logistic regression analyses also revealed that both NLR as well as NS were strong predictors of underweight (NLR: Wald = 4.30, p < 0.05; NS: Wald = 8.74, p < 0.001) and stunting (NLR: Wald = 10.17, p < 0.001; NS: Wald = 5.38, p < 0.05) among girls. Gender discrimination could be a likely cause for this sex difference in the impact of NRL and NS. Moreover, logistic regression were also undertaken with underweight and stunting status (yes/ no) as dependent variables and NLR and NS (combined) as independent variables to identify their effects, when considered together, on undernutrition. Results showed that NS had significant impact on underweight (Wald = 8.28, p < 0.001) rather than NLR among girls. Results also demonstrated that NLR had significant impact on stunting (Wald = 6.874, p < 0.01) rather than NS.

An individual-level meta-analysis assessing the impact of community-level sanitation access on child stunting, anemia, and diarrhea: Evidence from DHS and MICS surveys.

PubMed

Larsen, David A; Grisham, Thomas; Slawsky, Erik; Narine, Lutchmie

2017-06-01

A lack of access to sanitation is an important risk factor child health, facilitating fecal-oral transmission of pathogens including soil-transmitted helminthes and various causes of diarrheal disease. We conducted a meta-analysis of cross-sectional surveys to determine the impact that community-level sanitation access has on child health for children with and without household sanitation access. Using 301 two-stage demographic health surveys and multiple indicator cluster surveys conducted between 1990 and 2015 we calculated the sanitation access in the community as the proportion of households in the sampled cluster that had household access to any type of sanitation facility. We then conducted exact matching of children based on various predictors of living in a community with high access to sanitation. Using logistic regression with the matched group as a random intercept we examined the association between the child health outcomes of stunted growth, any anemia, moderate or severe anemia, and diarrhea in the previous two weeks and the exposure of living in a community with varying degrees of community-level sanitation access. For children with household-level sanitation access, living in a community with 100% sanitation access was associated with lowered odds of stunting (adjusted odds ratio [AOR] = 0.97, 95%; confidence interval (CI) = 0.94-1.00; n = 14,153 matched groups, 1,175,167 children), any anemia (AOR = 0.73; 95% CI = 0.67-0.78; n = 5,319 matched groups, 299,033 children), moderate or severe anemia (AOR = 0.72, 95% CI = 0.68-0.77; n = 5,319 matched groups, 299,033 children) and diarrhea (AOR = 0.94; 95% CI = 0.91-0.97); n = 16,379 matched groups, 1,603,731 children) compared to living in a community with < 30% sanitation access. For children without household-level sanitation access, living in communities with 0% sanitation access was associated with higher odds of stunting (AOR = 1.04, 95% CI = 1.02-1.06; n = 14,153 matched groups, 1,175,167 children), any anemia (AOR = 1.05, 95% CI = 1.00-1.09; n = 5,319 matched groups, 299,033 children), moderate or severe anemia (AOR = 1.04, 95% CI = 1.00-1.09; n = 5,319 matched groups, 299,033 children) but not diarrhea (AOR = 1.00, 95% CI = 0.98-1.02; n = 16,379 matched groups, 1,603,731 children) compared to children without household-level sanitation access living in communities with 1-30% sanitation access. Community-level sanitation access is associated with improved child health outcomes independent of household-level sanitation access. The proportion of children living in communities with 100% sanitation access throughout the world is appallingly low. Ensuring sanitation access to all by 2030 will greatly improve child health.

Impaired plant growth and development caused by human immunodeficiency virus type 1 Tat.

PubMed

Cueno, Marni E; Hibi, Yurina; Imai, Kenichi; Laurena, Antonio C; Okamoto, Takashi

2010-10-01

Previous attempts to express the human immunodeficiency virus 1 (HIV-1) Tat (trans-activator of transcription) protein in plants resulted in a number of physiological abnormalities, such as stunted growth and absence of seed formation, that could not be explained. In the study reported here, we expressed Tat in tomato and observed phenotypic abnormalities, including stunted growth, absence of root formation, chlorosis, and plant death, as a result of reduced cytokinin levels. These reduced levels were ascribed to a differentially expressed CKO35 in Tat-bombarded tomato. Of the two CKO isoforms that are naturally expressed in tomato, CKO43 and CKO37, only the expression of CKO37 was affected by Tat. Our analysis of the Tat confirmed that the Arg-rich and RGD motifs of Tat have functional relevance in tomato and that independent mutations at these motifs caused inhibition of the differentially expressed CKO isoform and the extracellular secretion of the Tat protein, respectively, in our Tat-bombarded tomato samples.

Nutritional status of under-five children in Bangladesh: a multilevel analysis.

PubMed

Alom, Jahangir; Quddus, Md Abdul; Islam, Mohammad Amirul

2012-09-01

The nutritional status of under-five children is a sensitive sign of a country's health status as well as economic condition. This study investigated the differential impact of some demographic, socioeconomic, environmental and health-related factors on the nutritional status among under-five children in Bangladesh using Bangladesh Demographic and Health Survey 2007 data. Two-level random intercept binary logistic regression models were used to identify the determinants of under-five malnutrition. The analyses revealed that 16% of the children were severely stunted and 25% were moderately stunted. Among the children under five years of age 3% were severely wasted and 14% were moderately wasted. Furthermore, 11% of the children were severely underweight and 28% were moderately underweight. The main contributing factors for under-five malnutrition were found to be child's age, mother's education, father's education, father's occupation, family wealth index, currently breast-feeding, place of delivery and division. Significant community-level variations were found in the analyses.

Effects of Pratylenchus vulnus and Xiphinema index singly and combined on vine growth of Vitis vinifera.

PubMed

Pinochet, J; Raski, D J; Goheen, A C

1976-10-01

Inoculation of 'Thompson Seedless' grapevines with 500 Xiphinerna index or 1,000 Pratylenchus vulnus alone or in combination suppressed vine shoot and root growth under greenhouse conditions. Pratytenchus vulnus caused greater stunting of roots than X. index. Each nematode species inhibited top growth about equally. Concomitant inoculations caused greater stunting of tops and roots than did inoculations of either nematode species alone. Differences in growth between inoculated and control plants increased with exposure time. Pratylenchus vulnus competed with and gradually superseded in numbers an established population of X. index. Both species reproduced on 'Thompson Seedless' roots, but P. vulnus increased to a much higher level than did X. index. The increase of P. vulnus, together with extensive damage, proves its pathogenicity to grapevines.

The consequences of linear growth stunting: influence on body composition among youth in the Bolivian Amazon.

PubMed

Tanner, Susan; Leonard, William R; Reyes-García, Victoria

2014-01-01

Stunting, or linear growth retardation, has been documented in up to half of all children in rural indigenous populations of South America. Stunting is well understood as a signal of adverse conditions during growth, and has been associated with developmentally induced modifications to body composition, including body fat and muscularity, that stem from early growth restriction. This article examines the relation between short stature and three anthropometric indicators of body composition during childhood and adolescence among a rural, indigenous population of forager-horticulturalists. Anthropometric data were collected annually from 483 Tsimane' youth, ages 2-10 years, in 13 communities in the Beni region of Bolivia for 6 consecutive years (2002-2007). Baseline height-for-age was used to indicate stunting (HAZ < -2.0) and compared with z-scores of body mass index (BMI), sum of two skinfolds, and arm muscle area. Multilevel regression models indicate baseline stunting is associated with lower BMI z-scores (B = -0.386; P < 0.001), body fatness (ZSkinfold, B = -0.164; P < 0.001), and arm muscularity (AMAZ, B = -0.580; P < 0.001) in youth across a period of 6 years. When split by sex, there was a stronger relation between baseline stunting and lower skinfold body fat scores among girls (B = -0.244; P < 0.001) than boys (B = -0.080; P = 0.087). In contrast, baseline stunting was associated with lower arm muscularity in both girls (B = -0.498; P < 0.001) and boys (B = -0.646; P < 0.001). The relation between linear growth restriction and indicators of body composition persist into adolescence, providing additional insight into the influence of adverse conditions during growth. Copyright © 2013 Wiley Periodicals, Inc.

The relationship between agricultural biodiversity, dietary diversity, household food security, and stunting of children in rural Kenya.

PubMed

M'Kaibi, Florence K; Steyn, Nelia P; Ochola, Sophie A; Du Plessis, Lissane

2017-03-01

The study was to determine the role of Dietary diversity (DD), household food security (HFS), and agricultural biodiversity (AB) on stunted growth in children. Two cross-sectional studies were undertaken 6 months apart. Interviews were done with mothers/caregivers and anthropometric measurements of children 24-59 months old. HFS was assessed by household food insecurity access scale (HFIAS). A repeated 24-h recall was used to calculate a dietary diversity score (DDS). Agricultural biodiversity (AB) was calculated by counting the number of edible plants and animals. The study was undertaken in resource-poor households in two rural areas in Kenya. Mothers/Care givers and household with children of 24-59 months of age were the main subjects. The prevalence of underweight [WAZ <-2SD] ranged between 16.7% and 21.6% and stunting [HAZ <-2SD] from 26.3% to 34.7%. Mean DDS ranged from 2.9 to 3.7 and HFIAS ranged from 9.3 to 16.2. AB was between 6.6 and 7.2 items. Households with and without children with stunted growth were significantly different in DDS ( P  = 0.047) after the rainy season and HFIAS ( P  = 0.009) in the dry season, but not with AB score ( P  = 0.486). The mean AB for households with children with stunted growth were lower at 6.8, compared to 7.0 for those with normal growth, however, the difference was insignificant. Data indicate that households with children with stunted growth and those without are significantly different in DDS and HFIAS but not with AB. This suggests some potential in using DDS and HFIAS as proxy measures for stunting.

Understanding Child Stunting in India: A Comprehensive Analysis of Socio-Economic, Nutritional and Environmental Determinants Using Additive Quantile Regression

PubMed Central

Fenske, Nora; Burns, Jacob; Hothorn, Torsten; Rehfuess, Eva A.

2013-01-01

Background Most attempts to address undernutrition, responsible for one third of global child deaths, have fallen behind expectations. This suggests that the assumptions underlying current modelling and intervention practices should be revisited. Objective We undertook a comprehensive analysis of the determinants of child stunting in India, and explored whether the established focus on linear effects of single risks is appropriate. Design Using cross-sectional data for children aged 0–24 months from the Indian National Family Health Survey for 2005/2006, we populated an evidence-based diagram of immediate, intermediate and underlying determinants of stunting. We modelled linear, non-linear, spatial and age-varying effects of these determinants using additive quantile regression for four quantiles of the Z-score of standardized height-for-age and logistic regression for stunting and severe stunting. Results At least one variable within each of eleven groups of determinants was significantly associated with height-for-age in the 35% Z-score quantile regression. The non-modifiable risk factors child age and sex, and the protective factors household wealth, maternal education and BMI showed the largest effects. Being a twin or multiple birth was associated with dramatically decreased height-for-age. Maternal age, maternal BMI, birth order and number of antenatal visits influenced child stunting in non-linear ways. Findings across the four quantile and two logistic regression models were largely comparable. Conclusions Our analysis confirms the multifactorial nature of child stunting. It emphasizes the need to pursue a systems-based approach and to consider non-linear effects, and suggests that differential effects across the height-for-age distribution do not play a major role. PMID:24223839

Food consumed does not account for the higher prevalence of obesity among stunted adults in a very-low-income population in the Northeast of Brazil (Maceió, Alagoas).

PubMed

Florêncio, T T; Ferreira, H S; Cavalcante, J C; Luciano, S M; Sawaya, A L

2003-11-01

To study the food pattern of stunted and nonstunted, obese and nonobese individuals in a very-low-income population. A household survey. Slum set up by the 'Homeless Movement', city of Maceió (Alagoas), Brazil. A total of 532 adults classified by sex, stature (Z -2s.d. of the NCHS curves), and body mass index (BMI) were compared using the following variables: waist circumference, waist-hip circumference ratio (W/H), percentage body fat (skinfold thickness and bioelectrical impedance), and food intake (24-h recall). The prevalence of stunting was 22.6%. In all, 30% of the stunted subjects were overweight or obese, compared with 23% for the nonstunted individuals (P<0.05). In women, logistic regression analysis showed a strong association among weight, abdominal fat, and stunting (r=0.81). No significant differences were observed in the values of W/H or in the qualitative menu of the different categories. Energy intake was below the RDA figures (about 63%). There was similarity among the groups regarding the proportion of macronutrients, except for the fact that stunted obese women ingested less fat and protein than nonstunted obese women. Stunted obese individuals consumed less energy (5962 kJ) than the population as a whole (6213 kJ), an amount far lower than their average needs, which were calculated on the basis of their shorter stature (8109 kJ). The observed energy consumption seems compatible with the panorama of undernutrition present in the population, but it does not explain the high prevalence of obesity detected.

Understanding child stunting in India: a comprehensive analysis of socio-economic, nutritional and environmental determinants using additive quantile regression.

PubMed

Fenske, Nora; Burns, Jacob; Hothorn, Torsten; Rehfuess, Eva A

2013-01-01

Most attempts to address undernutrition, responsible for one third of global child deaths, have fallen behind expectations. This suggests that the assumptions underlying current modelling and intervention practices should be revisited. We undertook a comprehensive analysis of the determinants of child stunting in India, and explored whether the established focus on linear effects of single risks is appropriate. Using cross-sectional data for children aged 0-24 months from the Indian National Family Health Survey for 2005/2006, we populated an evidence-based diagram of immediate, intermediate and underlying determinants of stunting. We modelled linear, non-linear, spatial and age-varying effects of these determinants using additive quantile regression for four quantiles of the Z-score of standardized height-for-age and logistic regression for stunting and severe stunting. At least one variable within each of eleven groups of determinants was significantly associated with height-for-age in the 35% Z-score quantile regression. The non-modifiable risk factors child age and sex, and the protective factors household wealth, maternal education and BMI showed the largest effects. Being a twin or multiple birth was associated with dramatically decreased height-for-age. Maternal age, maternal BMI, birth order and number of antenatal visits influenced child stunting in non-linear ways. Findings across the four quantile and two logistic regression models were largely comparable. Our analysis confirms the multifactorial nature of child stunting. It emphasizes the need to pursue a systems-based approach and to consider non-linear effects, and suggests that differential effects across the height-for-age distribution do not play a major role.

Socioeconomic status and chronic child malnutrition: Wealth and maternal education matter more in the Peruvian Andes than nationally.

PubMed

Urke, Helga B; Bull, Torill; Mittelmark, Maurice B

2011-10-01

This study investigated the association of parents' socioeconomic status (SES) with child stunting in the Peruvian Andes and in Peru nationally. It was hypothesized that the relationship of SES to child stunting would be weaker in the Andean compared with the national sample. This is consistent with earlier research indicating that the relationship of SES to health may be weak in poor regions. The data were from the Demographic and Health Survey 2004 to 2006. Two samples of children 3 to 60 months old were compared: a national sample (n = 1426) and an Andean sample (n = 543). Malnutrition was measured using the indicator "stunting," which is small stature for age. Socioeconomic status was measured using parental education, occupation, and household wealth index (WI). In both samples, SES was significantly related to stunting. The odds of stunting in the poorest WI quintile were significantly higher than in the richest quintile. The same pattern was observed in children of mothers having incomplete primary education compared with children of mothers having complete secondary or higher education. The odds of stunting were significantly lower in children of mothers working at home compared with mothers in professional occupations. The associations of WI and maternal education with stunting were significantly stronger in the Andean compared with the national sample; the study did not find support for the hypothesis. Even in very poor regions such as the Andes, SES may be associated with child health, suggesting the importance of public health measures to overcome the health disadvantages experienced by children living in low SES households. Copyright © 2011 Elsevier Inc. All rights reserved.

Evidence-based evolution of an integrated nutrition-focused agriculture approach to address the underlying determinants of stunting.

PubMed

Haselow, Nancy J; Stormer, Ame; Pries, Alissa

2016-05-01

Despite progress in reducing hunger and malnutrition since the 1990s, many still suffer from undernutrition and food insecurity, particularly women and young children, resulting in preterm birth, low birthweight and stunting, among other conditions. Helen Keller International (HKI) has addressed malnutrition and household food insecurity through implementation of an Enhanced Homestead Food Production (EHFP) programme that increases year-round availability and intake of diverse micronutrient-rich foods and promotes optimal nutrition and hygiene practices among poor households. This paper reviews the evolution and impact of HKI's EHFP programme and identifies core components of the model that address the underlying determinants of stunting. To date, evaluations of EHFP have shown impact on food production, consumption by women and children and household food security. Sale of surplus produce has increased household income, and the use of a transformative gender approach has empowered women. EHFP has also realized nutrition improvements in many project sites. Results from a randomized control trial (RCT) in Baitadi district, Nepal showed a significant improvement in a range of practices known to impact child growth, although no impact on stunting. Additional non-RCT evaluations in Kailali district of Nepal, demonstrated a 10.5% reduction in stunting and in the Chittagong Hill Tracts in Bangladesh, revealed an 18% decrease in stunting. Based on evidence, the EHFP has evolved into an integrated package that includes agriculture, nutrition, water/hygiene/sanitation, linkages to health care, women's empowerment, income generation and advocacy. Closing the stunting gap requires long-term exposure to targeted multi-sectoral solutions and rigorous evaluation to optimize impact. © 2016 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.

Consumption of animal source foods and dietary diversity reduce stunting in children in Cambodia

PubMed Central

2013-01-01

Background Malnutrition in children is a major public health concern. This study aimed to determine the association between dietary diversity and stunting, underweight, wasting, and diarrhea and that between consumption of each specific food group and these nutritional and health outcomes among children. Methods A nationally representative household survey of 6209 children aged 12 to 59 months was conducted in Cambodia. We examined the consumption of food in the 24 hours before the survey and stunting, underweight, wasting, and diarrhea that had occurred in the preceding 2 weeks. A food variety score (ranging from 0 to 9) was calculated to represent dietary diversity. Results Stunting was negatively associated with dietary diversity (adjusted odd ratios [ORadj] 0.95, 95% confident interval [CI] 0.91-0.99, P = 0.01) after adjusting for socioeconomic and geographical factors. Consumption of animal source foods was associated with reduced risk of stunting (ORadj 0.69, 95% CI 0.54-0.89, P < 0.01) and underweight (ORadj 0.74, 95% CI 0.57-0.96, P = 0.03). On the other hand, the higher risk of diarrhea was significantly associated with consumption of milk products (ORadj 1.46, 95% CI 1.10-1.92, P = 0.02) and it was significantly pronounced among children from the poorer households (ORadj 1.85, 95% CI 1.17-2.93, P < 0.01). Conclusions Consumption of a diverse diet was associated with a reduction in stunting. In addition to dietary diversity, animal source food was a protective factor of stunting and underweight. Consumption of milk products was associated with an increase in the risk of diarrhea, particularly among the poorer households. Both dietary diversity and specific food types are important considerations of dietary recommendation. PMID:23866682

High-risk driving attitudes and everyday driving violations of car and racing enthusiasts in Ontario, Canada.

PubMed

Yildirim-Yenier, Zümrüt; Vingilis, Evelyn; Wiesenthal, David L; Mann, Robert E; Seeley, Jane

2015-01-01

Attitudes and individual difference variables of car and racing enthusiasts regarding high-risk behaviors of street racing and stunt driving have recently been investigated. Positive attitudes toward high-risk driving, personality variables such as driver thrill seeking, and other self-reported risky driving acts were associated with these behaviors. However, probable relationships among high-risk driving tendencies, everyday driving behaviors, and negative road safety outcomes have remained largely unexamined. This study aimed to investigate the associations among car and racing enthusiasts' high-risk driving attitudes, self-reported everyday driving violations (i.e., ordinary and aggressive violations), and self-reported negative outcomes (i.e., collisions and driving offense citations). A web-based survey was conducted with members and visitors of car club and racing websites in Ontario, Canada. Data were obtained from 366 participants. The questionnaire included 4 attitude measures-(1) attitudes toward new penalties for Ontario's Street Racers, Stunt and Aggressive Drivers Legislation; (2) attitudes toward new offenses of stunt driving under the same legislation; (3) general attitudes toward street racing and stunt driving; (4) comparison of street racing with other risky driving behaviors-self-reported driving violations (i.e., ordinary and aggressive violations); self-reported collisions and offense citations; and background and driving questions (e.g., age, driving frequency). Results revealed that attitudes toward stunt driving offenses negatively and general attitudes toward street racing and stunt driving positively predicted ordinary violations, which, in turn, predicted offense citations. Moreover, general attitudes toward street racing and stunt driving positively predicted aggressive violations, which, in turn, predicted offense citations. The findings indicate that positive high-risk driving attitudes may be transferring to driving violations in everyday traffic, which mediates driving offense citations.

Economic inequality and child stunting in Bangladesh and Kenya: an investigation of six hypotheses.

PubMed

Reinbold, Gary W

2011-01-01

Consistent with the increasing focus on issues of equity in developing countries, I extend the literature analyzing the relationship between economic inequality and individual health to the developing world. Using survey data from Bangladesh and Kenya with economic status measured by a wealth index and with three different geographic definitions of community, I analyze six competing hypotheses for how economic inequality may be related to stunting among children younger than 5 years old. I find little support for the predominant hypothesis that economic inequality as measured by a Gini index is an important predictor of individual health. Instead, I find that the difference between a household's wealth and the mean household wealth in the community is the measure of economic inequality that is most closely related to stunting in these countries. In particular, a 1 standard deviation increase in household wealth relative to the community mean is associated with a 30–32 percent decrease in the odds of stunting in Bangladesh and a 16–21 percent decrease in the odds of stunting in Kenya.

Asymptomatic malaria, growth status, and anaemia among children in Lao People's Democratic Republic: a cross-sectional study.

PubMed

Akiyama, Takeshi; Pongvongsa, Tiengkham; Phrommala, Souraxay; Taniguchi, Tomoyo; Inamine, Yuba; Takeuchi, Rie; Watanabe, Tadashi; Nishimoto, Futoshi; Moji, Kazuhiko; Kano, Shigeyuki; Watanabe, Hisami; Kobayashi, Jun

2016-10-18

Asymptomatic malaria can be observed in both stable endemic areas and unstable transmission areas. However, although much attention has been given to acute malaria infections, relatively little attention has been paid to asymptomatic malaria. Nonetheless, because the asymptomatic host serves as a reservoir for the malaria parasite, asymptomatic malaria is now recognized as an important obstacle to malaria elimination. Asymptomatic malaria is also associated with anaemia, a global public health problem with serious consequences on human health as well as social and economic development. In Lao People's Democratic Republic (Lao PDR), malaria, anaemia, and malnutrition are serious public health concerns. However, few studies have focused on the relationship between these variables. Therefore, this study investigated the relationship between asymptomatic malaria, growth status, and the prevalence of anaemia among children aged 120 months old or younger in rural villages in Lao PDR. In December 2010 and March 2011, data were collected from five villages in Savannakhet province. Anthropometric measurements, blood samples, and malaria rapid diagnostic tests were conducted. The presence of malaria was confirmed with polymerase chain reaction assays for Plasmodium falciparum. Underweight status, stunting, and anaemia were defined according to World Health Organization standards. The mean age of participants (n = 319) was 88.3 months old (Standard Deviation: 20.6, ranged from 30-119 months old), and 20 participants (6.3 %) had an asymptomatic malaria infection, 92 (28.8 %) were anaemic, 123 (38.6 %) were underweight, and 137 (42.9 %) were stunted. Stunted children were more likely to be infected with asymptomatic malaria [odds ratio (OR) 3.34, 95 % confidence interval (CI) 1.25-8.93], and asymptomatic malaria was associated with anaemia [OR 5.17, 95 % CI 1.99-13.43]. These results suggest a significant association between asymptomatic malaria and anaemia in children. Furthermore, stunted children were more likely to have lower Hb levels and to be infected with asymptomatic malaria than children without stunting. However, further studies examining the impact of asymptomatic malaria infection on children's nutritional and development status are necessary.

The use of biocultural data in interpreting sex differences in body proportions among rural Amazonians.

PubMed

Vercellotti, Giuseppe; Piperata, Barbara A

2012-01-01

Variation in height and body proportions is relatively well-understood at the inter-population level, but less is known about intra-population variation. This study explores intra-population variation in body proportions among 172 (88 female; 84 male) adult rural Amazonians. We test the hypotheses that: (1) stunting is associated with changes in proportions and fatness; (2) the sexes express different proportions in response to similar environmental stress; and (3) female growth is negatively affected by the costs of reproduction. We examined height, sitting height, and total leg length in subsamples based on sex and nutritional status (stunted/nonstunted) in relation to biocultural factors including access to food and healthcare and female reproductive history parameters. Differences in proportions were examined using the Quick-Test (Tsutakawa and Hewett: Biometrics 33 (1977) 215-219); correlation analyses were used to detect associations between anthropometric data and body fatness, and female reproductive history parameters. We found significantly higher rates of stunting among females (X(2) = 5.31; P = 0.02; RR = 1.4). Stunted individuals exhibited relatively shorter legs than nonstunted individuals (P = 0.02), although this was not found in within-sex analyses. A significant negative correlation was found between leg length index and fatness (P < 0.01). Lastly, females exhibited relatively shorter legs than males (P = 0.0003) and, among females, height and leg length were significantly positively correlated with age-at-first-birth (P < 0.02) suggesting that adolescent pregnancy may negatively affect growth in this population. Our findings provide insights for the study of intra-population variation in body proportions and highlight the importance of biocultural data in interpreting the pattern of variation observed in living and past populations. Copyright © 2011 Wiley Periodicals, Inc.

What Explains Cambodia’s Success in Reducing Child Stunting-2000-2014?

PubMed Central

Zanello, Giacomo; Srinivasan, C. S.; Shankar, Bhavani

2016-01-01

In many developing countries, high levels of child undernutrition persist alongside rapid economic growth. There is considerable interest in the study of countries that have made rapid progress in child nutrition to uncover the driving forces behind these improvements. Cambodia is often cited as a success case having reduced the incidence of child stunting from 51% to 34% over the period 2000 to 2014. To what extent is this success driven by improvements in the underlying determinants of nutrition, such as wealth and education, (“covariate effects”) and to what extent by changes in the strengths of association between these determinants and nutrition outcomes (“coefficient effects”)? Using determinants derived from the widely-applied UNICEF framework for the analysis of child nutrition and data from four Demographic and Health Surveys datasets, we apply quantile regression based decomposition methods to quantify the covariate and coefficient effect contributions to this improvement in child nutrition. The method used in the study allows the covariate and coefficient effects to vary across the entire distribution of child nutrition outcomes. There are important differences in the drivers of improvements in child nutrition between severely stunted and moderately stunted children and between rural and urban areas. The translation of improvements in household endowments, characteristics and practices into improvements in child nutrition (the coefficient effects) may be influenced by macroeconomic shocks or other events such as natural calamities or civil disturbance and may vary substantially over different time periods. Our analysis also highlights the need to explicitly examine the contribution of targeted child health and nutrition interventions to improvements in child nutrition in developing countries. PMID:27649080

Determinants of undernutrition among children aged 6 to 59 months in rural Zambézia Province, Mozambique: Results of two population-based serial cross-sectional surveys

PubMed Central

Rose, Elizabeth S.; Blevins, Meridith; González-Calvo, Lazaro; Ndatimana, Elisée; Green, Ann F.; Lopez, Melanie; Olupona, Omo; Vermund, Sten H.; Moon, Troy D.

2016-01-01

Background While many countries are transitioning from epidemics of undernutrition to overnutrition, Mozambique’s very high 44% prevalence of stunting in children under age 5 years is cause for serious concern. Methods We conducted two population-based cross-sectional surveys of ~4000 female heads of households each in Zambézia Province, Mozambique from August–September 2010 (Baseline) and April–May 2014 (Endline) as part of the USAID funded Strengthening Communities through Integrated Programs (SCIP) grant. Anthropometric measurements were collected on 560 children aged 6–59 months at Baseline and 912 children at Endline and classified as: “stunted,” a height-for-age z-score less than -2; “wasted,” weight-for-height z-score less than -2; and “underweight,” weight-for-age z-score less than -2. Descriptive statistics and logistic regression using Stata 13.1 were used to examine factors associated with undernutrition. Results Of children under age five years, 43% were undernourished in 2010 and 55% in 2014. The most common form of undernutrition was stunting (39% in 2010, 51% in 2014), followed by underweight (13% in both 2010 and 2014), and wasting (7% in 2010, 5% in 2014). Child’s age was found to have a non-linear association with stunting. Vitamin A supplementation was associated with a 31% (p=0.04) decreased odds of stunting. Children who were exclusively breastfed for at least six months had an 80% (p=0.02) lower odds of wasting in 2014 and 57% (p=0.05) decreased odds of being underweight in 2014. Introducing other foods after age six months was associated with a five-fold increased odds of wasting in 2014 (p=0.02); household food insecurity was associated with wasting (OR=2.08; p=0.03) and underweight in 2010 (OR=2.31; p=0.05). Children whose mother washed her hands with a cleaning agent had a 40% (p=0.05) decreased odds of being underweight. Surprisingly, per point increase in household dietary diversity score, children had 12% greater odds of being stunted in 2010 (p=0.01) but 9% decreased odds of being underweight in 2014 (p=0.02). Conclusions A combination of household and individual level factors was associated with undernutrition. As such, employment of multidimensional interventions should be considered to decrease undernutrition in children under five years old. PMID:27182448

Global genomics and proteomics approaches to identify host factors as targets to induce resistance against Tomato bushy stunt virus.

PubMed

Nagy, Peter D; Pogany, Judit

2010-01-01

The success of RNA viruses as pathogens of plants, animals, and humans depends on their ability to reprogram the host cell metabolism to support the viral infection cycle and to suppress host defense mechanisms. Plus-strand (+)RNA viruses have limited coding potential necessitating that they co-opt an unknown number of host factors to facilitate their replication in host cells. Global genomics and proteomics approaches performed with Tomato bushy stunt virus (TBSV) and yeast (Saccharomyces cerevisiae) as a model host have led to the identification of 250 host factors affecting TBSV RNA replication and recombination or bound to the viral replicase, replication proteins, or the viral RNA. The roles of a dozen host factors involved in various steps of the replication process have been validated in yeast as well as a plant host. Altogether, the large number of host factors identified and the great variety of cellular functions performed by these factors indicate the existence of a truly complex interaction between TBSV and the host cell. This review summarizes the advantages of using a simple plant virus and yeast as a model host to advance our understanding of virus-host interactions at the molecular and cellular levels. The knowledge of host factors gained can potentially be used to inhibit virus replication via gene silencing, expression of dominant negative mutants, or design of specific chemical inhibitors leading to novel specific or broad-range resistance and antiviral tools against (+)RNA plant viruses. Copyright © 2010 Elsevier Inc. All rights reserved.

Patterns and Determinants of Double-Burden of Malnutrition among Rural Children: Evidence from China.

PubMed

Zhang, Nan; Bécares, Laia; Chandola, Tarani

2016-01-01

Chinese children are facing dual burden of malnutrition-coexistence of under-and over-nutrition. Little systematic evidence exists for explaining the simultaneous presence of under-and over-nutrition. This study aims to explore underlying mechanisms of under-and over-nutrition among children in rural China. This study used a nationwide longitudinal dataset of children (N = 5,017) from 9 provinces across China, with four exclusively categories of nutritional outcomes including under-nutrition (stunting and underweight), over-nutrition (overweight only including obesity), paradox (stunted overweight), with normal nutrition as reference. Multinomial logit models (Level-1: occasions; Level-2: children; Level-3: villages) were fitted which corrected for non-independence of observations due to geographic clustering and repeated observations of individuals. A mixture of risk factors at the individual, household and neighbourhood levels predicted under-and over-nutrition among children in rural China. Improved socioeconomic status and living in more urbanised villages reduced the risk of stunted overweight among rural children in China. Young girls appeared to have higher risk of under-nutrition, and the risk decreased with age more markedly than for boys up to age 5. From age 5 onwards, boys tended to have higher risk of under-nutrition than girls. Girls aged around 12 and older were less likely to suffer from under-nutrition, while boys' higher risk of under-nutrition persisted throughout adolescence. Children were less likely to suffer from over-nutrition compared to normal nutrition. Boys tended to have an even lower risk of over-nutrition than girls and the gender difference widened with age until adolescence. Our results have important policy implications that improving household economic status, in particular, maternal education and health insurance for children, and living environment are important to enhance rural children's nutritional status in China. Investments in early years of childhood can be effective to reduce gender inequality in nutritional health in rural China.

Effects of individual, household and community characteristics on child nutritional status in the slums of urban Bangladesh.

PubMed

Ahsan, Karar Zunaid; Arifeen, Shams El; Al-Mamun, Md Abdullah; Khan, Shusmita H; Chakraborty, Nitai

2017-01-01

Bangladesh urban population is expected to overtake rural population by 2040, and a significant part of the increase will be in slums. Wide disparities between urban slums and the rest of the country can potentially push country indicators off track unless the specific health and nutrition needs of the expanding slum communities are addressed. The study aims at describing the individual, household and community determinants of undernutrition status among children living in major urban strata, viz. City Corporation slums and non-slums, in order to understand the major drivers of childhood undernutrition in urban slum settings. Data are derived from Bangladesh Urban Health Survey conducted in 2013. This survey is a large-scale, nationally representative of urban areas, household survey designed specifically to provide health and nutrition status of women and children in urban Bangladesh. Data showed that 50% of under-5 children in slums are stunted and 43% are underweight, whereas for non-slums these rates are 33 and 26% respectively. In terms of severity, proportion of under-5 children living in slums severely underweight or stunted are nearly double than the children living in non-slums. Logistic analyses indicate that mother's education, child's age, and household's socio-economic status significantly affects stunting and underweight levels among children living in the urban slums. Logistic models also indicate that all individual-level characteristics, except exposure to mass media and mother's working outside home, significantly affect undernutrition levels among children living on non-slums. Among the household- and community-level characteristics, only household's socioeconomic status remains significant for the non-slums. Poor nutritional status is a major concern in slum areas, particularly as this group is expected to grow rapidly in the next few years. The situation calls for specially designed and well targeted interventions that take into account that many of the mothers are poorer and less educated, which affects their ability to provide care to their children.

Patterns and Determinants of Double-Burden of Malnutrition among Rural Children: Evidence from China

PubMed Central

Zhang, Nan; Bécares, Laia; Chandola, Tarani

2016-01-01

Chinese children are facing dual burden of malnutrition—coexistence of under-and over-nutrition. Little systematic evidence exists for explaining the simultaneous presence of under-and over-nutrition. This study aims to explore underlying mechanisms of under-and over-nutrition among children in rural China. This study used a nationwide longitudinal dataset of children (N = 5,017) from 9 provinces across China, with four exclusively categories of nutritional outcomes including under-nutrition (stunting and underweight), over-nutrition (overweight only including obesity), paradox (stunted overweight), with normal nutrition as reference. Multinomial logit models (Level-1: occasions; Level-2: children; Level-3: villages) were fitted which corrected for non-independence of observations due to geographic clustering and repeated observations of individuals. A mixture of risk factors at the individual, household and neighbourhood levels predicted under-and over-nutrition among children in rural China. Improved socioeconomic status and living in more urbanised villages reduced the risk of stunted overweight among rural children in China. Young girls appeared to have higher risk of under-nutrition, and the risk decreased with age more markedly than for boys up to age 5. From age 5 onwards, boys tended to have higher risk of under-nutrition than girls. Girls aged around 12 and older were less likely to suffer from under-nutrition, while boys’ higher risk of under-nutrition persisted throughout adolescence. Children were less likely to suffer from over-nutrition compared to normal nutrition. Boys tended to have an even lower risk of over-nutrition than girls and the gender difference widened with age until adolescence. Our results have important policy implications that improving household economic status, in particular, maternal education and health insurance for children, and living environment are important to enhance rural children’s nutritional status in China. Investments in early years of childhood can be effective to reduce gender inequality in nutritional health in rural China. PMID:27391448

Evidence of a Double Burden of Malnutrition in Urban Poor Settings in Nairobi, Kenya

PubMed Central

Kimani-Murage, Elizabeth W.; Muthuri, Stella K.; Oti, Samuel O.; Mutua, Martin K.; van de Vijver, Steven; Kyobutungi, Catherine

2015-01-01

Background Many low- and middle-income countries are undergoing a nutrition transition associated with rapid social and economic transitions. We explore the coexistence of over and under- nutrition at the neighborhood and household level, in an urban poor setting in Nairobi, Kenya. Methods Data were collected in 2010 on a cohort of children aged under five years born between 2006 and 2010. Anthropometric measurements of the children and their mothers were taken. Additionally, dietary intake, physical activity, and anthropometric measurements were collected from a stratified random sample of adults aged 18 years and older through a separate cross-sectional study conducted between 2008 and 2009 in the same setting. Proportions of stunting, underweight, wasting and overweight/obesity were dettermined in children, while proportions of underweight and overweight/obesity were determined in adults. Results Of the 3335 children included in the analyses with a total of 6750 visits, 46% (51% boys, 40% girls) were stunted, 11% (13% boys, 9% girls) were underweight, 2.5% (3% boys, 2% girls) were wasted, while 9% of boys and girls were overweight/obese respectively. Among their mothers, 7.5% were underweight while 32% were overweight/obese. A large proportion (43% and 37%%) of overweight and obese mothers respectively had stunted children. Among the 5190 adults included in the analyses, 9% (6% female, 11% male) were underweight, and 22% (35% female, 13% male) were overweight/obese. Conclusion The findings confirm an existing double burden of malnutrition in this setting, characterized by a high prevalence of undernutrition particularly stunting early in life, with high levels of overweight/obesity in adulthood, particularly among women. In the context of a rapid increase in urban population, particularly in urban poor settings, this calls for urgent action. Multisectoral action may work best given the complex nature of prevailing circumstances in urban poor settings. Further research is needed to understand the pathways to this coexistence, and to test feasibility and effectiveness of context-specific interventions to curb associated health risks. PMID:26098561

Growth faltering and recovery in children aged 1-8 years in four low- and middle-income countries: Young Lives.

PubMed

Lundeen, Elizabeth A; Behrman, Jere R; Crookston, Benjamin T; Dearden, Kirk A; Engle, Patrice; Georgiadis, Andreas; Penny, Mary E; Stein, Aryeh D

2014-09-01

We characterized post-infancy child growth patterns and determined the incidence of becoming stunted and of recovery from stunting. Data came from Young Lives, a longitudinal study of childhood poverty in four low- and middle-income countries. We analysed length/height measurements for children at ages 1, 5 and 8 years. Children (n 7171) in Ethiopia, India, Peru and Vietnam. Mean height-for-age Z-score (HAZ) at age 1 year ranged from -1·51 (Ethiopia) to -1·08 (Vietnam). From age 1 to 5 years, mean HAZ increased by 0·27 in Ethiopia (P < 0·001) and decreased among the other cohorts (range: -0·19 (Peru) to -0·32 (India); all P < 0·001). From 5 to 8 years, mean HAZ increased in all cohorts (range: 0·19 (India) to 0·38 (Peru); all P < 0·001). Prevalence of stunting (HAZ<-2·0) at 1 year ranged from 21 % (Vietnam) to 46 % (Ethiopia). From age 1 to 5 years, stunting prevalence decreased by 15·1 percentage points in Ethiopia (P < 0·001) and increased in the other cohorts (range: 3·0 percentage points (Vietnam) to 5·3 percentage points (India); all P ≤ 0·001). From 5 to 8 years, stunting prevalence decreased in all cohorts (range: 5·0 percentage points (Vietnam) to 12·7 percentage points (Peru); all P < 0·001). The incidence of becoming stunted between ages 1 to 5 years ranged from 11 % (Vietnam) to 22 % (India); between ages 5 to 8 years, it ranged from 3 % (Peru) to 6 % (India and Ethiopia). The incidence of recovery from stunting between ages 1 and 5 years ranged from 27 % (Vietnam) to 53 % (Ethiopia); between ages 5 and 8 years, it ranged from 30 % (India) to 47 % (Ethiopia). We found substantial recovery from early stunting among children in four low- and middle-income countries.

Differences in Body Build in Children of Different Ethnic Groups and their Impact on the Prevalence of Stunting, Thinness, Overweight, and Obesity.

PubMed

Poh, Bee Koon; Wong, Jyh Eiin; Norimah, A Karim; Deurenberg, Paul

2016-03-01

The prevalence of stunting, thinness, overweight, and obesity among children differs by ethnicity. It is not known whether differences in body build across the ethnic groups influence the interpretation of nutritional parameters. To explore the differences in body build across the 5 main ethnic groups in Malaysia and to determine whether differences in body build have an impact on the interpretation of nutrition indicators. A total of 3227 children aged 2.0 to 12.9 years who participated in the South East Asian Nutrition Surveys (SEANUTS) in Malaysia were included in this analysis. Body weight, height, sitting height, wrist and knee breadths, and biceps and subscapular skinfolds were measured, and relative leg length, slenderness index, and sum of skinfolds were calculated. Z scores for height-for-age (HAZ) and body mass index-for-age (BAZ) were calculated using the World Health Organization (WHO) 2007 growth standards. Differences in relative leg length and slenderness across the ethnic groups were correlated with HAZ and BAZ. Correction for differences in body build did, in some ethnic groups, have significant impact on the prevalence of stunting, thinness, overweight, and obesity, and the pattern of prevalence across ethnic groups changed. At the population level, corrections for body build had only minor and mostly nonsignificant effects on prevalence, but at an individual level, corrections for body build placed a substantial number of children in different height or weight categories. Whether these misclassifications warrant additional assessment of body build in clinical practice will need further investigation. © The Author(s) 2016.

Study of the Determinants of Chronic Malnutrition in Northern Nigeria: Quantitative Evidence from the Nigeria Demographic and Health Surveys International Food Policy Research Institute (IFPRI) Working Paper 45 (September 2017).

PubMed

Amare, Mulubrhan; Benson, Todd; Fadare, Olusegun; Oyeyemi, Motunrayo

2018-06-01

Close to half of all children younger than 5 years in the Northeast and Northwest geopolitical zones were estimated to be stunted in their growth for their age in 2013 compared to 22% of children in the rest of Nigeria. We examine the drivers of chronic child undernutrition in northern Nigeria and how those drivers differ from other areas of the country. Both a standard child-level regression-based approach and decomposition analysis were used to address the determinants of stunting and decompose how drivers differ between northern Nigeria and other areas of the country using 2008 and 2013 Nigeria DHS data. There are strong differences in the levels of the determinants of undernutrition in young children between the 2 parts of the country. However, equally important, the decomposition analysis shows that there are significant differences between northern Nigeria and other areas of Nigeria in the effect of the same determinant of nutritional status in accelerating or retarding the linear growth of young children. A national program to address child undernutrition must recognize this heterogeneity in its design. To impose across Nigeria, a single set of approaches to address the factors which results in stunted children is likely to fail for large numbers of children if these strong geographical differences in how these determinants operate to affect child nutritional status are not considered. Solutions need to be developed within northern Nigeria to more closely reflect the way the determinants of nutritional status operate in this area of the country.

An analysis of socio-demographic patterns in child malnutrition trends using Ghana demographic and health survey data in the period 1993-2008.

PubMed

Amugsi, Dickson A; Mittelmark, Maurice B; Lartey, Anna

2013-10-16

A small but growing body of research indicates that progress in reducing child malnutrition is substantially uneven from place to place, even down to the district level within countries. Yet child malnutrition prevalence and trend estimates available for public health planning are mostly available only at the level of global regions and/or at country level. To support carefully targeted intervention to reduce child malnutrition, public health planners and policy-makers require access to more refined prevalence data and trend analyses than are presently available. Responding to this need in Ghana, this report presents trends in child malnutrition prevalence in socio-demographic groups within the country's geographic regions. The study uses the Ghana Demographic and Health Surveys (GDHS) data. The GDHS are nationally representative cross-sectional surveys that have been carried out in many developing countries. These surveys constitute one of the richest sources of information currently available to examine time trends in child malnutrition. Data from four surveys were used for the analysis: 1993, 1998, 2003 and 2008. The results show statistically significant declining trends at the national level for stunting (F (1, 7204) = 7.89, p ≤ .005), underweight (F (1, 7441) = 44.87, p ≤ .001) and wasting (F (1, 7130) = 6.19, p ≤ .013). However, analyses of the sex-specific trends revealed that the declining trends in stunting and wasting were significant among males but not among females. In contrast to the national trend, there were significantly increasing trends in stunting for males (F (1, 2004) = 3.92, p ≤ .048) and females (F (1, 2004) = 4.34, p ≤ .037) whose mothers had higher than primary education, while the trends decreased significantly for males and females whose mothers had no education. At the national level in Ghana, child malnutrition is significantly declining. However, the aggregate national trend masks important deviations in certain socio-demographic segments, including worsening levels of malnutrition. This paper shows the importance of disaggregated analyses of national child malnutrition data, to unmask underlying geographic and socio-demographic differences.

The North Pacific Summer Jet and Climate Extremes Over North America: Mechanisms and Model Biases

NASA Astrophysics Data System (ADS)

Schubert, S. D.; Wang, H.; Chang, Y.; Koster, R. D.; Molod, A.

2017-12-01

The North Pacific summer jet (NPSJ) plays a critical role as a waveguide for weather systems and other sub-seasonal Rossby waves entering North America and therefore has a controlling influence on the warm season weather and climate extremes over much of the continent. In particular, much of the warm season precipitation that occurs over the central United States depends on subseasonal transients that are able to tap moisture from the Gulf of Mexico as they propagate across the continent. The GEOS-5 atmospheric general circulation model (AGCM), like many AGCMs, is deficient in the simulation of the NPSJ. It is shown that the deficiency is composed of: 1) a stunted jet in which the strongest winds are confined to the Asian continent, failing to extend across the North Pacific into the Gulf of Alaska as observed, and 2) a zonally symmetric poleward shift in the jet. These biases combine to impede the eastward propagation of the weather systems into the continent (the stunted jet), and deprive those systems that do enter the continent access to the moisture from the Gulf (the northward shift), leading to a dry bias over the central US. It is shown that the stunted jet bias is the result of too strong heating that occurs just south of the jet core over and near Tibet. Furthermore, it is shown that the poleward shift of the NPSJ can be corrected in the current GEOS-5 AGCM by increasing the vertical resolution. The implications of these results for improving warm season forecasts of extreme events will be discussed.

The North Pacific Summer Jet and Climate Extremes over North America: Mechanisms and Model Biases

NASA Technical Reports Server (NTRS)

Schubert, S.; Wang, H.; Chang, Y.; Koster, R.; Molod, A.; Barahona, D.

2017-01-01

The North Pacific summer jet (NPSJ) plays a critical role as a waveguide for weather systems and other sub-seasonal Rossby waves entering North America and therefore has a controlling influence on the warm season weather and climate extremes over much of the continent. In particular, much of the warm season precipitation that occurs over the central United States depends on subseasonal transients that are able to tap moisture from the Gulf of Mexico as they propagate across the continent. The GEOS-5 atmospheric general circulation model (AGCM), like many AGCMs, is deficient in the simulation of the NPSJ. It is shown that the deficiency is composed of: 1) a stunted jet in which the strongest winds are confined to the Asian continent, failing to extend across the North Pacific into the Gulf of Alaska as observed, and 2) a zonally symmetric poleward shift in the jet. These biases combine to impede the eastward propagation of the weather systems into the continent (the stunted jet), and deprive those systems that do enter the continent access to the moisture from the Gulf (the northward shift), leading to a dry bias over the central US. It is shown that the stunted jet bias is the result of too strong heating that occurs just south of the jet core over and near Tibet. Furthermore, it is shown that the poleward shift of the NPSJ can be corrected in the current GEOS-5 AGCM by increasing the vertical resolution. The implications of these results for improving warm season forecasts of extreme events will be discussed.

Inadequate dietary protein intake: When does it occur and what are the consequences?

USDA-ARS?s Scientific Manuscript database

Previous work with country-level data has shown associations between inadequate protein supply and stunting rates. Inadequate protein intake is known to be deleterious in animals. Low dietary protein intake in children is associated with growth faltering. According to World Health Organization (WHO)...

Trends and determinants of inequities in childhood stunting in Bangladesh from 1996/7 to 2014.

PubMed

Rabbani, Atonu; Khan, Akib; Yusuf, Sifat; Adams, Alayne

2016-11-16

We explore long-term trends and determinants of socioeconomic inequities in chronic childhood undernutrition measured by stunting among under-five children in Bangladesh. Given that one in three children remain stunted in Bangladesh, the socioeconomic mapping of stunting prevalence may be critical in designing public policies and interventions to eradicate childhood undernutrition. Six rounds of Bangladesh Demographic and Health Survey data are utilized, spanning the period 1996/97 to 2014. Using recognized measures of absolute and relative inequality (namely, absolute and relative difference, concentration curve and index), we quantify trends, and decompose changes in the concentration index to identify factors that best explain observed dynamics. Despite remarkable improvements in average nutritional status over the last two decades, socio-economic inequalities have persisted, and according to some measures, even worsened. For example, expressed as rate-ratios, the relative inequality in under-five stunting increased by 56% and the concentration index more than doubled between 1996/97 and 2014. Decomposition analyses find that wealth and maternal factors such as mothers' schooling and short stature are major contributors to observed socio-economic inequalities in child undernutrition and their changes over time. Reflecting on recent success around socioeconomic and gender equity in child mortality, and the weak legacy of nutrition policy in Bangladesh, we suggest that nutrition programming energies be focused specifically on the most disadvantaged and applied at scale to close socioeconomic gaps in stunting prevalence.

The dynamic relationship between cash transfers and child health: can the child support grant in South Africa make a difference to child nutrition?

PubMed

Zembe-Mkabile, Wanga; Ramokolo, Vundli; Sanders, David; Jackson, Debra; Doherty, Tanya

2016-02-01

Cash transfer programmes targeting children are considered an effective strategy for addressing child poverty and for improving child health outcomes in developing countries. In South Africa, the Child Support Grant (CSG) is the largest cash transfer programme targeting children from poor households. The present paper investigates the association of the duration of CSG receipt with child growth at 2 years in three diverse areas of South Africa. The study analysed data on CSG receipt and anthropometric measurements from children. Predictors of stunting were assessed using a backward regression model. Paarl (peri-urban), Rietvlei (rural) and Umlazi (urban township), South Africa, 2008. Children (n 746), median age 22 months. High rates of stunting were observed in Umlazi (28 %), Rietvlei (20 %) and Paarl (17 %). Duration of CSG receipt had no effect on stunting. HIV exposure (adjusted OR=2·30; 95 % CI 1·31, 4·03) and low birth weight (adjusted=OR 2·01, 95 % CI 1·02, 3·96) were associated with stunting, and maternal education had a protective effect on stunting. Our findings suggest that, despite the presence of the CSG, high rates of stunting among poor children continue unabated in South Africa. We argue that the effect of the CSG on nutritional status may have been eroded by food price inflation and limited progress in the provision of other important interventions and social services.

Gender discrimination in undernutrition with mediating factors among Bengalee school children from Eastern India.

PubMed

Mondal, Prakash Ranjan; Biswas, Sadaruddin; Bose, Kaushik

2012-04-01

This study was undertaken to determine age and sex variations in the prevalence of underweight and stunting, and to assess the impact of some socio-economic variables on undernutrition among 6-16 year old school children of Bengalee ethnicity in Chapra, West Bengal, India. The subjects were selected randomly from various schools and madrassas of the Chapra Block. A total of 725 children (342 boys and 383 girls) aged 6-16 years were measured and data on their socio-economic status were collected. Age and sex combined rates of underweight and stunting were 44.40% and 37.20%, respectively. Weight-for-age Z-score (WAZ) showed significant association with per-capita income (PCI) among boys (F=5.45) and girls (F=8.14). Height-for-age Z-score (HAZ) has also shown the association with per-capita income among boys (F=4.43) and girls (F=9.69). The WAZ was significantly associated with fathers' educational status (FOS) (t=-2.95) and the number of living rooms (NLR) (t=-2.91) among girls. The HAZ showed significant association with number of siblings (NS) among girls (F=4.25). Linear regression analyses revealed that NLR (t=2.04) and NS (t=1.95) had a significant impact on HAZ among boys. Among girls, PCI (t=3.38), FOS (t=2.87) and NLR (t=2.81) had a significant impact on WAZ and also PCI (t=3.28) and FOS (t=2.90) had a significant impact on HAZ. NLR had significant associations with underweight (χ(2)=3.59) and stunting (χ(2)=4.20) among boys. Among girls, PCI had significant associations with underweight (χ(2)=11.15) and stunting (χ(2)=11.64). FOS also showed significant associations with underweight (χ(2)=8.10) as well as stunting (χ(2)=8.28) among girls. NLR showed a significant association with underweight (χ(2)=7.75). Logistics regression analyses revealed that FOS (Wald=8.00) and NLR (Wald=4.09) were significant predictors of stunting among boys. Among girls, PCI was a significant predictor of underweight (Wald=10.95) as well as stunting (Wald=10.45). FOS, NLR and NS were also significant predictors of stunting (Wald=8.16), underweight (Wald=7.68) and stunting (Wald=6.97) respectively. The present study revealed that the nutritional status of the children was unsatisfactory and it is of paramount importance not only to increase the amount of food supplementation given but also to promote gender equality. Copyright © 2012 Elsevier GmbH. All rights reserved.

Multi-sectoral interventions for healthy growth.

PubMed

Casanovas, Ma del Carmen; Lutter, Chessa K; Mangasaryan, Nune; Mwadime, Robert; Hajeebhoy, Nemat; Aguilar, Ana Maria; Kopp, Ciro; Rico, Luis; Ibiett, Gonzalo; Andia, Doris; Onyango, Adelheid W

2013-09-01

The risk of stunted growth and development is affected by the context in which a child is born and grows. This includes such interdependent influences as the political economy, health and health care, education, society and culture, agriculture and food systems, water and sanitation, and the environment. Here, we briefly review how factors linked with the key sectors can contribute to healthy growth and reduced childhood stunting. Emphasis is placed on the role of agriculture/food security, especially family farming; education, particularly of girls and women; water, sanitation, and hygiene and their integration in stunting reduction strategies; social protection including cash transfers, bearing in mind that success in this regard is linked to reducing the gap between rich and poor; economic investment in stunting reduction including the work with the for-profit commercial sector balancing risks linked to marketing foods that can displace affordable and more sustainable alternatives; health with emphasis on implementing comprehensive and effective health care interventions and building the capacity of health care providers. We complete the review with examples of national and subnational multi-sectoral interventions that illustrate how critical it is for sectors to work together to reduce stunting. © 2013 John Wiley & Sons Ltd.

Using Circus Stunts in the Physical Education Program

ERIC Educational Resources Information Center

Burkel, John R.

1969-01-01

To eliminate boredom, a three week unit of circus stunts requiring little space and a minimum of equipment was presented to a senior boys' gym class at Miles Township High School West, Skokie, Illinois. (AP)

The effect of early childhood stunting on children’s cognitive achievements: Evidence from young lives Ethiopia

PubMed Central

Woldehanna, Tassew; Behrman, Jere R.; Araya, Mesele W.

2017-01-01

Background There is little empirical evidence on the effect of childhood malnutrition on children’s cognitive achievements in low income countries like Ethiopia. A longitudinal data is thus vital to understand the factors that influence cognitive development of children over time, particularly how early childhood stunting affects cognitive achievement of children up to the age of 8 years. Objective To examine the effect of early childhood stunting on cognitive achievements of children using longitudinal data that incorporate anthropometric measurements and results of cognitive achievement tests such as Peabody Picture Vocabulary Test and Cognitive Development Assessment quantitative tests. Method Defining stunted children as those having a standardized height for age z-score less than −2; we used a Propensity Score Matching (PSM) to examine the effect of early childhood stunting on measures of cognitive performance of children. The balance of the propensity score matching techniques was checked and found to be satisfied (P<0.01) Results Early childhood stunting is significantly negatively associated with cognitive performance of children. Controlled for confounding variables such as length of breastfeeding, relative size of the child at birth, health problems of early childhood such as acute respiratory illness and malaria, baseline household wealth, child gender, household size and parental education, estimates from PSM show that stunted children scored 16.1% less in the Peabody Picture Vocabulary Test and 48.8% less in the Quantitative Assessment test at the age of eight, both statistically significant at P<0.01. Conclusions It is important to realize the importance of early investment in terms of child health and nutrition until five years for the cognitive performance of children. As household wealth and parental education are particularly found to play an important role in children’s nutritional achievements, policy measures that are directed in improving household’s livelihood may have a spill-over impact in improving child nutritional status, and consequently cognitive development and schooling. PMID:29249889

Influence of maternal stature, pregnancy age, and infant birth weight on growth during childhood in Yucatan, Mexico: a test of the intergenerational effects hypothesis.

PubMed

Varela-Silva, Maria Inês; Azcorra, Hugo; Dickinson, Federico; Bogin, Barry; Frisancho, A R

2009-01-01

In developing nations, obesity has increased dramatically in the last decade, but a high prevalence of stunting still coexists. The intergenerational influences hypothesis (IIH) is one explanation for this. We test the IIH regarding variation in maternal stature, mother's age at pregnancy, and infant birth weight in relation to risk for overweight and stunting in 206 Maya children (4-6 years old) from Mérida, Yucatan, Mexico. The Maya children are compared with growth references (Frisancho 2008: Anthropometric Standards: An Interactive Nutritional Reference of Body Size and Body Composition for Children and Adults. Ann Arbor, MI: The University of Michigan Press. 335 pp) for height, weight, and body mass index (BMI). Almost 70% of the mothers are shorter than 150 cm. Mothers' height and child's birth weight predict overweight. Children with a mother shorter than 150 cm are less than half as likely (OR = 0.44) to be overweight compared to children whose mothers are equal to or taller than 150 cm. Children with birth weights below 3,000 g are only a third as likely to be overweight (OR = 0.28) than their peers within the range of normal birth weight (3,000-3,500 g). Sex of the child, mother's height, and birth weight predict stunting. Girls are only 40% as likely as boys to be stunted. Children with a mother below 150 cm are 3.6 times more likely of being stunted. Children with birth weights below 3000 g are over 3 times more likely to be stunted relative to children with birth weights within the normal range. Mother's age at pregnancy is not a predictor of overweight or stunting. Our findings conform the IIH and with similar studies of populations undergoing nutritional/epidemiological transitions from traditional to globalized lifestyles.

The importance of public health, poverty reduction programs and women's empowerment in the reduction of child stunting in rural areas of Moramanga and Morondava, Madagascar.

PubMed

Remonja, Chitale Rabaoarisoa; Rakotoarison, Rado; Rakotonirainy, Nivo Heritiana; Mangahasimbola, Reziky Tiandraza; Randrianarisoa, Alain Berthin; Jambou, Ronan; Vigan-Womas, Inès; Piola, Patrice; Randremanana, Rindra Vatosoa

2017-01-01

Malnutrition accounts for 45% of mortality in children under five years old, despite a global mobilization against chronic malnutrition. In Madagascar, the most recent data show that the prevalence of stunting in children under five years old is still around 47.4%. This study aimed to identify the determinants of stunting in children in rural areas of Moramanga and Morondava districts to target the main areas for intervention. A case-control study was conducted in children aged from 6 to 59.9 months, in 2014-2015. We measured the height and weight of mothers and children and collected data on child, mother and household characteristics. One stool specimen was collected from each child for intestinal parasite identification. We used a multivariate logistic regression model to identify the determinants of stunting using backwards stepwise methods. We included 894 and 932 children in Moramanga and in Morondava respectively. Stunting was highly prevalent in both areas, being 52.8% and 40.0% for Moramanga and Morondava, respectively. Stunting was most associated with a specific age period (12mo to 35mo) in the two study sites. Infection with Trichuris trichiura (aOR: 2.4, 95% CI: 1.1-5.3) and those belonging to poorer households (aOR: 2.3, 95% CI: 1.6-3.4) were the major risk factors in Moramanga. In Morondava, children whose mother had activities outside the household (aOR: 1.7, 95% CI: 1.2-2.5) and those perceived to be small at birth (aOR: 1.6, 95% CI: 1.1-2.1) were more likely to be stunted, whereas adequate birth spacing (≥24months) appeared protective (aOR: 0.4, 95% CI: 0.3-0.7). Interventions that could improve children's growth in these two areas include poverty reduction, women's empowerment, public health programmes focusing on WASH and increasing acceptability, and increased coverage and quality of child/maternal health services.

Household food (in)security and nutritional status of urban poor children aged 6 to 23 months in Kenya.

PubMed

Mutisya, Maurice; Kandala, Ngianga-Bakwin; Ngware, Moses Waithanji; Kabiru, Caroline W

2015-10-13

Millions of people in low and low middle income countries suffer from extreme hunger and malnutrition. Research on the effect of food insecurity on child nutrition is concentrated in high income settings and has produced mixed results. Moreover, the existing evidence on food security and nutrition in children in low and middle income countries is either cross-sectional and/or is based primarily on rural populations. In this paper, we examine the effect of household food security status and its interaction with household wealth status on stunting among children aged between 6 and 23 months in resource-poor urban setting in Kenya. We use longitudinal data collected between 2006 and 2012 from two informal settlements in Nairobi, Kenya. Mothers and their new-borns were recruited into the study at birth and followed prospectively. The analytical sample comprised 6858 children from 6552 households. Household food security was measured as a latent variable derived from a set of questions capturing the main domains of access, availability and affordability. A composite measure of wealth was calculated using asset ownership and amenities. Nutritional status was measured using Height-for-Age (HFA) z-scores. Children whose HFA z-scores were below -2 standard deviation were categorized as stunted. We used Cox regression to analyse the data. The prevalence of stunting was 49 %. The risk of stunting increased by 12 % among children from food insecure households. When the joint effect of food security and wealth status was assessed, the risk of stunting increased significantly by 19 and 22 % among children from moderately food insecure and severely food insecure households and ranked in the middle poor wealth status. Among the poorest and least poor households, food security was not statistically associated with stunting. Our results shed light on the joint effect of food security and wealth status on stunting. Study findings underscore the need for social protection policies to reduce the high rates of child malnutrition in the urban informal settlements.

Food insecurity and maternal–child nutritional status in Mexico: cross-sectional analysis of the National Health and Nutrition Survey 2012

PubMed Central

Shamah-Levy, Teresa; Mundo-Rosas, Verónica; Morales-Ruan, Carmen; Cuevas-Nasu, Lucia; Méndez-Gómez-Humarán, Ignacio; Pérez-Escamilla, Rafael

2017-01-01

Objective To examine the association between household food insecurity (HFI) and risk of childhood stunting and to determine whether this association is modified by maternal–child overweight/obesity. Design Observational cross-sectional study. Setting Data come from the Mexican National Health and Nutrition Survey (ENSANUT 2012 by its initials in Spanish), representative of rural and urban areas. Participants Our study sample included 5087 mother–preschool child pairs and 7181 mother–schoolchild pairs. Main outcome measures Differences in the prevalence (95% CI) of each HFI category by socioeconomic characteristics and maternal–child nutritional status were estimated. A logistic regression model was conducted for stunting and overweight among preschool children and for stunting and overweight/obesity among schoolchildren, adjusting for pertinent covariates. HFI was measured according to the Latin American and Caribbean Food Security Scale (ELCSA by its initials in Spanish). Weight and recumbent lenght or height measures were obtained from children. Overweight and obesity in women were determined according to the WHO Growth Reference Charts. The following covariates were included: sex of the child. urbanicity (urban/rural), region of residence and maternal education. Benefiting from food assistance programmes and socioeconomic status index were also included. Results were expressed as adjusted ORs. Results Stunting proved more prevalent in preschool children with moderate or severe HFI (16.2% and 16.8%, respectively) (p=0.036 and p=0.007, respectively) than in their counterparts with mild or no HFI (13.2% and 10.7%, respectively). Furthermore, the interaction between HFI and maternal obesity had a significant impact on stunting in preschool children (p<0.05). Severe HFI increased risk of stunting in children with non-obese mothers but not in those with obese mothers. Conclusion We have discovered a new relationship between HFI and maternal obesity on the one hand and risk of childhood stunting on the other hand. This may reflect a shared mechanism involving dual forms of malnutrition. PMID:28760785

Effects of Macroposthonia xenoplax on the growth of Concord grape.

PubMed

Santo, G S; Bolander, W J

1977-07-01

Concord grape (Vitis labrusca) plants were inoculated with Macroposthonia xenoplax at levels of 100, 1,000, and 10,000 nematodes. After 4 months, plants inoculated with 10,000 M. xenoplax were stunted, and root systems were darker and had fewer feeder roots than those in other treatments. The lower nematode inoculation levels suppressed top growth but did not affect root growth. M. xenoplax reproduced well on Concord grapes.

Maternal depression and early childhood growth in developing countries: systematic review and meta-analysis

PubMed Central

Kennedy, Caitlin E; Hurley, Kristen M; Black, Maureen M

2011-01-01

Abstract Objective To investigate the relationship between maternal depression and child growth in developing countries through a systematic literature review and meta-analysis. Methods Six databases were searched for studies from developing countries on maternal depression and child growth published up until 2010. Standard meta-analytical methods were followed and pooled odds ratios (ORs) for underweight and stunting in the children of depressed mothers were calculated using random effects models for all studies and for subsets of studies that met strict criteria on study design, exposure to maternal depression and outcome variables. The population attributable risk (PAR) was estimated for selected studies. Findings Seventeen studies including a total of 13 923 mother and child pairs from 11 countries met inclusion criteria. The children of mothers with depression or depressive symptoms were more likely to be underweight (OR: 1.5; 95% confidence interval, CI: 1.2–1.8) or stunted (OR: 1.4; 95% CI: 1.2–1.7). Subanalysis of three longitudinal studies showed a stronger effect: the OR for underweight was 2.2 (95% CI: 1.5–3.2) and for stunting, 2.0 (95% CI: 1.0–3.9). The PAR for selected studies indicated that if the infant population were entirely unexposed to maternal depressive symptoms 23% to 29% fewer children would be underweight or stunted. Conclusion Maternal depression was associated with early childhood underweight and stunting. Rigorous prospective studies are needed to identify mechanisms and causes. Early identification, treatment and prevention of maternal depression may help reduce child stunting and underweight in developing countries. PMID:21836759

Is Economic Growth Associated with Reduction in Child Undernutrition in India?

PubMed Central

Subramanyam, Malavika A.; Kawachi, Ichiro; Berkman, Lisa F.; Subramanian, S. V.

2011-01-01

Background Economic growth is widely perceived as a major policy instrument in reducing childhood undernutrition in India. We assessed the association between changes in state per capita income and the risk of undernutrition among children in India. Methods and Findings Data for this analysis came from three cross-sectional waves of the National Family Health Survey (NFHS) conducted in 1992–93, 1998–99, and 2005–06 in India. The sample sizes in the three waves were 33,816, 30,383, and 28,876 children, respectively. After excluding observations missing on the child anthropometric measures and the independent variables included in the study, the analytic sample size was 28,066, 26,121, and 23,139, respectively, with a pooled sample size of 77,326 children. The proportion of missing data was 12%–20%. The outcomes were underweight, stunting, and wasting, defined as more than two standard deviations below the World Health Organization–determined median scores by age and gender. We also examined severe underweight, severe stunting, and severe wasting. The main exposure of interest was per capita income at the state level at each survey period measured as per capita net state domestic product measured in 2008 prices. We estimated fixed and random effects logistic models that accounted for the clustering of the data. In models that did not account for survey-period effects, there appeared to be an inverse association between state economic growth and risk of undernutrition among children. However, in models accounting for data structure related to repeated cross-sectional design through survey period effects, state economic growth was not associated with the risk of underweight (OR 1.01, 95% CI 0.98, 1.04), stunting (OR 1.02, 95% CI 0.99, 1.05), and wasting (OR 0.99, 95% CI 0.96, 1.02). Adjustment for demographic and socioeconomic covariates did not alter these estimates. Similar patterns were observed for severe undernutrition outcomes. Conclusions We failed to find consistent evidence that economic growth leads to reduction in childhood undernutrition in India. Direct investments in appropriate health interventions may be necessary to reduce childhood undernutrition in India. Please see later in the article for the Editors' Summary PMID:21408084

Nutritional Status of Under-five Children Living in an Informal Urban Settlement in Nairobi, Kenya

PubMed Central

Burke, Heather; Cosmas, Leonard; Bamrah, Sapna; Dooling, Kathleen; Feikin, Daniel R.; Talley, Leisel E.; Breiman, Robert F.

2011-01-01

Malnutrition in sub-Saharan Africa contributes to high rates of childhood morbidity and mortality. However, little information on the nutritional status of children is available from informal settlements. During the period of post-election violence in Kenya during December 2007–March 2008, food shortages were widespread within informal settlements in Nairobi. To investigate whether food insecurity due to post-election violence resulted in high prevalence of acute and chronic malnutrition in children, a nutritional survey was undertaken among children aged 6-59 months within two villages in Kibera, where the Kenya Medical Research Institute/Centers for Disease Control and Prevention conducts population-based surveillance for infectious disease syndromes. During 25 March–4 April 2008, a structured questionnaire was administered to caregivers of 1,310 children identified through surveillance system databases to obtain information on household demographics, food availability, and child-feeding practices. Anthropometric measurements were recorded on all participating children. Indices were reported in z-scores and compared with the World Health Organization (WHO) 2005 reference population to determine the nutritional status of children. Data were analyzed using the Anthro software of WHO and the SAS. Stunting was found in 47.0% of the children; 11.8% were underweight, and 2.6% were wasted. Severe stunting was found in 23.4% of the children; severe underweight in 3.1%, and severe wasting in 0.6%. Children aged 36-47 months had the highest prevalence (58.0%) of stunting while the highest prevalence (4.1%) of wasting was in children aged 6-11 months. Boys were more stunted than girls (p<0.01), and older children were significantly (p<0.0001) stunted compared to younger children. In the third year of life, girls were more likely than boys to be wasted (p<0.01). The high prevalence of chronic malnutrition suggests that stunting is a sustained problem within this urban informal settlement, not specifically resulting from the relatively brief political crisis. The predominance of stunting in older children indicates failure in growth and development during the first two years of life. Food programmes in Kenya have traditionally focused on rural areas and refugee camps. The findings of the study suggest that tackling childhood stunting is a high priority, and there should be fostered efforts to ensure that malnutrition-prevention strategies include the urban poor. PMID:21957674

Nutritional status of under-five children living in an informal urban settlement in Nairobi, Kenya.

PubMed

Olack, Beatrice; Burke, Heather; Cosmas, Leonard; Bamrah, Sapna; Dooling, Kathleen; Feikin, Daniel R; Talley, Leisel E; Breiman, Robert F

2011-08-01

Malnutrition in sub-Saharan Africa contributes to high rates of childhood morbidity and mortality. However, little information on the nutritional status of children is available from informal settlements. During the period of post-election violence in Kenya during December 2007-March 2008, food shortages were widespread within informal settlements in Nairobi. To investigate whether food insecurity due to post-election violence resulted in high prevalence of acute and chronic malnutrition in children, a nutritional survey was undertaken among children aged 6-59 months within two villages in Kibera, where the Kenya Medical Research Institute/Centers for Disease Control and Prevention conducts population-based surveillance for infectious disease syndromes. During 25 March-4 April 2008, a structured questionnaire was administered to caregivers of 1,310 children identified through surveillance system databases to obtain information on household demographics, food availability, and child-feeding practices. Anthropometric measurements were recorded on all participating children. Indices were reported in z-scores and compared with the World Health Organization (WHO) 2005 reference population to determine the nutritional status of children. Data were analyzed using the Anthro software of WHO and the SAS. Stunting was found in 47.0% of the children; 11.8% were underweight, and 2.6% were wasted. Severe stunting was found in 23.4% of the children; severe underweight in 3.1%, and severe wasting in 0.6%. Children aged 36-47 months had the highest prevalence (58.0%) of stunting while the highest prevalence (4.1%) of wasting was in children aged 6-11 months. Boys were more stunted than girls (p < 0.01), and older children were significantly (p < 0.0001) stunted compared to younger children. In the third year of life, girls were more likely than boys to be wasted (p < 0.01). The high prevalence of chronic malnutrition suggests that stunting is a sustained problem within this urban informal settlement, not specifically resulting from the relatively brief political crisis. The predominance of stunting in older children indicates failure in growth and development during the first two years of life. Food programmes in Kenya have traditionally focused on rural areas and refugee camps. The findings of the study suggest that tackling childhood stunting is a high priority, and there should be fostered efforts to ensure that malnutrition-prevention strategies include the urban poor.

Malaria, helminths and malnutrition: a cross-sectional survey of school children in the South-Tongu district of Ghana.

PubMed

Ayeh-Kumi, Patrick Ferdinand; Addo-Osafo, Kantanka; Attah, Simon Kwaku; Tetteh-Quarcoo, Patience Borkor; Obeng-Nkrumah, Noah; Awuah-Mensah, Georgina; Abbey, Harriet Naa Afia; Forson, Akua; Cham, Momodou; Asare, Listowell; Duedu, Kwabena Obeng; Asmah, Richard Harry

2016-04-27

As part of malaria characterization study in the South-Tongu district of Ghana, the current study was conducted to explore relationships between malaria, schistosomiasis, soil transmitted helminths and malnutrition in riparian community settings that had hitherto encountered episodes of mass deworming exercises. School-age children were enrolled in a cross-sectional study from April through July 2012. Stool and urine samples were examined respectively for helminths and Schistosoma haematobium. Blood samples were analyzed for malaria parasites and haemoglobin (Hb) concentrations, respectively. Anthropometric indices were measured. Relationships were determined using generalized linear models. The results show low numbers of asymptomatic Plasmodium falciparum (9.2%, n = 37/404) and S. haematobium (2.5%, n = 10/404) infections. The associations between significance terms in the multivariate analysis for P. falciparum infections were further assessed to test the significance of the product terms directly i.e., age in years [adjusted odds ratio (AOR), 3.1; 95% confidence interval (CI) 1.1-5.6], Hb concentration (AOR = 0.71; 95% CI 0.42-2.3), and stunted malnutrition (AOR, 8.72; 95% CI 4.8-25.1). The P. falciparum-associated decrease in mean Hb concentration was 2.82 g/dl (95% CI 1.63-4.1 g/dl; P = 0.001) in stunted children, and 0.75 g/dl (95% CI 1.59-0.085 g/dl; P = 0.076) in the non-stunted cohort. The anaemia-associated decrease in mean parasitaemia in stunted children was 3500 parasites/µl of blood (95% CI 262.46-6737.54 parasites/µl of blood; P = 0.036), and in non-stunted children 2127 parasites/µl of blood (95% CI -0.27 to 4.53; P = 0.085). Stunted malnutrition was the strongest predictor of S. haematobium infection (AOR = 11; 95% CI 3.1-33.6) but significant associations as described for P. falciparum infections were absent. The population attributable risk of anaemia due to P. falciparum was 6.3% (95% CI 2.5-9.3), 0.9% (95% CI 0.4-2.3) for S. haematobium, and 12.5% (95% CI 9.11-19.52) for stunted malnutrition. Plasmodium falciparum, S. haematobium, intestinal helminths and their co-infections were uncommon in our school-age children. Stunting exacerbated the extent to which malaria was associated with loss in Hb concentration.

Modeling the Complexities of Water and Hygiene in Limpopo Province South Africa

NASA Astrophysics Data System (ADS)

Mellor, J. E.; Smith, J. A.; Learmonth, G.; Netshandama, V.; Dillingham, R.

2012-12-01

Access to sustainable water and sanitation services is one of the biggest challenges the developing world faces as an increasing number of people inhabit those areas. Inadequate access to water and sanitation infrastructure often leads children to drink poor quality water which can result in early childhood diarrhea (ECD). Repeated episodes of ECD can cause serious problems such as growth stunting, cognitive impairment, and even death. Although researchers have long studied the connection between poor access to water and hygiene facilities and ECD, most studies have relied on intervention-control methods to study the effects of singular interventions. Such studies are time-consuming, costly, and fail to acknowledge that the causes and prevention strategies for ECD are numerous and complex. An alternate approach is to think of a community as a complex system in which the engineered, natural and social environments interact in ways that are not easily predicted. Such complex systems have no central or coordinating mechanism and may exhibit emergent behavior which can be counterintuitive and lead to valuable insights. The goal of this research is to develop a robust, quantitative understanding of the complex pathogen transmission chain that leads to ECD. To realize this goal, we have developed an Agent-Based Model (ABM) which simulates individual community member behavior. We have validated this transdisciplinary model with four years of field data from a community in Limpopo Province, South Africa. Our model incorporates data such as household water source preferences, collection habits, household- and source-water quality, water-source reliability and biological regrowth. Our outcome measures are household water quality, ECD incidences, and child growth stunting. This technique allows us to test hypotheses on the computer. Future researchers can implement promising interventions with our partner institution, the University of Venda, and the model can be refined as the results of those interventions become available. Our model accurately reproduces current pathogen transport through the communities and child growth stunting. An intensive sensitivity analysis found that biological regrowth, biofilm layers and collection habits are all factors in pathogen transmission. We also report on the effects of multiple interventions and our exploration of emergent behavior. Our results indicate that the dominant source of fecal-oral transmission is through the contamination of drinking water after collection, but before consumption. Furthermore sub-optimal interventions such as improved, but still inconsistent water treatment have little protective effect against ECD. Finally, interventions such as the introduction of point-of-use water treatment technologies or improved water-storage practices are the best ECD prevention strategies. The complexities of the causes and prevention strategies of pathogen loading and ECD in the developing world are poorly understood. This project goes beyond previous studies through its ability to model the complex engineered/natural/social pathogen transmission chain using an ABM informed by field data. We hope that this and similar tools may be used by scientists, policy-makers and humanitarian organizations when designing community-level interventions to prevent ECD in similar settings around the world.

Lead exposure from battery recycling in Indonesia.

PubMed

Haryanto, Budi

2016-03-01

In Indonesia, more than 200 illegal used lead acid battery (ULAB) smelters are currently operating. Only a few health studies support the finding of lead-related symptoms and diseases among populations living near the smelters. To assess the blood lead levels (BLLs) and potential health impacts among the population surrounding ULAB recycling smelters, we evaluated health effects reported from 2003 to 2013, conducted focus group discussions with lead smelter owner/workers and a group of 35 female partners of smelter owners or workers not actively engaged in smelter work, and retook and measured BLLs. It was found that many children in the areas were having difficulty achieving high grades at school and having stunting or other problems with physical development. The average mean of BLLs increased by almost double in 2015, compared with in 2011. The risk of having hypertension, interference in the ability to make red blood cells in females occurred among 24% of respondents; Elevated blood pressure, hearing loss, and interference in the ability to make red bloods cell occurred in 20% of males; Kidney damage, infertility in male, nerve problems, including decreased sensation and decreased ability to move quickly occurred in 13%; Decreased ability to make red blood cells (20%), and; Frank anemia, decreased life-span, coma/seizures were experienced by 22%. The populations living in areas surrounding ULAB smelters are experiencing severe chronic health problems. It is recommended that the smelters must be moved and placed far away from the municipality.

Beet yellow stunt

USDA-ARS?s Scientific Manuscript database

Beet yellow stunt virus (BYSV) is a potentially destructive yellows-type virus affecting plants in the family Asteraceae. The virus is a member of the genus Closterovirus, family Closteroviridae, and has been found in California and England. Initial symptoms consist of chlorosis of the older leaves,...

Lettuce dieback

USDA-ARS?s Scientific Manuscript database

Two related viruses, Tomato bushy stunt virus (TBSV) and Moroccan pepper virus (MPV) cause a disease known as lettuce dieback in California and Arizona. Lettuce dieback is characterized by yellowing, necrosis, stunting and death of lettuce plants, and often occurs in low lying areas with poor drain...

Seasonal variation in the nutritional status of children aged 6 to 60 months in a resettlement village in West Timor.

PubMed

Miller, Jacqueline; Ritchie, Brett; Tran, Cuong; Beggs, Sean; Lada, Christina Olly; Whetter, Kathryn; Cobiac, Lynne

2013-01-01

Childhood malnutrition remains a public health issue in Indonesia with a national prevalence of wasting of 13% and stunting of 36%. In rural areas nutritional status depends on local agriculture and may fluctuate in relation to harvest time. The aim of this study was to characterise seasonal variations in nutritional status in two resettlement villages in the Oesao district, Nusa Tenggara Timur. A cross sectional study was conducted in a convenience sample of children after the wet season (March). Children aged 6 to 60 months were assessed for nutritional status using anthropometric and biochemical measures. A subset of these children was re-assessed for anthropometry after the dry season (November). Weight-for-height z scores improved significantly from mean±SD of -1.7± 0.9 in March to -1.3±0.9 in November (p<0.001). There was no significant change in height between seasons. Prevalence of wasting, (weight-for-height z score <-2), was 42% in March and 19% in November (p<0.001). However, stunting rates increased significantly from 42% in March to 45% in November (p<0.001). Thirty six per cent of children were anaemic (Hb level <11 mg/100 mL), 68% were vitamin A deficient (plasma vitamin A level <0.8 μmol/L) and 50% were zinc deficient (plasma zinc <9.94 μmol/L). All children except one were positive for intestinal parasites. These data indicate seasonal changes in anthropometry with inconsistent effects depending on the anthropometric index measured. Wasting and stunting were higher than the national average, alongside high rates of anaemia, zinc and vitamin A deficiencies.

The Global Hidden Hunger Indices and Maps: An Advocacy Tool for Action

PubMed Central

Muthayya, Sumithra; Rah, Jee Hyun; Sugimoto, Jonathan D.; Roos, Franz F.; Kraemer, Klaus; Black, Robert E.

2013-01-01

The unified global efforts to mitigate the high burden of vitamin and mineral deficiency, known as hidden hunger, in populations around the world are crucial to the achievement of most of the Millennium Development Goals (MDGs). We developed indices and maps of global hidden hunger to help prioritize program assistance, and to serve as an evidence-based global advocacy tool. Two types of hidden hunger indices and maps were created based on i) national prevalence data on stunting, anemia due to iron deficiency, and low serum retinol levels among preschool-aged children in 149 countries; and ii) estimates of Disability Adjusted Life Years (DALYs) attributed to micronutrient deficiencies in 136 countries. A number of countries in sub-Saharan Africa, as well as India and Afghanistan, had an alarmingly high level of hidden hunger, with stunting, iron deficiency anemia, and vitamin A deficiency all being highly prevalent. The total DALY rates per 100,000 population, attributed to micronutrient deficiencies, were generally the highest in sub-Saharan African countries. In 36 countries, home to 90% of the world’s stunted children, deficiencies of micronutrients were responsible for 1.5-12% of the total DALYs. The pattern and magnitude of iodine deficiency did not conform to that of other micronutrients. The greatest proportions of children with iodine deficiency were in the Eastern Mediterranean (46.6%), European (44.2%), and African (40.4%) regions. The current indices and maps provide crucial data to optimize the prioritization of program assistance addressing global multiple micronutrient deficiencies. Moreover, the indices and maps serve as a useful advocacy tool in the call for increased commitments to scale up effective nutrition interventions. PMID:23776712

Association between intimate partner violence and poor child growth: results from 42 demographic and health surveys.

PubMed

Chai, Jeanne; Fink, Günther; Kaaya, Sylvia; Danaei, Goodarz; Fawzi, Wafaie; Ezzati, Majid; Lienert, Jeffrey; Smith Fawzi, Mary C

2016-05-01

To determine the impact of intimate partner violence against women on children's growth and nutritional status in low- and middle-income countries. We pooled records from 42 demographic and health surveys in 29 countries. Data on maternal lifetime exposure to physical or sexual violence by an intimate partner, socioeconomic and demographic characteristics were collected. We used logistic regression models to determine the association between intimate partner violence and child stunting and wasting. Prior exposure to intimate partner violence was reported by 69 652 (34.1%) of the 204 159 ever-married women included in our analysis. After adjusting for a range of characteristics, stunting in children was found to be positively associated with maternal lifetime exposure to only physical (adjusted odds ratio, aOR: 1.11; 95% confidence interval, CI: 1.09-1.14) or sexual intimate partner violence (aOR: 1.09; 95% CI: 1.05-1.13) and to both forms of such violence (aOR: 1.10; 95% CI: 1.05-1.14). The associations between stunting and intimate partner violence were stronger in urban areas than in rural ones, for mothers who had low levels of education than for women with higher levels of education, and in middle-income countries than in low-income countries. We also found a small negative association between wasting and intimate partner violence (aOR: 0.94; 95%CI: 0.90-0.98). Intimate partner violence against women remains common in low- and middle-income countries and is highly detrimental to women and to the growth of the affected women's children. Policy and programme efforts are needed to reduce the prevalence and impact of such violence.

Stunting, adiposity, and the individual-level "dual burden" among urban lowland and rural highland Peruvian children.

PubMed

Pomeroy, Emma; Stock, Jay T; Stanojevic, Sanja; Miranda, J Jaime; Cole, Tim J; Wells, Jonathan C K

2014-01-01

The causes of the "dual burden" of stunting and obesity remain unclear, and its existence at the individual level varies between populations. We investigate whether the individual dual burden differentially affects low socioeconomic status Peruvian children from contrasting environments (urban lowlands and rural highlands), and whether tibia length can discount the possible autocorrelation between adiposity proxies and height due to height measurement error. Stature, tibia length, weight, and waist circumference were measured in children aged 3-8.5 years (n = 201). Height and body mass index (BMI) z scores were calculated using international reference data. Age-sex-specific centile curves were also calculated for height, BMI, and tibia length. Adiposity proxies (BMI z score, waist circumference-height ratio (WCHtR)) were regressed on height and also on tibia length z scores. Regression model interaction terms between site (highland vs. lowland) and height indicate that relationships between adiposity and linear growth measures differed significantly between samples (P < 0.001). Height was positively associated with BMI among urban lowland children, and more weakly with WCHtR. Among rural highland children, height was negatively associated with WCHtR but unrelated to BMI. Similar results using tibia length rather than stature indicate that stature measurement error was not a major concern. Lowland and rural highland children differ in their patterns of stunting, BMI, and WCHtR. These contrasts likely reflect environmental differences and overall environmental stress exposure. Tibia length or knee height can be used to assess the influence of measurement error in height on the relationship between stature and BMI or WCHtR. Copyright © 2014 Wiley Periodicals, Inc.

Association between intimate partner violence and poor child growth: results from 42 demographic and health surveys

PubMed Central

Fink, Günther; Kaaya, Sylvia; Danaei, Goodarz; Fawzi, Wafaie; Ezzati, Majid; Lienert, Jeffrey; Smith Fawzi, Mary C

2016-01-01

Abstract Objective To determine the impact of intimate partner violence against women on children’s growth and nutritional status in low- and middle-income countries. Methods We pooled records from 42 demographic and health surveys in 29 countries. Data on maternal lifetime exposure to physical or sexual violence by an intimate partner, socioeconomic and demographic characteristics were collected. We used logistic regression models to determine the association between intimate partner violence and child stunting and wasting. Findings Prior exposure to intimate partner violence was reported by 69 652 (34.1%) of the 204 159 ever-married women included in our analysis. After adjusting for a range of characteristics, stunting in children was found to be positively associated with maternal lifetime exposure to only physical (adjusted odds ratio, aOR: 1.11; 95% confidence interval, CI: 1.09–1.14) or sexual intimate partner violence (aOR: 1.09; 95% CI: 1.05–1.13) and to both forms of such violence (aOR: 1.10; 95% CI: 1.05–1.14). The associations between stunting and intimate partner violence were stronger in urban areas than in rural ones, for mothers who had low levels of education than for women with higher levels of education, and in middle-income countries than in low-income countries. We also found a small negative association between wasting and intimate partner violence (aOR: 0.94; 95%CI: 0.90–0.98). Conclusion Intimate partner violence against women remains common in low- and middle-income countries and is highly detrimental to women and to the growth of the affected women’s children. Policy and programme efforts are needed to reduce the prevalence and impact of such violence. PMID:27147763

Maternal depression does not affect complementary feeding indicators or stunting status of young children (6-23 months) in Northern Ghana.

PubMed

Wemakor, Anthony; Iddrisu, Habib

2018-06-25

Maternal depression may affect child feeding practice which is an important determinant of child nutritional status. The objective of this study was to explore the association between maternal depression and WHO complementary feeding indicators [minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum acceptable diet (MAD)] or stunting status of children (6-23 months) in Tamale Metropolis, Ghana. A community-based cross-sectional study was carried out involving 200 mother-child pairs randomly sampled from three communities in Tamale Metropolis, Ghana. The prevalence of MDD, MMF, and MAD were 56.5, 65.0, and 44.0% respectively and 41.0% of the children sampled were stunted. A third of the mothers (33.5%) screened positive for depression. Maternal depression did not influence significantly MDD (p = 0.245), MMF (p = 0.442), and MAD (p = 0.885) or children's risk of stunting (p = 0.872). In conclusion maternal depression and child stunting are prevalent in Northern Ghana but there is a lack of evidence of an association between maternal depression and child feeding practices or nutritional status in this study population. Further research is needed to assess the effect of maternal depression on feeding practices and growth of young children.

Micronutrient adequacy is poor, but not associated with stunting between 12-24 months of age: A cohort study findings from a slum area of Bangladesh

PubMed Central

Islam, M. Munirul; Mahfuz, Mustafa; Ahmed, A. M. Shamsir; Mondal, Dinesh; Haque, Rashidul; Ahmed, Tahmeed

2018-01-01

The prevalence of stunting among children below 5 years of age is higher in the slum-dwelling population of Bangladesh compared to that in both urban and rural areas. Studies have reported that several factors such as inadequate nutrition, low socio-economic status, poor hygiene and sanitation and lack of maternal education are the substantial predictors of childhood stunting. Almost all these factors are universally present in the slum-dwelling population of Bangladesh. However, few studies have prospectively examined such determinants of stunting among slum populations. In this paper, we reveal the findings of a cohort study with an aim to explore the status of micronutrient adequacy among such vulnerable children and establish its association with stunting along with other determinants. Two-hundred-sixty-five children were enrolled and followed since birth until 24 months of age. We collected anthropometric, morbidity and dietary intake data monthly. We used the 24-hour multiple-pass recall approach to collect dietary intake data from the age of 9 months onward. Micronutrient adequacy of the diet was determined by the mean adequacy ratio (MAR) which was constructed from the average intake of 9 vitamins and 4 minerals considered for the analysis. We used generalized estimating equation (GEE) regression models to establish the determinants of stunting between 12–24 months of age in our study population. The prevalence of low-birth-weight (LBW) was about 28.7% and approximately half of the children were stunted by the age of 24 months. The average micronutrient intake was considerably lower than the recommended dietary allowance and the MAR was only 0.48 at 24 months of age compared to the optimum value of 1. However, the MAR was not associated with stunting between 12–24 months of age. Rather, LBW was the significant determinant (AOR = 3.03, 95% CI: 1.69–5.44) after adjusting for other factors such as age (AOR = 2.12, 95% CI: 1.45–3.11 at 24 months and AOR = 1.97, 95% CI: 1.49–2.59 at 18 months, ref: 12 months) and sex (AOR = 1.98, 95% CI: 1.17–3.33, ref: female). Improving the nutritional quality of complementary food in terms of adequacy of micronutrients is imperative for optimum growth but may not be adequate to mitigate under-nutrition in this setting. Further research should focus on identifying multiple strategies that can work synergistically to diminish the burden of stunting in resource-poor settings. PMID:29596493

Physical growth and nutritional status of Tsimane' Amerindian children of lowland Bolivia.

PubMed

Foster, Z; Byron, E; Reyes-García, V; Huanca, T; Vadez, V; Apaza, L; Pérez, E; Tanner, S; Gutierrez, Y; Sandstrom, B; Yakhedts, A; Osborn, C; Godoy, R A; Leonard, W R

2005-03-01

This study examines patterns of growth and nutritional status of indigenous Tsimane' children under 9 years of age (n = 199 boys and 210 girls), based on a cross-sectional sample from 58 villages from the Beni Deparment of lowland Bolivia. Compared with US children, Tsimane' children are quite short, with linear growth tracking at or below the US 5th centile in both sexes. The prevalence of low height-for-age ("stunting;" HA Z-scores

Sea level rise may increase extinction risk of a saltmarsh ontogenetic habitat specialist.

PubMed

Johnson, David Samuel; Williams, Bethany L

2017-10-01

Specialist species are more vulnerable to environmental change than generalist species. For species with ontogenetic niche shifts, specialization may occur at a particular life stage making those stages more susceptible to environmental change. In the salt marshes in the northeast U.S., accelerated sea level rise is shifting vegetation patterns from flood-intolerant species such as Spartina patens to the flood-tolerant Spartina alterniflora . We tested the potential impact of this change on the coffee bean snail, Melampus bidentatus , a numerically dominant benthic invertebrate with an ontogenetic niche shift. From a survey of eight marshes throughout the northeast U.S., small snails were found primarily in S. patens habitats, and large snails were found primarily in stunted S. alterniflora habitats. When transplanted into stunted S. alterniflora , small snails suffered significantly higher mortality relative to those in S. patens habitats; adult snail survivorship was similar between habitats. Because other habitats were not interchangeable with S. patens for young snails, these results suggest that Melampus is an ontogenetic specialist where young snails are habitat specialists and adult snails are habitat generalists. Temperature was significantly higher and relative humidity significantly lower in stunted S. alterniflora than in S. patens . These data suggest that thermal and desiccation stress restricted young snails to S. patens habitat, which has high stem density and a layer of thatch that protects snails from environmental stress. Other authors predict that if salt marshes in the northeast U.S. are unable to migrate landward, sea level rise will eliminate S. patens habitats. We suggest that if a salt marsh loses its S. patens habitats, it will also lose its coffee bean snails. Our results demonstrate the need to consider individual life stages when determining a species' vulnerability to global change.

Double Burden of Malnutrition in Rural West Java: Household-Level Analysis for Father-Child and Mother-Child Pairs and the Association with Dietary Intake.

PubMed

Sekiyama, Makiko; Jiang, Hong Wei; Gunawan, Budhi; Dewanti, Linda; Honda, Ryo; Shimizu-Furusawa, Hana; Abdoellah, Oekan S; Watanabe, Chiho

2015-10-02

Indonesia is facing household-level double burden malnutrition. This study aimed at examining (1) household-level double burden for the mother-child and father-child pairs; (2) risk of adiposity of double burden households; and (3) associated dietary factors. Subjects were 5th and 6th grade elementary school children (n = 242), their mothers (n = 242), and their fathers (n = 225) in five communities (1 = urban, 4 = rural) in the Bandung District. Questionnaires on socioeconomic factors, blood hemoglobin measurements, and anthropometric measurements were administered. For adults, body fat percentage (BF%) was estimated by bioelectrical impedance (BF%-BI) and by converting skinfold thickness (ST) data using Durnin and Womersley's (1974) formula (BF%-ST). Food frequency questionnaires were also completed. Double burden was defined as coexistence of maternal or paternal overweight (Body mass index (BMI) ≥ 23) and child stunting (height-for-age z-score <-2) within households. Maternal-child double burden occurred in 30.6% of total households, whereas paternal-child double burden was only in 8.4%. Mothers from double burden households showed high adiposity; 87.3% with BF%-BI and 66.2% with BF%-ST had BF% >35%, and 60.6% had waists >80 cm. The major dietary patterns identified were "Modern" and "High-animal products". After controlling for confounding factors, children in the highest quartile of the "High-animal products" dietary pattern had a lower risk of maternal-child double burden (Adjusted OR: 0.46, 95% CI: 0.21-1.04) than those in the lowest quartile. Given that the "High-animal products" dietary pattern was associated with the decreased risk of maternal-child double burden through a strong negative correlation with child stunting, improving child stunting through adequate intake of animal products is critical to solve the problem of maternal-child double burden in Indonesia.

Double Burden of Malnutrition in Rural West Java: Household-Level Analysis for Father-Child and Mother-Child Pairs and the Association with Dietary Intake

PubMed Central

Sekiyama, Makiko; Jiang, Hong Wei; Gunawan, Budhi; Dewanti, Linda; Honda, Ryo; Shimizu-Furusawa, Hana; Abdoellah, Oekan S.; Watanabe, Chiho

2015-01-01

Indonesia is facing household-level double burden malnutrition. This study aimed at examining (1) household-level double burden for the mother-child and father-child pairs; (2) risk of adiposity of double burden households; and (3) associated dietary factors. Subjects were 5th and 6th grade elementary school children (n = 242), their mothers (n = 242), and their fathers (n = 225) in five communities (1 = urban, 4 = rural) in the Bandung District. Questionnaires on socioeconomic factors, blood hemoglobin measurements, and anthropometric measurements were administered. For adults, body fat percentage (BF%) was estimated by bioelectrical impedance (BF%-BI) and by converting skinfold thickness (ST) data using Durnin and Womersley’s (1974) formula (BF%-ST). Food frequency questionnaires were also completed. Double burden was defined as coexistence of maternal or paternal overweight (Body mass index (BMI) ≥ 23) and child stunting (height-for-age z-score <−2) within households. Maternal-child double burden occurred in 30.6% of total households, whereas paternal-child double burden was only in 8.4%. Mothers from double burden households showed high adiposity; 87.3% with BF%-BI and 66.2% with BF%-ST had BF% >35%, and 60.6% had waists >80 cm. The major dietary patterns identified were “Modern” and “High-animal products”. After controlling for confounding factors, children in the highest quartile of the “High-animal products” dietary pattern had a lower risk of maternal-child double burden (Adjusted OR: 0.46, 95% CI: 0.21–1.04) than those in the lowest quartile. Given that the “High-animal products” dietary pattern was associated with the decreased risk of maternal-child double burden through a strong negative correlation with child stunting, improving child stunting through adequate intake of animal products is critical to solve the problem of maternal-child double burden in Indonesia. PMID:26445058

The nutrition transition in the Venezuelan Amazonia: increased overweight and obesity with transculturation.

PubMed

Hidalgo, G; Marini, E; Sanchez, W; Contreras, M; Estrada, I; Comandini, O; Buffa, R; Magris, M; Dominguez-Bello, M G

2014-01-01

Amerindians have a particularly high propensity to overweight and obesity as they change lifestyle and experience a nutrition transition. The aim of this study was to evaluate the effects of transculturation on nutritional status in three Amazonian Amerindian villages. Nutritional status was assessed in 232 volunteers: 65 Yanomami from an isolated village and 167 Guahibo subjects from villages with intermediate and high levels of transculturation. There was a significant pattern of decreasing stunting and increasing overweight and obesity across the gradient of transculturation. From the jungle Yanomami to the intermediate and transculturated Guahibo, stunting was respectively 72, 55, and 39%, and children /adult overweight was 0, 3/44, and 15/89%. These anthropometric-based patterns were confirmed by bioimpedance vector analysis. Transculturation in these Amerindian populations is associated with an increase in overweight and obesity coexisting with undernourished children. © 2014 Wiley Periodicals, Inc.

[Height deficit in school aged children: a multivariate analysis of possible risk factors, Pernambuco-1997].

PubMed

Laurentino, G E C; Arruda, I K G; Raposo, M C F; Batista Filho, M

2005-06-01

The nutritional status and some risk factors in 894 school children (ages 6 to 12) in the State of Pernambuco, Brazil, were analyzed based on the data collected by the Second State Research on Nourishment, Health and Nutrition carried out in 1997. The cutoff point used in the nutritional evaluation was the limit referring to -2 score-Z, being the NCHS the reference standard. The prevalence of stunting in the state was of 16.9%. Rural areas were more affected, reaching 27.1%. Bivariate analysis showed that the low socioeconomic level of the children and their families is associated with the occurrence of stunting. The logistic regression model pointed the variables: residence location, gender, access to treated potable water, low education, and per-capita income as the main determinants in stunting. The conjunct analysis of all the factors that explain the malnutrition found among the school children studied showed that the probability of a school-aged child to present height deficit varied from 1.5 to 60.3% depending on the risk factors taken into account, therefore showing different epidemiological "scenarios." The study also concluded that in the State of Pernambuco the height deficit constitutes a public health problem especially for school children in rural areas, showing two very different epidemiologic realities between urban and rural areas.

Progressive growth deterioration in a context of nutritional transition: a case study from Vientiane (Lao PDR).

PubMed

Benefice, Eric; Lévi, Pierre; Banouvong, Phonetip

2012-05-01

The high rates of rapid urban and economic growth occurring in Asia are bringing about parallel changes in both food consumption patterns and nutritional status. The aim of this study is to examine the impact of these changes on the nutritional and health status of mothers and their offspring in Vientiane, Lao PDR. Over 2 consecutive years, a follow-up study of 150 infant-mother pairs living at three different levels of urbanization was performed in Vientiane. The mothers completed a questionnaire on their eating habits. Clinical examinations and anthropometric measurements were also carried out. The results showed that, in general, the dietary energy content was low (providing only 83% of the energy requirement) and there were deficiencies in calcium, vitamin A, Folate and iron. The main energy source was rice (providing 40.9%), while 40% of the protein provided by meat and fish provided 19.8%. The differences observed in the food contribution to energy intakes and in food diversity varied with the level of urbanization. The prevalence of stunting (13.9%; CI 10.0 ∼ 18.6%) was less than that reported at the country level. Stunting was related to age, the sex of the child and the mother's physique and varied according to the level of urbanization. The level of urbanization in Vientiane influences the pace of the ongoing process of nutritional transition.

Clinical utility of endocrine markers predicting myocardial siderosis in transfusion dependent thalassemia major.

PubMed

Ehsan, Lubaina; Rashid, Mariam; Alvi, Najveen; Awais, Khadija; Nadeem, Omair; Asghar, Aleezay; Sajjad, Fatimah; Fatima, Malika; Qidwai, Asim; Hussain, Shabneez; Hasan, Erum; Brown, Nick; Altaf, Sadaf; Hasan, Babar; Kirmani, Salman

2018-06-12

Endocrinopathy due to iron overload is the most common morbidity whereas myocardial siderosis causing toxic cardiomyopathy is the leading cause of mortality among patients with transfusion dependent thalassemia major (TDTM). If detected early, this can be treated with aggressive chelation. T2* cardiac magnetic resonance imaging (CMR) guided chelation protocols are now the gold standard but have limited availability in low and middle-income countries. We hypothesized that markers of endocrine dysfunction would correlate with T2* CMR and can be used to predict the severity of myocardial siderosis and guide chelation therapy. We undertook a multicenter retrospective study of 280 patients with TDTM to assess the prevalence of endocrinopathies and the predictive value of a number of individual and composite markers of endocrinopathy with T2* CMR. The prevalence of hypogonadism, stunting, hypoparathyroidism, and hypothyroidism was 82%, 69%, 40%, and 30%, respectively. The sensitivity of hypogonadism and stunting predicting severe myocardial siderosis was 90% and 80%, respectively. We conclude that clinical markers of endocrine dysfunction, especially hypogonadism (positive likelihood ratio [LR+] = 1.4, 95% confidence interval [CI] = 1.0-1.9; positive predictive value [PPV] = 77%, 95% CI = 70-82; negative predictive value [NPV] = 57%, 95% CI = 34-77] and stunting (LR+ = 1.3, 95% CI = 1.1-1.6; PPV = 64%, 95% CI = 60-69; NPV = 55%, 95% CI = 45-64) in TDTM can predict severe myocardial siderosis and can potentially guide chelation therapy, especially where access to T2* CMR is limited. © 2018 Wiley Periodicals, Inc.

Association between gross motor function and nutritional status in children with cerebral palsy: a cross-sectional study from Colombia.

PubMed

Herrera-Anaya, Elizabeth; Angarita-Fonseca, Adriana; Herrera-Galindo, Víctor M; Martínez-Marín, Rocío D P; Rodríguez-Bayona, Cindy N

2016-09-01

To determine the association between gross motor function and nutritional status in children with cerebral palsy (CP) residing in an urban area in a developing country. We conducted a cross-sectional study in 177 children (ages 2-12y, 59.3% male) with a diagnosis of CP who were attending rehabilitation centres in Bucaramanga, Colombia (2012-2013). A physiotherapist evaluated patients using the Gross Motor Function Classification System (GMFCS, levels I to V). Nutritional status was evaluated by nutritionists and classified according to the World Health Organization growth charts. We used linear and multinomial logistic regression methods to determine the associations. There were 39.5%, 6.8%, 5.6%, 16.4%, and 31.6% patients classified in levels I to V respectively. The mean adjusted differences for weight-for-age, height-for-age, BMI-for-age, and height-for-weight z-scores were significantly larger for children classified in levels II to V compared with those in level I. The children classified in levels IV and V were more likely to have malnutrition (adjusted odds ratio [OR] 5.64; 95% confidence interval [CI] 2.27-14.0) and stunting (OR 8.42; 95% CI 2.90-24.4) than those classified in GMFCS levels I to III. Stunting and malnutrition are prevalent conditions among paediatric patients with CP, and both are directly associated with higher levels of gross motor dysfunction. © 2016 Mac Keith Press.

Association of the Familial Coexistence of Child Stunting and Maternal Overweight with Indigenous Women in Guatemala.

PubMed

Lee, J; Houser, R; Must, A; Palma, P; Bermudez, O

2017-11-01

Objectives This study investigated the association of the familial coexistence of child stunting and maternal overweight with indigenous women in Guatemala. Methods We selected 2388 child-mother pairs from the data set of the Living Standards Measurement Study conducted in Guatemala in 2000. This study examined the association between maternal and household characteristics and the nutritional status of children aged 6-60 months and mothers aged 18-49 years by using multivariable logistic regression models. Results Compared with non-indigenous households, a significantly higher percentage of indigenous households exhibited stunted child and overweight mother (SCOM) pairs (15.9 vs. 22.2%). Compared with normal-weight mothers, overweight mothers were less likely to have stunted children [adjusted odds ratio (AOR) 0.66, 95% confidence interval (CI) 0.50-0.88]. However, compared with mothers who were not short and overweight, short and overweight mothers were significantly more likely to have stunted children (AOR 1.80, 95% CI 1.19-2.73) and were more likely to be indigenous women living in urban areas (AOR 3.01, 95% CI 1.19-7.60) or rural areas (AOR 3.02, 95% CI 1.28-7.14). The order of observed prevalence of SCOM pairs in different types of households was as follows: urban indigenous (25.0%), rural indigenous (21.2%), rural non-indigenous (19.8%), and urban non-indigenous households (10.7%). Conclusions for Practice Urban indigenous households were more likely to have SCOM pairs. This study provided useful information for identifying the most vulnerable groups and areas with a high prevalence of the familial coexistence of child stunting and maternal overweight.

Trends in Early Growth Indices in the First 24 Months of Life in Uruguay over the Past Decade

PubMed Central

Campoy, Cristina; Uauy, Ricardo; Miranda, Teresa; Cerruti, Florencia

2014-01-01

ABSTRACT Early growth is an important indicator of health and wellbeing of children and a good predictor of adult health. The objective of this study was to examine trends and determinants of overweight and stunting among infants aged 0 to 23 month(s) over the past decade (1999-2011) in Uruguay. Data were used from four large representative samples of 11,056 infants aged 0-23 month(s), who attended public and private health services in 1999, 2003, 2007, and 2011, using a similar methodology. Linear regression analysis was used for assessing trends in early growth indices and binary logistic regression to estimate the probability of being stunted and overweight. Although prevalence of overweight fell from 12.5% (1999) to 9.5% (2011) and stunting from 13.6% to 10.9% respectively, both rates remained higher than expected. Low birthweight (LBW) was the main predictor of stunting [OR 6.5 (5.6-7.6)] and macrosomia of overweight [6.7 (5.3-8.3)]. We did not observe changes in LBW (7.8-8.8%) or macrosomia (5.9-6.7%) over the last decade. Boys showed increased chance of being overweight [OR 1.2 (1.04-1.3)]. Being stunted doubles the chances of being overweight [OR 2.5 (2.2-3.0)]. Overweight [OR 7.1 (6.1-8.3)], LBW [OR 13.2 (11.0-15.9)], and non-breastfed infants [OR 1.9 (1.7-2.1)] showed rapid weight gain. Uruguay has taken positive steps to decline the prevalence of stunting and overweight but both remain excessively high. PMID:25895193

Socioeconomic Inequalities Persist Despite Declining Stunting Prevalence in Low- and Middle-Income Countries.

PubMed

da Silva, Inácio Crochemore M; França, Giovanny V; Barros, Aluisio J D; Amouzou, Agbessi; Krasevec, Julia; Victora, Cesar G

2018-02-01

Global stunting prevalence has been nearly halved between 1990 and 2016, but it remains unclear whether this decline has benefited poor and rural populations within low- and middle-income countries (LMICs). We assessed time trends in stunting among children <5 y of age (under-5) according to household wealth and place of residence in 67 LMICs. Stunting prevalence was analyzed in 217 nationally representative Demographic and Health Surveys and Multiple Indicator Cluster Surveys from 67 countries with ≥2 surveys between 1993 and 2014. National estimates were stratified by wealth and area of residence, comparing the poorest 40% with the wealthiest 60%, and those residing in urban and rural areas. Time trends were calculated for LMICs by using multilevel regression models weighted by under-5 population, with stratification by wealth and by residence. Trends in absolute (slope index of inequality; SII) and relative (concentration index; CIX) inequalities were calculated. Mean prevalences in 1993 were 53.7% in low-income and 48.2% in middle-income countries, with annual average linear declines of 0.76 and 0.72 percentage points (pp), respectively. Although similar slopes of declines were observed for the poorest 40% and wealthiest 60% groups in all countries (0.78 and 0.74 pp, respectively), absolute and relative inequalities increased over time in low-income countries (SII increased from -19.3% in 1993 to -23.7% in 2014 and CIX increased from -6.2% to -10.8% in the same period). In middle-income countries, socioeconomic inequalities remained stable. Overall, stunting prevalence decreased more rapidly among rural than for urban children (0.78 and 0.55 pp, respectively). The prevalence of stunting is decreasing. Poor-rich gaps are stable in middle-income countries and slightly increasing in low-income countries. Rural-urban inequalities are decreasing over time.

A Study on Nutritional Status of Rural School going Children in Kavre District.

PubMed

Mansur, D I; Haque, M K; Sharma, K; Mehta, D K; Shakya, R

2015-01-01

Background Childhood is a time of active growth in terms of physical size, mental, emotional and psychological development. Normal growth is dependent on adequate nutrition and encompasses major transformations from birth to adulthood. Nutrition is a focal point for health and well being; and has special significance in countries with disadvantages in socioeconomic and hygienic standards. Objective The objective of the present study was to assess the nutritional status in terms of prevalence of underweight, stunting and thinness among rural school going children. Method The present study was cross-sectional study, conducted on 438 rural school going children (169 male and 259 female) with the age group 4-16 years, during the period from April 2014 to July 2014. Age was recorded in year; height and weight were measured in centimeter and kilogram respectively. BMI was calculated by using standard equation. Result The present study concluded that the nutritional status in terms of prevalence of underweight, stunting and thinness were found to be 30.85%, 24.54% and 10.05% respectively among rural school going children of Kavre district. It was revealed that 37.87% was underweight, 29.59% was stunted and 11.25% was thinness among male children whereas in female children, 26.27% was underweight, 21.24% was stunted and 9.27% was thinness. Hence, high prevalence of underweight, stunting and thinness were observed in male than in female children. Conclusion The present study has successfully documented the nutritional status in terms of prevalence of underweight, stunting and thinness among the rural school going children of Kavre district. The results of the present study will be useful for policy makers in their endeavor to formulate various developmental and health care programs.

LBW and SGA Impact Longitudinal Growth and Nutritional Status of Filipino Infants

PubMed Central

Baltazar, Palmera; Ayaso, Edna B.; Monterde, Donna Bella S.; Acosta, Luz P.; Olveda, Remigio M.; Tallo, Veronica; Friedman, Jennifer F.

2016-01-01

We performed this study to longitudinally compare rates of stunting, wasting and underweight among low birthweight (LBW), non-LBW, and/or small-for-gestational age (SGA) and non-SGA infants in Leyte, The Philippines and factors that predicted catch up. Birthweights of 357 infants born in Leyte, The Philippines were obtained within 48 hours of delivery and infants were evaluated at one, six and 12 months. Newborns were classified as LBW, SGA, or both. We derived length-for-age, weight-for-length and weight-for-age Z-scores using WHOAnthro. Generalized estimating equations models were used to compare the differences in prevalence and mean Z-scores for these growth and nutritional outcomes, with separate models made with LBW and SGA as distinct primary predictors. We compared the longitudinal risk of stunting, wasting and underweight during infancy among LBW versus non-LBW and SGA versus non-SGA infants, while also evaluating key potential confounding, explanatory and modifying covariates. Overall, 9.0% of infants were born prematurely, 14.0% of infants were LBW and 22.9% were SGA. LBW infants had significantly increased odds of stunting, wasting and underweight persisting to 12 months of age, and SGA infants had significantly increased odds of stunting and underweight. LBW and SGA infants had higher rates of weight-for-length gain in the first month of life. Maternal educational attainment and exclusive breastfeeding decreased the risk of stunting and undernutrition. In this setting, LBW and SGA infants have higher rates of growth stunting and undernutrition during the first year of life and do not exhibit catch-up growth by 12 months of age. Clinical Trial Registration NCT00486863 PMID:27441564

A Conditional Cash Transfer Program in the Philippines Reduces Severe Stunting.

PubMed

Kandpal, Eeshani; Alderman, Harold; Friedman, Jed; Filmer, Deon; Onishi, Junko; Avalos, Jorge

2016-09-01

Pantawid, a conditional cash transfer (CCT) program in the Philippines, provided grants conditioned on health-related behaviors for children aged 0-5 y and schooling for those aged 10-14 y. We investigated whether Pantawid improved anthropometric measurements in children aged 6-36 mo. We estimated cross-sectional intention-to-treat effects using a 2011 cluster-randomized trial across 130 villages-65 treated and 65 control-with data collected after 31 mo of implementation. Anthropometry characteristics were measured for 241 children in treated areas and 244 children in control areas. Health service use for children aged 6-36 mo and dietary intake for those aged 6-60 mo also were measured. Outcome variables were height-for-age z scores (HAZs) and weight-for-age z scores (WAZs), stunting, severe stunting, underweight, and severely underweight. Impact also was assessed on perinatal care, institutional delivery, presence of skilled birth attendant, breastfeeding practices, immunization, growth monitoring and deworming, care-seeking, and children's intake of protein-rich foods. Pantawid was associated with a significant reduction in severe stunting [<-3 SD from WHO standards for healthy children; β = -10.2 percentage points (95% CI -18.8, -1.6 percentage points); P = 0.020] as well as a marginally significant increase in HAZs [β = 0.284 SDs (95% CI -0.033, 0.602 SDs); P = 0.08]. WAZs, stunting, underweight, and severely underweight status did not change. Concomitantly, several measures of health-seeking behavior increased significantly. To our knowledge, Pantawid is one of few CCT programs worldwide that significantly reduced severe stunting in children aged 6-36 mo; changes in key parenting practices, including children's intake of protein-rich foods and care-seeking behavior, were concurrent. © 2016 American Society for Nutrition.

Stunting at birth: recognition of early-life linear growth failure in the western highlands of Guatemala.

PubMed

Solomons, Noel W; Vossenaar, Marieke; Chomat, Anne-Marie; Doak, Colleen M; Koski, Kristine G; Scott, Marilyn E

2015-07-01

Measurements of length at birth, or in the neonatal period, are challenging to obtain and often discounted for lack of validity. Hence, classical 'under-5' stunting rates have been derived from surveys on children from 6 to 59 months of age. Guatemala has a high prevalence of stunting (49.8%), but the age of onset of growth failure is not clearly defined. The objective of the study was to assess length-for-age within the first 1.5 months of life among Guatemalan infants. As part of a cross-sectional observational study, supine length was measured in young infants. Mothers' height was measured. Length-for-age Z-scores (HAZ) were generated and stunting was defined as HAZ <-2 using WHO growth standards. Eight rural, indigenous Mam-Mayan villages (n 200, 100% of Mayan indigenous origin) and an urban clinic of Quetzaltenango (n 106, 27% of Mayan indigenous origin), Guatemala. Three hundred and six newborns with a median age of 19 d. The median rural HAZ was -1.56 and prevalence of stunting was 38%; the respective urban values were -1.41 and 25%. Linear regression revealed no relationship between infant age and HAZ (r = 0.101, r(2) = 0.010, P = 0.077). Maternal height explained 3% of the variability in HAZ (r = 0.171, r(2) = 0.029, P = 0.003). Stunting must be carried over from in utero growth retardation in short-stature Guatemalan mothers. As linear growth failure in this setting begins in utero, its prevention must be linked to maternal care strategies during gestation, or even before. A focus on maternal nutrition and health in an intergenerational dimension is needed to reduce its prevalence.

Children concurrently wasted and stunted: A meta‐analysis of prevalence data of children 6–59 months from 84 countries

PubMed Central

Khara, Tanya; Mwangome, Martha; Ngari, Moses

2017-01-01

Abstract Children can be stunted and wasted at the same time. Having both deficits greatly elevates risk of mortality. The analysis aimed to estimate the prevalence and burden of children aged 6–59 months concurrently wasted and stunted. Data from demographic and health survey and Multi‐indicator Cluster Surveys datasets from 84 countries were analysed. Overall prevalence for being wasted, stunted, and concurrently wasted and stunted among children 6 to 59 months was calculated. A pooled prevalence of concurrence was estimated and reported by gender, age, United Nations regions, and contextual categories. Burden was calculated using population figures from the global joint estimates database. The pooled prevalence of concurrence in the 84 countries was 3.0%, 95% CI [2.97, 3.06], ranging from 0% to 8.0%. Nine countries reported a concurrence prevalence greater than 5%. The estimated burden was 5,963,940 children. Prevalence of concurrence was highest in the 12‐ to 24‐month age group 4.2%, 95% CI [4.1, 4.3], and was significantly higher among boys 3.54%, 95% CI [3.47, 3.61], compared to girls; 2.46%, 95% CI [2.41, 2.52]. Fragile and conflict‐affected states reported significantly higher concurrence 3.6%, 95% CI [3.5, 3.6], than those defined as stable 2.24%, 95% CI [2.18, 2.30]. This analysis represents the first multiple country estimation of the prevalence and burden of children concurrently wasted and stunted. Given the high risk of mortality associated with concurrence, the findings indicate a need to report on this condition as well as investigate whether these children are being reached through existing programmes. PMID:28944990

World Health Organization (WHO) infant and young child feeding indicators: associations with growth measures in 14 low-income countries.

PubMed

Marriott, Bernadette P; White, Alan; Hadden, Louise; Davies, Jayne C; Wallingford, John C

2012-07-01

Eight World Health Organization (WHO) feeding indicators (FIs) and Demographic and Health Survey data for children <24 months were used to assess the relationship of child feeding with stunting and underweight in 14 poor countries. Also assessed were the correlations of FI with country gross national income (GNI). Prevalence of underweight and stunting increased with age and ≥ 50% of 12-23-month children were stunted. About 66% of babies received solids by sixth to eighth months; 91% were still breastfeeding through months 12-15. Approximately half of the children were fed with complementary foods at the recommended daily frequency, but <25% met food diversity recommendations. GNI was negatively correlated with a breastfeeding index (P < 0.01) but not with other age-appropriate FI. Regression modelling indicated a significant association between early initiation of breastfeeding and a reduction in risk of underweight (P < 0.05), but a higher risk of underweight for continued breastfeeding at 12-15 months (P < 0.001). For infants 6-8 months, consumption of solid foods was associated with significantly lower risk of both stunting and underweight (P < 0.001), as was meeting WHO guidance for minimum acceptable diet, iron-rich foods (IRF) and dietary diversity (P < 0.001); desired feeding frequency was only associated with lower risk of underweight (P < 0.05). Timely solid food introduction, dietary diversity and IRF were associated with reduced probability of underweight and stunting that was further associated with maternal education (P < 0.001). These results identify FI associated with growth and reinforce maternal education as a variable to reduce risk of underweight and stunting in poor countries. © 2011 Blackwell Publishing Ltd.

Association between household food access insecurity and nutritional status indicators among children aged <5 years in Nepal: results from a national, cross-sectional household survey.

PubMed

Sreeramareddy, Chandrashekhar T; Ramakrishnareddy, N; Subramaniam, Mayoori

2015-11-01

To examine the association between household food insecurity score and Z-scores of childhood nutritional status indicators. Population-based, cross-sectional survey, Nepal Demographic and Health Survey 2011. A nationally representative sample of 11 085 households selected by a two-stage, stratified cluster sampling design to interview eligible men and women. Children (n 2591) aged 0-60 months in a sub-sample of households selected for men's interview. Prevalence of moderate and severe household food insecurity was 23·2% and 19·0%, respectively, for children aged 0-60 months. Weighted prevalence rates for stunting (height-for-age Z-score (HAZ) <-2), wasting (weight-for-height Z-score (WHZ) <-2) and underweight (weight-for-age Z-score (WAZ) <-2) were 41·6% (95% CI 38·9, 44·3%), 11·5% (95% CI 9·8, 13·2%) and 30·1% (95% CI 27·5, 32·8%), respectively. Prevalences of stunting, severe stunting (HAZ<-3) and underweight by level of household food insecurity were statistically significant (P<0·001). By multiple linear regression analyses and after adjustment for sociodemographic, child and environmental factors, household food access insecurity score was associated with HAZ (β=-0·02, P=0·01) and WAZ (β=-0·01, P=0·01) but was not associated with WHZ and BMI-for-age Z-score. A 10-point increase in household food access insecurity score was associated with a decrease in HAZ of 0·2 (95% CI 0·05, 0·39) and decrease in WAZ of 0·1 (95% CI 0·03, 0·27). Our results from a nationally representative sample confirm the previously reported association of household food insecurity with stunting and underweight. Community nutrition interventions may use household food insecurity scales for identifying those households where children may be at risk of growth faltering.

Freshwater Clams (Pilsbryoconcha Exilis) as an Potential Local Mineral Sources in Weaning Food to Overcome Stunting in Grobogan, Central Java, Indonesia

NASA Astrophysics Data System (ADS)

Putri, S. R.; Anjani, Gemala; Wijayanti, Hartanti Sandi; Nuryanto

2018-02-01

Based on a preliminary survey in Grobogan Central Java, one of the local food that has a prospective nutrient content developed is freshwater clams. Results of PSG report in 2015, especially in Grobogan district with stunting problem of 31.5% consisting of 7.2% very short and 24.1% short. From the stunting event factor, the role of weaning food in the form of baby porridge is the most important component in the fulfillment of infant nutrition. The research is divided into two stages of the research is the initial stage to make the formulation process by way of freshwater clams, nutrient analysis, and formula calculation. The second stage is the process of formulation weaning food by way of formula making, nutrient analysis, and acceptance test of weaning food on the baby slurry is substituted by the freshwater clams. The influence statistically different substitution of freshwater clams on protein content (p=0.014), fat (p=0,041), carbohydrate (p=0,039), water (p=0,0001), ash (p=0.0001), iron (p=0.0001), and zinc (p=0.0001). There is no influence substitution of freshwater clams on energy content (p=0,129) and fiber (p=0,225). The percentage of favorite level on the acceptance test of color (p=0,005) and taste (p=0,006) was statistically different, but there was no difference flavour (p=0,913) and texture (p=0,198). freshwater clams flour is rich in iron and zinc content, so it can serve as local food, especially in Grobogan Central Java as a stunting handling. Obtained from the results of several formulations substituted of freshwater clams in formulation 2 is a formula that can meet the standards of KEPMENKES except on the content of protein and moisture content. Formula 2 acceptable to the panelists, except for the assessment of taste.

The double burden household in sub-Saharan Africa: maternal overweight and obesity and childhood undernutrition from the year 2000: results from World Health Organization Data (WHO) and Demographic Health Surveys (DHS).

PubMed

Wojcicki, Janet M

2014-10-31

Previous studies have characterized an increasing trend of double burden households, or households with individuals experiencing both undernutrition and obesity, in countries undergoing a nutrition transition. Although most prior studies indicate the prevalence of double burden households is highest in middle-income countries, there is some support for an increase in double burden households in sub-Saharan African countries as well. Using data from the Demographic Health Surveys (DHS) and the World Health Organization (WHO), the prevalence of double burden households in sub-Saharan African countries was calculated and the associations between prevalence of overweight/obese adults and underweight, stunted and wasted children were evaluated at the country and household (DHS only) levels. Restricted analyses and frequencies were calculated using urban-only datasets. Surveys from 28 African countries were available using WHO data and 26 from the DHS surveys. Only surveys that were conducted after 2000 were included in analyses. Using the WHO datasets, there were inverse associations between the prevalence of overweight and obesity in adults and underweight, stunting and wasting in children. Correspondingly, there were positive associations between adult underweight and child underweight, stunting and wasting. These associations were not significant in a smaller sample size using urban-only surveys. The prevalence of double burden households in DHS datasets was low: under 5 percent for obese mothers and underweight, stunted or wasted child pairs with a slightly higher percentage for overweight mothers and children with undernutrition. Restricting the analysis to urban only populations did not increase the frequencies of double burden households significantly. There was a low prevalence of double burden households in recent data from sub-Saharan Africa. Countries that have a high prevalence of child undernutrition correspondingly have a high prevalence of adult underweight and low prevalence of adult overweight and obesity.

A Promising Tool to Assess Long Term Public Health Effects of Natural Disasters: Combining Routine Health Survey Data and Geographic Information Systems to Assess Stunting after the 2001 Earthquake in Peru

PubMed Central

Rydberg, Henny; Marrone, Gaetano; Strömdahl, Susanne; von Schreeb, Johan

2015-01-01

Background Research on long-term health effects of earthquakes is scarce, especially in low- and middle-income countries, which are disproportionately affected by disasters. To date, progress in this area has been hampered by the lack of tools to accurately measure these effects. Here, we explored whether long-term public health effects of earthquakes can be assessed using a combination of readily available data sources on public health and geographic distribution of seismic activity. Methods We used childhood stunting as a proxy for public health effects. Data on stunting were attained from Demographic and Health Surveys. Earthquake data were obtained from U.S. Geological Survey’s ShakeMaps, geographic information system-based maps that divide earthquake affected areas into different shaking intensity zones. We combined these two data sources to categorize the surveyed children into different earthquake exposure groups, based on how much their area of residence was affected by the earthquake. We assessed the feasibility of the approach using a real earthquake case – an 8.4 magnitude earthquake that hit southern Peru in 2001. Results and conclusions Our results indicate that the combination of health survey data and disaster data may offer a readily accessible and accurate method for determining the long-term public health consequences of a natural disaster. Our work allowed us to make pre- and post- earthquake comparisons of stunting, an important indicator of the well-being of a society, as well as comparisons between populations with different levels of exposure to the earthquake. Furthermore, the detailed GIS based data provided a precise and objective definition of earthquake exposure. Our approach should be considered in future public health and disaster research exploring the long-term effects of earthquakes and potentially other natural disasters. PMID:26090999

Children malnutrition in northwestern, central and southern regions of Iran: does geographic location matter?

PubMed

Nouri Saeidlou, Sakineh; Babaei, Fariba; Ayremlou, Parvin

2014-04-02

Malnutrition is one of the most important morbidity and mortality causes in children. In comparison with healthy children malnourished children are at higher risk of illness and death as 60 percent of more than 7 million deaths in children aged less than five years are attributed to the malnutrition. The present study is intended to determine the prevalence of malnutrition in West Azerbaijan and compare with Kermanshah and Isfahan provinces. The current survey is a cross-sectional study which is conducted with the aim of determining the nutritional status of children aged less than five years in three West Azerbaijan, Kermanshah and Isfahan provinces using ENA software and has been performed since 16th until 30th October, 2011 with the cooperation of the Office of Community Nutrition Improvement and the United Nations Children's Fund (UNICEF). Research data are collected by questionnaire and according WHO index, percentage of children with malnutrition (underweight, wasting, stunting) were calculated. Chi-square test was used to assess the relationship between variables and malnutrition. The rate of underweight, stunting, and wasting in West Azerbaijan was 2.3%, 7.3% and 1.4%, respectively. Wasting rate in boys was higher than in girls while stunting and underweight were more common in girls but differences were not significant. Results showed that the percentage prevalence of stunting in rural areas was higher than in urban areas, and this difference was significant. (p < 0.03) prevalence of overweight in West Azarbijan, Kermanshah and Isfahan was 5.1%, 4.5% and 3.7%, respectively. Also, Prevalence of obesity in West Azarbijan, Kermanshah and Isfahan was 1.3%, 0.7% and 0.1%, respectively. Given the differences between various provinces and regions of the country which are as a result of the differences between the levels of development in these areas, the necessity of designing and implementing targeted strategies are required for different areas.

Food insecurity and age at menarche among adolescent girls in Jimma Zone Southwest Ethiopia: a longitudinal study.

PubMed

Belachew, Tefera; Hadley, Craig; Lindstrom, David; Getachew, Yehenew; Duchateau, Luc; Kolsteren, Patrick

2011-09-13

Age at menarche is the reflection of cumulative pre-adolescent exposure of girls to either adverse environment such as food insecurity or affluent living conditions. Food insecurity could result in inadequate nutrient intake and stress, both of which are hypothesized to have opposing effects on the timing of menarche through divergent pathways. It is not known whether food insecure girls have delayed menarche or early menarche compared with their food secure peers. In this study we test the competing hypothesis of the relationship between food insecurity and age at menarche among adolescent girls in the Southwest Ethiopia. We report on 900 girls who were investigated in the first two rounds of the five year longitudinal survey. The semi-parametric frailty model was fitted to determine the effect of adolescent food insecurity on time to menarche after adjusting for socio-demographic and economic variables. Food insecure girls have menarche one year later than their food secure peer (median age of 15 years vs 14 years). The hazard of menarche showed a significant decline (P = 0.019) as severity of food insecurity level increased, the hazard ratio (HR) for mild food insecurity and moderate/severe food insecurity were 0.936 and 0.496, respectively compared to food secure girls. Stunted girls had menarche nearly one year later than their non-stunted peers (HR = 0.551, P < 0.001). Food insecurity is associated with delay of age at menarche by one year among girls in the study area. Stunted girls had menarche one year later than their non-stunted peers. Age at menarche reflects the development of girls including the timing of sexual maturation, nutritional status and trajectory of growth during the pre-pubertal periods. The findings reflect the consequence of chronic food insecurity on the development and well-being of girls in the study area.

Nutritional status of children during and post-global economic crisis in China.

PubMed

Chen, ChunMing; He, Wu; Wang, YuYing; Deng, LiNa; Jia, FengMei

2011-08-01

To describe the impact of the global economic crisis on the nutritional status of children in China during and after the crisis. Data from 1990 to 2010 were sourced from the National Food and Nutrition Surveillance System. Approximately 16 000 children under 5 years old were selected using a stratified random cluster method from 40 surveillance sites. Anthropometric and hemoglobin measurements for children under 5 were conducted. Nutritional status was determined according to WHO child growth standards. Prevalence of underweight and stunting in children under 5 had a downward trend. Underweight prevalence was close to normal (less than 5%), with prevalence of stunting 12.6% in 2009 and 12.1% in 2010 in rural areas. Prevalence of stunting in infants under 6 months and 6-12 months old in poorer rural areas increased from 5.7%-9.1% and 6.7%-12.5%, respectively, in 2008-2009. This trend also continued post-crisis in 2010. Prevalence of stunting in children left behind by mothers was 20%-30% higher than in children the same age in general and poorer rural areas. Prevalence of anemia in children did not change in rural areas, but prevalence of anemia in all age groups increased in poorer rural areas, especially in children under 24 months old. Level reached 30%-40% in 2009, and fluctuated in 2010. The nutritional status of children under 5 was comparatively stable during and after the global economic crisis, attributable to the Chinese government's policy response. The nutritional status in poorer rural areas fluctuated in response to the economic crisis and, thus, relevant action and intervention must be taken immediately to help the most vulnerable population in poorer rural areas. A proper national nutritional strategy for children under 2 years old, including nutrition supplementation for pregnant women and in-home fortification for complementary feeding, should be initiated. Copyright © 2011 The Editorial Board of Biomedical and Environmental Sciences. Published by Elsevier B.V. All rights reserved.

A Promising Tool to Assess Long Term Public Health Effects of Natural Disasters: Combining Routine Health Survey Data and Geographic Information Systems to Assess Stunting after the 2001 Earthquake in Peru.

PubMed

Rydberg, Henny; Marrone, Gaetano; Strömdahl, Susanne; von Schreeb, Johan

2015-01-01

Research on long-term health effects of earthquakes is scarce, especially in low- and middle-income countries, which are disproportionately affected by disasters. To date, progress in this area has been hampered by the lack of tools to accurately measure these effects. Here, we explored whether long-term public health effects of earthquakes can be assessed using a combination of readily available data sources on public health and geographic distribution of seismic activity. We used childhood stunting as a proxy for public health effects. Data on stunting were attained from Demographic and Health Surveys. Earthquake data were obtained from U.S. Geological Survey's ShakeMaps, geographic information system-based maps that divide earthquake affected areas into different shaking intensity zones. We combined these two data sources to categorize the surveyed children into different earthquake exposure groups, based on how much their area of residence was affected by the earthquake. We assessed the feasibility of the approach using a real earthquake case--an 8.4 magnitude earthquake that hit southern Peru in 2001. Our results indicate that the combination of health survey data and disaster data may offer a readily accessible and accurate method for determining the long-term public health consequences of a natural disaster. Our work allowed us to make pre- and post-earthquake comparisons of stunting, an important indicator of the well-being of a society, as well as comparisons between populations with different levels of exposure to the earthquake. Furthermore, the detailed GIS based data provided a precise and objective definition of earthquake exposure. Our approach should be considered in future public health and disaster research exploring the long-term effects of earthquakes and potentially other natural disasters.

Tomato apical stunt viroid - Data Sheet

USDA-ARS?s Scientific Manuscript database

Tomato apical stunt viroid (TASVd), a member of the family Pospiviroidae, genus Pospiviroid, is a small, covalently closed, circular single-stranded, highly base-paired RNA molecule that ranges in size from 362 to 364 nucleotides. Viroids do not encode peptides or proteins, and use host proteins for...

Decomposition of childhood malnutrition in Cambodia.

PubMed

Sunil, Thankam S; Sagna, Marguerite

2015-10-01

Childhood malnutrition is a major problem in developing countries, and in Cambodia, it is estimated that approximately 42% of the children are stunted, which is considered to be very high. In the present study, we examined the effects of proximate and socio-economic determinants on childhood malnutrition in Cambodia. In addition, we examined the effects of the changes in these proximate determinants on childhood malnutrition between 2000 and 2005. Our analytical approach included descriptive, logistic regression and decomposition analyses. Separate analyses are estimated for 2000 and 2005 survey. The primary component of the difference in stunting is attributable to the rates component, indicating that the decrease of stunting is due mainly to the decrease in stunting rates between 2000 and 2005. While majority of the differences in childhood malnutrition between 2000 and 2005 can be attributed to differences in the distribution of malnutrition determinants between 2000 and 2005, differences in their effects also showed some significance. © 2013 John Wiley & Sons Ltd.

Nutritional Status and Effect of Maternal Employment among Children Aged 6-59 Months in Wolayta Sodo Town, Southern Ethiopia: A Cross-sectional Study.

PubMed

Eshete, Hiwot; Abebe, Yewelsew; Loha, Eskindir; Gebru, Teklemichael; Tesheme, Tesfalem

2017-03-01

Childhood malnutrition remains common in many parts of the world; the magnitude of worldwide stunting, underweight and wasting in children under five years of age were 24.7 %, 15.1 % and 7.8 %, respectively. More than 150 million children under the age of five years in the developing world are malnourished. Ethiopia is one of the countries in sub-Saharan Africa with the highest rates of malnutrition. In Ethiopia, 44.4% and 9.7% of children under-five years old were stunted and wasted, respectively. This study was aimed to assess nutritional status and effect of maternal employment among children aged 6-59 months. A cross-sectional study was conducted in Wolayta Sodo Town, Southern Ethiopia. Socio-demographic characteristics, child feeding and healthcare seeking practice of mothers, and child's anthropometric status were assessed. Probability proportional to size sampling approach was used to select a sample of 316 mothers having children aged 6-59 months. The study was ethically approved by Institutional Review Board of Health Science College, Hawasa University. The overall result revealed that the prevalence of stunting was 22.2%, of which 21.8% and 22.6% were in children of employed and unemployed mothers, respectively. Low-weight-for age was 10.8% for children of employed mothers and 13.4% for children of unemployed mothers. Wasting was 8.8% and 10.8% for children of employed and unemployed mothers, respectively. There was no statistically significant association between maternal employment and nutritional status of their children. However, chronic malnutrition (stunting) was influenced by being educated mother (OR: 0.37) child age group of 24-59 months (OR: 0.36) and households' fifth wealth quintile (OR: 0.28). Low prevalence of stunting was observed. Stunting is a public health concern in the study area. Furthermore, stunting is significantly influenced by mothers' education, household wealth and child age. However, maternal employment was not statistically associated with child nutritional status. Thus, nutritional intervention initiatives should focus on improving household food security, maternal education and agricultural diversification.

Food insecurity and maternal-child nutritional status in Mexico: cross-sectional analysis of the National Health and Nutrition Survey 2012.

PubMed

Shamah-Levy, Teresa; Mundo-Rosas, Verónica; Morales-Ruan, Carmen; Cuevas-Nasu, Lucia; Méndez-Gómez-Humarán, Ignacio; Pérez-Escamilla, Rafael

2017-07-31

To examine the association between household food insecurity (HFI) and risk of childhood stunting and to determine whether this association is modified by maternal-child overweight/obesity. Observational cross-sectional study. Data come from the Mexican National Health and Nutrition Survey ( ENSANUT 2012 by its initials in Spanish), representative of rural and urban areas. Our study sample included 5087 mother-preschool child pairs and 7181 mother-schoolchild pairs. Differences in the prevalence (95% CI) of each HFI category by socioeconomic characteristics and maternal-child nutritional status were estimated. A logistic regression model was conducted for stunting and overweight among preschool children and for stunting and overweight/obesity among schoolchildren, adjusting for pertinent covariates. HFI was measured according to the Latin American and Caribbean Food Security Scale (ELCSA by its initials in Spanish). Weight and recumbent lenght or height measures were obtained from children. Overweight and obesity in women were determined according to the WHO Growth Reference Charts. The following covariates were included: sex of the child. urbanicity (urban/rural), region of residence and maternal education. Benefiting from food assistance programmes and socioeconomic status index were also included. Results were expressed as adjusted ORs. Stunting proved more prevalent in preschool children with moderate or severe HFI (16.2% and 16.8%, respectively) (p=0.036 and p=0.007, respectively) than in their counterparts with mild or no HFI (13.2% and 10.7%, respectively). Furthermore, the interaction between HFI and maternal obesity had a significant impact on stunting in preschool children (p<0.05). Severe HFI increased risk of stunting in children with non-obese mothers but not in those with obese mothers. We have discovered a new relationship between HFI and maternal obesity on the one hand and risk of childhood stunting on the other hand. This may reflect a shared mechanism involving dual forms of malnutrition. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Assessment of the effectiveness of a small quantity lipid-based nutrient supplement on reducing anaemia and stunting in refugee populations in the Horn of Africa: Secondary data analysis.

PubMed

Style, Sarah; Tondeur, Melody; Grijalva-Eternod, Carlos; Pringle, Josephine; Kassim, Ismail; Wilkinson, Caroline; Oman, Allison; Dolan, Carmel; Spiegel, Paul; Seal, Andrew

2017-01-01

Stunting and micronutrient malnutrition are persistent public health problems in refugee populations. UNHCR and its partner organisations implement blanket supplementary feeding programmes using a range of special nutritional products as one approach to address these issues. The evidence base for the efficacy and effectiveness of a small quantity lipid-based nutrient supplement, Nutributter®, in reducing stunting and anaemia is limited. Secondary data analysis was used to assess the effectiveness of Nutributter® distribution on anaemia and stunting in children aged 6-23 months (programme target group) and 6-59 months (the standard age group sampled in routine nutrition surveys). Analysis was conducted using routine pre and post-intervention cross-sectional nutrition survey data collected between 2008-2011 in five refugee camps in Kenya and Djibouti. Changes in total anaemia (Haemoglobin<110g/L), anaemia categories (mild, moderate and severe), and stunting (height-for-age z-score <-2) were explored using available data on the Nutributter® programme and contextual factors. A significant reduction in the prevalence of anaemia in children aged 6-23 months and 6-59 months was seen in four of five, and in all five camps, respectively (p<0.05). Reductions ranged from 12.4 to 23.0, and 18.3 to 29.3 percentage points in each age group. Improvements were largely due to reductions in moderate and severe anaemia and occurred where the prevalence of acute malnutrition was stable or increasing. No change in stunting was observed in four of five camps. The replicability of findings across five sites strongly suggests that Nutributter® distribution was associated with a reduction in anaemia, but not stunting, among refugee children in the Horn of Africa. Benefits were not restricted to the 6-23 month target group targeted by the nutrition programme. However, even following this intervention anaemia remained a serious public health problem and additional work to define and evaluate an effective intervention package is warranted.

Stunting, poor iron status and parasite infection are significant risk factors for lower cognitive performance in Cambodian school-aged children.

PubMed

Perignon, Marlene; Fiorentino, Marion; Kuong, Khov; Burja, Kurt; Parker, Megan; Sisokhom, Sek; Chamnan, Chhoun; Berger, Jacques; Wieringa, Frank T

2014-01-01

Nutrition is one of many factors affecting the cognitive development of children. In Cambodia, 55% of children <5 y were anemic and 40% stunted in 2010. Currently, no data exists on the nutritional status of Cambodian school-aged children, or on how malnutrition potentially affects their cognitive development. To assess the anthropometric and micronutrient status (iron, vitamin A, zinc, iodine) of Cambodian schoolchildren and their associations with cognitive performance. School children aged 6-16 y (n = 2443) from 20 primary schools in Cambodia were recruited. Anthropometry, hemoglobin, serum ferritin, transferrin receptors, retinol-binding protein and zinc concentrations, inflammation status, urinary iodine concentration and parasite infection were measured. Socio-economic data were collected in a sub-group of children (n = 616). Cognitive performance was assessed using Raven's Colored Progressive Matrices (RCPM) and block design and picture completion, two standardized tests from the Wechsler Intelligence Scale for Children (WISC-III). The prevalence of anemia, iron, zinc, iodine and vitamin A deficiency were 15.7%; 51.2%, 92.8%, 17.3% and 0.7% respectively. The prevalence of stunting was 40.0%, including 10.9% of severe stunting. Stunted children scored significantly lower than non-stunted children on all tests. In RCPM test, boys with iron-deficiency anemia had lower scores than boys with normal iron status (-1.46, p<0.05). In picture completion test, children with normal iron status tended to score higher than iron-deficient children with anemia (-0.81; p = 0.067) or without anemia (-0.49; p = 0.064). Parasite infection was associated with an increase in risk of scoring below the median value in block design test (OR = 1.62; p<0.05), and with lower scores in other tests, for girls only (both p<0.05). Poor cognitive performance of Cambodian school-children was multifactorial and significantly associated with long-term (stunting) and current nutritional status indicators (iron status), as well as parasite infection. A life-cycle approach with programs to improve nutrition in early life and at school-age could contribute to optimal cognitive performance.

Risk factors of stunting among children living in an urban slum of Bangladesh: findings of a prospective cohort study.

PubMed

Islam, M Munirul; Sanin, Kazi Istiaque; Mahfuz, Mustafa; Ahmed, A M Shamsir; Mondal, Dinesh; Haque, Rashidul; Ahmed, Tahmeed

2018-01-30

Bangladesh is one of the 20 countries with highest burden of stunting globally. A large portion (around 2.2 million) of the population dwells in the slum areas under severe vulnerable conditions. Children residing in the slums are disproportionately affected with higher burden of undernutrition particularly stunting. In this paper, findings of a prospective cohort study which is part of a larger multi-country study are presented. Two hundred and sixty five children were enrolled and followed since their birth till 24 months of age. Anthropometric measurements, dietary intake and morbidity information were collected monthly. Data from 9 to 12, 15-18 and 21-24 months were collated to analyze and report findings for 12, 18 and 24 months of age. Generalized estimating equation models were constructed to determine risk factors of stunting between 12 and 24 months of age. Approximately, 18% of children were already stunted (LAZ < -2SD) at birth and the proportion increased to 48% at 24 months of age. Exclusive breastfeeding prevalence was only 9.4% following the WHO definition at 6 months. Dietary energy intake as well as intakes of carbohydrate, fat and protein were suboptimal for majority of the children. However, in regression analysis, LAZ at birth (AOR = 0.40, 95% CI: 0.26, 0.61), household with poor asset index (AOR = 2.81, 95% CI: 1.43, 5.52; ref.: average asset index), being male children (AOR = 1.75, 95% CI: 1.04, 2.95; ref.: female) and age (AOR = 2.34, 95% CI: 1.56, 3.52 at 24 months, AOR = 2.13, 95% CI: 1.55, 2.92 at 18 months; ref.: 12 months of age) were the significant predictors of stunting among this population. As the mechanism of stunting begins even before a child is born, strategies must be focused on life course approach and preventive measurement should be initiated during pregnancy. Alongside, government and policymakers have to develop sustainable strategies to improve various social and environmental factors those are closely interrelated with chronic undernutrition particularly concentrating on urban slum areas.

Assessment of the effectiveness of a small quantity lipid-based nutrient supplement on reducing anaemia and stunting in refugee populations in the Horn of Africa: Secondary data analysis

PubMed Central

Style, Sarah; Tondeur, Melody; Grijalva-Eternod, Carlos; Pringle, Josephine; Kassim, Ismail; Wilkinson, Caroline; Oman, Allison; Dolan, Carmel; Spiegel, Paul

2017-01-01

Stunting and micronutrient malnutrition are persistent public health problems in refugee populations. UNHCR and its partner organisations implement blanket supplementary feeding programmes using a range of special nutritional products as one approach to address these issues. The evidence base for the efficacy and effectiveness of a small quantity lipid-based nutrient supplement, Nutributter®, in reducing stunting and anaemia is limited. Secondary data analysis was used to assess the effectiveness of Nutributter® distribution on anaemia and stunting in children aged 6–23 months (programme target group) and 6–59 months (the standard age group sampled in routine nutrition surveys). Analysis was conducted using routine pre and post-intervention cross-sectional nutrition survey data collected between 2008–2011 in five refugee camps in Kenya and Djibouti. Changes in total anaemia (Haemoglobin<110g/L), anaemia categories (mild, moderate and severe), and stunting (height-for-age z-score <-2) were explored using available data on the Nutributter® programme and contextual factors. A significant reduction in the prevalence of anaemia in children aged 6–23 months and 6–59 months was seen in four of five, and in all five camps, respectively (p<0.05). Reductions ranged from 12.4 to 23.0, and 18.3 to 29.3 percentage points in each age group. Improvements were largely due to reductions in moderate and severe anaemia and occurred where the prevalence of acute malnutrition was stable or increasing. No change in stunting was observed in four of five camps. The replicability of findings across five sites strongly suggests that Nutributter® distribution was associated with a reduction in anaemia, but not stunting, among refugee children in the Horn of Africa. Benefits were not restricted to the 6–23 month target group targeted by the nutrition programme. However, even following this intervention anaemia remained a serious public health problem and additional work to define and evaluate an effective intervention package is warranted. PMID:28591166

Evaluation of DNA damage and mutagenicity induced by lead in tobacco plants.

PubMed

Gichner, Tomás; Znidar, Irena; Száková, Jirina

2008-04-30

Tobacco (Nicotiana tabacum L. var. xanthi) seedlings were treated with aqueous solutions of lead nitrate (Pb2+) at concentrations ranging from 0.4 mM to 2.4 mM for 24 h and from 25 microM to 200 microM for 7 days. The DNA damage measured by the comet assay was high in the root nuclei, but in the leaf nuclei a slight but significant increase in DNA damage could be demonstrated only after a 7-day treatment with 200 microM Pb2+. In tobacco plants growing for 6 weeks in soil polluted with Pb2+ severe toxic effects, expressed by the decrease in leaf area, and a slight but significant increase in DNA damage were observed. The tobacco plants with increased levels of DNA damage were severely injured and showed stunted growth, distorted leaves and brown root tips. The frequency of somatic mutations in tobacco plants growing in the Pb2+-polluted soil did not significantly increase. Analytical studies by inductively coupled plasma optical emission spectrometry demonstrate that after a 24-h treatment of tobacco with 2.4 mM Pb2+, the accumulation of the heavy metal is 40-fold higher in the roots than in the above-ground biomass. Low Pb2+ accumulation in the above-ground parts may explain the lower levels or the absence of Pb2+-induced DNA damage in leaves.

STS-37 crewmembers watch Pilot Cameron juggle cassettes on OV-104's middeck

NASA Technical Reports Server (NTRS)

1991-01-01

STS-37 crewmembers watch Pilot Kenneth D. Cameron juggle cassette tapes on the middeck of Atlantis, Orbiter Vehicle (OV) 104. Laughing at Cameron's stunt are Mission Specialist (MS) Linda M. Godwin (foreground), Commander Steven R. Nagel (behind Cameron), and MS Jerry L. Ross (at floor level). Ross snacks on chocolate candy during the performance.

An analysis of socio-demographic patterns in child malnutrition trends using Ghana demographic and health survey data in the period 1993–2008

PubMed Central

2013-01-01

Background A small but growing body of research indicates that progress in reducing child malnutrition is substantially uneven from place to place, even down to the district level within countries. Yet child malnutrition prevalence and trend estimates available for public health planning are mostly available only at the level of global regions and/or at country level. To support carefully targeted intervention to reduce child malnutrition, public health planners and policy-makers require access to more refined prevalence data and trend analyses than are presently available. Responding to this need in Ghana, this report presents trends in child malnutrition prevalence in socio-demographic groups within the country’s geographic regions. Methods The study uses the Ghana Demographic and Health Surveys (GDHS) data. The GDHS are nationally representative cross-sectional surveys that have been carried out in many developing countries. These surveys constitute one of the richest sources of information currently available to examine time trends in child malnutrition. Data from four surveys were used for the analysis: 1993, 1998, 2003 and 2008. Results The results show statistically significant declining trends at the national level for stunting (F (1, 7204) = 7.89, p ≤ .005), underweight (F (1, 7441) = 44.87, p ≤ .001) and wasting (F (1, 7130) = 6.19, p ≤ .013). However, analyses of the sex-specific trends revealed that the declining trends in stunting and wasting were significant among males but not among females. In contrast to the national trend, there were significantly increasing trends in stunting for males (F (1, 2004) = 3.92, p ≤ .048) and females (F (1, 2004) = 4.34, p ≤ .037) whose mothers had higher than primary education, while the trends decreased significantly for males and females whose mothers had no education. Conclusions At the national level in Ghana, child malnutrition is significantly declining. However, the aggregate national trend masks important deviations in certain socio-demographic segments, including worsening levels of malnutrition. This paper shows the importance of disaggregated analyses of national child malnutrition data, to unmask underlying geographic and socio-demographic differences. PMID:24131558

How Did They Grow: An Intervention to Reduce Stunted Growth in Low-Income Mexican-American Children.

PubMed

Reifsnider, Elizabeth; Shin, Cha-Nam; Todd, Michael; Jeong, Mihyun; Gallagher, Martina; Moramarco, Michael

2016-04-01

Growth stunting is a complex phenomenon related to undernutrition that can contribute to developmental delay, cognitive deficits, and small size and obesity in adulthood. Stunted growth, defined as height for age below the 5th percentile, is primarily caused by chronic malnutrition. In this study, a community-based intervention to reduce undernutrition was tested in a quasi-experimental design with 174 low-income, Mexican-American mothers and children recruited from a Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinic in a major southwestern city. The intervention was based on the public health nursing practice of collaborating with mothers of young children on appropriate nutrition and parenting, and was tailored by the author and community informants for mothers of children with stunted growth. Data were collected on child height and weight, dietary intake, maternal acculturation, maternal perceived stress as measured by the Perceived Stress Scale (PSS), home environment as measured by the home screening questionnaire (HSQ), and maternal-child interaction as measured by the Nursing Child Assessment Teaching Scale (NCATS). Intervention children had higher growth velocity than the children in the comparison group. These findings were especially prominent for children of women who were older and less acculturated. Results suggest that a nursing intervention delivered in collaboration with WIC can make a significant improvement in growth of low-income children with growth stunting. © 2016 Wiley Periodicals, Inc.

Relationship between Malnutrition and the Number of Permanent Teeth in Filipino 10- to 13-Year-Olds

PubMed Central

Heinrich-Weltzien, Roswitha; Monse, Bella

2013-01-01

In the present study, we determined whether there is a delay in the eruption of permanent teeth (PT) among Filipino adolescents with stunting or thinness. Height, weight, and number of PT were recorded in 1554 Filipino 10- to 13-year-olds (711 boys; 843 girls). z-scores for height (HAZ) and body mass index (BMI) were calculated according to the WHO growth reference, and their correlations to the number of PT were assessed. 54.9% of the children have at least one form of malnutrition. Significantly, more boys (22.9%) than girls (16.5%) were thin, while no sex difference in stunting was noted (boys 48.5%; girls 44.0%). The number of PT was significantly correlated to HAZ and BMI-z-score. Stunted and thin students had significantly fewer PT than their nonaffected peers. These differences tended to be the result of delay in tooth eruption in thin and stunted adolescents. In 13-year-old girls, all PT were erupted regardless of their nutritional status indicating a catch-up. Thin and stunted boys had one tooth less than normal boys at this age. Impaired physical growth and dental development seem to have common risk factors. Therefore, regular monitoring of growth and dental development might be helpful for targeting support programmes in developing countries. PMID:24069590

Associations of gender inequality with child malnutrition and mortality across 96 countries.

PubMed

Marphatia, A A; Cole, T J; Grijalva-Eternod, C; Wells, J C K

2016-01-01

National efforts to reduce low birth weight (LBW) and child malnutrition and mortality prioritise economic growth. However, this may be ineffective, while rising gross domestic product (GDP) also imposes health costs, such as obesity and non-communicable disease. There is a need to identify other potential routes for improving child health. We investigated associations of the Gender Inequality Index (GII), a national marker of women's disadvantages in reproductive health, empowerment and labour market participation, with the prevalence of LBW, child malnutrition (stunting and wasting) and mortality under 5 years in 96 countries, adjusting for national GDP. The GII displaced GDP as a predictor of LBW, explaining 36% of the variance. Independent of GDP, the GII explained 10% of the variance in wasting and stunting and 41% of the variance in child mortality. Simulations indicated that reducing GII could lead to major reductions in LBW, child malnutrition and mortality in low- and middle-income countries. Independent of national wealth, reducing women's disempowerment relative to men may reduce LBW and promote child nutritional status and survival. Longitudinal studies are now needed to evaluate the impact of efforts to reduce societal gender inequality.

Detection and management of stunt and stubby root nematodes in a southern forest nursery

Treesearch

Michelle M. Cram; Stephen W. Fraedrich

2007-01-01

Populations of stunt (Tylenchorhynchus claytoni) and stubby-root (Paratrichodorus minor) nematodes, as well as predaceous nematodes (Mylonchulus spp., Mononchus spp.), were monitored in 2005 for 8 months in three loblolly pine fields at a southern forest nursery. The fields were selected based...

Three pythium species isolated from severely stunted wheat during an outbreak in North Carolina

USDA-ARS?s Scientific Manuscript database

Large portions of eastern North Carolina experienced prolonged soil waterlogging in 2016. Severely stunted wheat plants from saturated fields were examined and Pythium consistently was associated with the symptoms observed. Three species of Pythium were identified among 15 isolates derived from wh...

76 FR 51887 - Safety Zone; Patuxent River, Patuxent River, MD

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-19

... and September 4, 2011. The public event will consist of military and civilian aircraft performing low-flying, high-speed precision maneuvers and aerial stunts over both the airfield at Naval Air Station... civilian aircraft performing in the air show will conduct practice and demonstration maneuvers and stunts...

Recessive resistance to Cucurbit yellow stunting disorder virus in melon

USDA-ARS?s Scientific Manuscript database

Cucurbit yellow stunting disorder virus (CYSDV) reduces melon (Cucumis melo L.) fruit quality and yield in many parts of the world. CYSDV and its vector, sweetpotato whitefly (MEAM1 cryptic species of Bemisia tabaci; SPWF) are a devastating combination in the Sonoran Desert areas of California and A...

Bifurcations of 2-Periodic Nonautonomous Stunted Tent Systems

NASA Astrophysics Data System (ADS)

Silva, L.; Rocha, J. Leonel; Silva, M. T.

2017-06-01

In this paper, we will consider a family of 2-periodic nonautonomous dynamical systems, generated by the alternate iteration of two stunted tent maps and study its bifurcation skeleton. We will describe the bifurcation phenomena along and around the bones accomplished with the combinatorial data furnished by the respective symbolic dynamics.

THE RETURNS OF FAMILY PLANNING: MACRO-LEVEL ASSESSMENT OF THE EFFECT OF CONTRACEPTIVE USE ON WOMEN'S ANAEMIA AND CHILDHOOD UNDERNUTRITION.

PubMed

Rana, Md Juel; Goli, Srinivas

2017-11-01

This study investigated the effect of family planning on the levels of women's anaemia and child undernutrition at the aggregate level using the compiled databases of the World Bank, UNICEF and the Economist Intelligence Unit. Correlation scatter matrix plots and multivariate OLS regression models were employed to assess the effect of family planning on women's anaemia and child nutritional status across countries. At the aggregate level, the bivariate correlation estimates found that the Contraceptive Prevalence Rate (CPR) was negatively associated with women's anaemia (r=-0.62, p<0.01), child underweight (r=-0.57, p<0.01) and child stunting (r=-0.63, p<0.01). The results of the OLS regression showed that the independent effect of CPR on women's anaemia (β=-0.35, p<0.01), child underweight (β=-0.13, p<0.01) and child stunting (β=-0.18, p<0.05) was negative, even after controlling for child marriage, female literacy, per capita GDP, poverty ratio, health expenditure and food security. The synthesis of these findings with the existing literature based on micro-data suggests pathways through which family planning influences the nutritional status of women and children. Family planning helps in avoiding shorter birth intervals, unintended pregnancy and unsafe abortion, which would otherwise result in nutrient depletion among mothers and further increase the risk of undernutrition in their children.

The Efficacy of Bacillus thuringiensis spp. galleriae Against Rice Water Weevil (Coleoptera: Curculionidae) for Integrated Pest Management in California Rice.

PubMed

Aghaee, Mohammad-Amir; Godfrey, Larry D

2015-02-01

Rice water weevil (Lissorhoptrus oryzophilus Kushel) is the most damaging insect pest of rice in the United States. Larval feeding on the roots stunt growth and reduce yield. Current pest management against the weevil in California relies heavily on pyrethroids that can be damaging to aquatic food webs. Examination of an environmentally friendly alternative biopesticide based on Bacillus thuringiensis spp. galleriae chemistry against rice water weevil larvae showed moderate levels of activity in pilot studies. We further examined the performance of different formulations of Bt.galleriae against the leading insecticide used in California rice, λ-cyhalothrin. The granular formulation performed as well as the λ-cyhalothrin in use in California in some of our greenhouse and field studies. This is the first reported use of B. thuringiensis spp. galleriae against rice water weevil. © The Authors 2015. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Growth and nutritional status of preschool children in India: a study of two recent time periods.

PubMed

Sen, Pronab; Bharati, Susmita; Som, Suparna; Pal, Manoranjan; Bharati, Premananda

2011-06-01

Preschool children call for focused attention in India because India has the highest percentage of undernourished children in the world. To compare the growth and nutritional status of Indian preschool children for the periods 1998/99 and 2005/06, Using data on weight and length/height as well as the sociodemographic background of preschool children from the National Family Health Surveys (NFHS) from 1998/99 and 2005/06, we determined the distribution of weight and length/height and their association with sociodemographic variables. The distributions of weight and length/height around the mean remained remarkably stable over age but were much greater in India than the international norms. The rates of growth of mean weight and length/ height were far lower in India than the international norms up to the age of 2 years. The temporal trend indicates declines in the percentages of undernourished (low weight-for-age) and stunted (low height-for-age) children over the 7-year period, although the degree of improvement was far better for stunting than for underweight. Mother's educational status is the only variable that has been found to influence child nutrition. The level of mothers' education needs urgent attention with top priority to reduce the prevalence of underweight and stunting of children. This also implies that, for future benefit, girls should be given more facilities for better education. Breastfeeding and weaning practices also need special attention.

Trends in adiposity in Brazilian 7-10-year-old schoolchildren: evidence for increasing overweight but not obesity between 2002 and 2007.

PubMed

Leal, Danielle Biazzi; de Assis, Maria Alice Altenburg; González-Chica, David Alejandro; da Costa, Filipe Ferreira

2014-01-01

The negative health consequences of childhood overweight/obesity (OW/OB) are well known. Therefore, an accurate monitoring of the OW/OB prevalence is essential. Anthropometry is the most practical and cost-effective method for nutritional status evaluation. To describe trends in the nutritional status among 7-10-year-old children by investigating changes in the prevalence of stunting, thinness, overweight, obesity, risk and excess abdominal adiposity, and to study changes in height-for-age, body mass index (BMI) and waist circumference (WC). A school-based sample of 7-10-year-old children participated in two cross-sectional studies in 2002 (n = 2936) and 2007 (n = 1232) in Florianopolis, southern Brazil. Prevalence of stunting, risk and excess abdominal adiposity and changes in the distribution of height-for-age, BMI-for-age, WC-for-age z-scores were evaluated. Three BMI-based references were used to define the prevalence of thinness, overweight and obesity. Between 2002-2007, the prevalence of stunting, thinness, obesity and excess abdominal adiposity remained stable, whereas overweight (including obesity) increased 10-23% in boys and 18-21% in girls, depending on the BMI reference used. The risk of abdominal adiposity increased in boys, but not in girls. No significant change was observed in mean height, BMI, WC-for-age z-scores. This study identified a potential levelling off in the prevalence of obesity and excess abdominal adiposity, but a continuing increase in the prevalence of overweight.

Global burden of maternal and child undernutrition and micronutrient deficiencies.

PubMed

Ahmed, Tahmeed; Hossain, Muttaquina; Sanin, Kazi Istiaque

2012-01-01

Maternal and child undernutrition and micronutrient deficiencies affect approximately half of the world's population. These conditions include intrauterine growth restriction (IUGR), low birth weight, protein-energy malnutrition, chronic energy deficit of women, and micronutrient deficiencies. Although the rates of stunting or chronic protein-energy malnutrition are increasing in Africa, the absolute numbers of stunted children are much higher in Asia. The four common micronutrient deficiencies include those of iron, iodine, vitamin A, and zinc. All these conditions are responsible directly or indirectly for more than 50% of all under-5 deaths globally. According to more recent estimates, IUGR, stunting and severe wasting are responsible for one third of under-5 mortality. About 12% of deaths among under-5 children are attributed to the deficiency of the four common micronutrients. Despite tremendous progress in different disciplines and unprecedented improvement with many health indicators, persistently high undernutrition rates are a shame to the society. Human development is not possible without taking care to control undernutrition and micronutrient deficiencies. Poverty, food insecurity, ignorance, lack of appropriate infant and young child feeding practices, heavy burden of infectious illnesses, and poor hygiene and sanitation are factors responsible for the high levels of maternal and child undernutrition in developing countries. These factors can be controlled or removed by scaling up direct nutrition interventions and eliminating the root conditions including female illiteracy, lack of livelihoods, lack of women's empowerment, and poor hygiene and sanitation. Copyright © 2013 S. Karger AG, Basel.

Trends of child undernutrition in rural Ecuadorian communities with differential access to roads, 2004-2013.

PubMed

Lopez, Velma K; Dombecki, Carolyn; Trostle, James; Mogrovejo, Patricia; Castro Morillo, Nancy; Cevallos, William; Goldstick, Jason; Jones, Andrew D; Eisenberg, Joseph N S

2018-02-07

Road access can influence protective and risk factors associated with nutrition by affecting various social and biological processes. In northern coastal Ecuador, the construction of new roads created a remoteness gradient among villages, providing a unique opportunity to examine the impact of roads on child nutritional outcomes 10 years after the road was built. Anthropometric and haemoglobin measurements were collected from 2,350 children <5 years in Esmeraldas, Ecuador, from 2004 to 2013 across 28 villages with differing road access. Logistic generalized estimating equation models assessed the longitudinal association between village remoteness and prevalence of stunting, wasting, underweight, overweight, obesity, and anaemia. We examined the influence of socio-economic characteristics on the pathway between remoteness and nutrition by comparing model results with and without household-level socio-economic covariates. Remoteness was associated with stunting (OR = 0.43, 95% CI [0.30, 0.63]) and anaemia (OR = 0.56, 95% CI [0.44, 0.70]). Over time, the prevalence of stunting was generally decreasing but remained higher in villages closer to the road compared to those farther away. Obesity increased (0.5% to 3%) over time; wasting was high (6%) but stable during the study period. Wealth and education partially explained the better nutritional outcomes in remote vs. road villages more than a decade after some communities gained road access. Establishing the extent to which these patterns persist requires additional years of observation. © 2018 John Wiley & Sons Ltd.

Understanding the double burden of malnutrition in food insecure households in Brazil.

PubMed

Gubert, Muriel Bauermann; Spaniol, Ana Maria; Segall-Corrêa, Ana Maria; Pérez-Escamilla, Rafael

2017-07-01

Household food insecurity (HFI) has been associated with both obesity among mothers and undernutrition among children. However, this association has not been well investigated in mother/child pairs living in the same household. The objective of this study was to examine the relationship of coexistence of maternal overweight and child stunting with HFI in Brazil. We conducted secondary data analyses of the 2006 Brazilian National Demographic and Health Survey. We analyzed the nutritional status of 4299 pairs of 15-49-year-olds mothers and their children under 5 years of age. The double burden of malnutrition (DBM) was defined as the presence of an overweight mother and a stunted child in the same household. HFI was measured with the Brazilian HFI Measurement Scale. The association between DBM and HFI was examined with hierarchical multivariable logistic regression analyses. Severe HFI was associated with DBM after adjusting for macroeconomic and household level socio-economic and demographic variables (Adjusted OR: 2.65 - CI: 1.17-8.53). Findings suggest that policies and programmes targeting HFI are needed to prevent the coexistence of child chronic undernutrition and maternal overweight/obesity in the same household. These investments are likely to be highly cost-effective as stunting has been identified as one of the major risk factors for poor child development and adult overweight/obesity and a strong risk factor for the development of costly chronic diseases including type 2 diabetes and cardiovascular disease. © 2016 John Wiley & Sons Ltd.

Hypothyroidism with scholastic excellence

PubMed Central

Salini, S.; Ramesh, Shanthi; Ramesh, Jagdeep; Vijayasekaran, D.

2015-01-01

A 9-year-old boy had presented with not gaining adequate height with complaints of constipation from 5 years, lethargy and loss of appetite from past 6 months. He was diagnosed to have hypothyroidism with high thyroid antibody levels. Though he was stunted his neurocognition and scholastic performance was excellent as evidenced by his school rank cards. His physical symptoms had improved after thyroxin supplement PMID:26015757

A job analysis of community health workers in the context of integrated nutrition and early child development.

PubMed

Phuka, John; Maleta, Kenneth; Thomas, Mavuto; Gladstone, Melisa

2014-01-01

Stunting and poor child development are major public health concerns in Malawi. Integrated nutrition and early child development (ECD) interventions have shown potential to reduce stunting, but it is not known how these integrated approaches can be implemented in Malawi. In this paper, we aimed to evaluate the current jobs status of community health workers and their potential to implement integrated approaches. This was accomplished by a desk review of nutrition and ECD policy documents, as well as interviews with key informants, community health workers, and community members. We found that Malawi has comprehensive policies and well-outlined coordination structures for nutrition and ECD that advocate for integrated approaches. Strong multidisciplinary interaction exists at central levels but not at the community level. Integration of community health workers from different sectors is limited by workload, logistics, and a lack of synchronized work schedules. Favorable, sound policies and well-outlined coordination structures alone are not enough for the establishment of integrated nutrition and ECD activities. Balanced bureaucratic structures, improved task allocation, and synchronization of work schedules across all relevant sectors are needed for integrated intervention in Malawi. © 2014 New York Academy of Sciences.

In Vitro Synthesized RNA Generated from cDNA Clones of Both Genomic Components of Cucurbit yellow stunting disorder virus Replicates in Cucumber Protoplasts

PubMed Central

Owen, Carolyn A.; Moukarzel, Romy; Huang, Xiao; Kassem, Mona A.; Eliasco, Eleonora; Aranda, Miguel A.; Coutts, Robert H. A.; Livieratos, Ioannis C.

2016-01-01

Cucurbit yellow stunting disorder virus (CYSDV), a bipartite whitefly-transmitted virus, constitutes a major threat to commercial cucurbit production worldwide. Here, construction of full-length CYSDV RNA1 and RNA2 cDNA clones allowed the in vitro synthesis of RNA transcripts able to replicate in cucumber protoplasts. CYSDV RNA1 proved competent for replication; transcription of both polarities of the genomic RNA was detectable 24 h post inoculation. Hybridization of total RNA extracted from transfected protoplasts or from naturally CYSDV-infected cucurbits revealed high-level transcription of the p22 subgenomic RNA species. Replication of CYSDV RNA2 following co-transfection with RNA1 was also observed, with similar transcription kinetics. A CYSDV RNA2 cDNA clone (T3CM8Δ) comprising the 5′- and 3′-UTRs plus the 3′-terminal gene, generated a 2.8 kb RNA able to replicate to high levels in protoplasts in the presence of CYSDV RNA1. The clone T3CM8Δ will facilitate reverse genetics studies of CYSDV gene function and RNA replication determinants. PMID:27314380

A comparative study of three detection techniques for Leifsonia xyli subsp. xyli, the causal pathogen of sugarcane ratoon stunting disease

USDA-ARS?s Scientific Manuscript database

Ratoon stunting disease (RSD), which is caused by the bacterium Leifsonia xyli subsp. xyli (Lxx), is now recognized worldwide as the most economically devastating disease impacting sugarcane. RSD causes significant yield losses and variety degradation. Diagnosis of RSD is challenging because it does...

Stunted patches in onion bulb crops in Oregon and Washington: Etiology and yield loss

USDA-ARS?s Scientific Manuscript database

Onion stunting caused by Rhizoctonia spp. is an important soilborne disease in the Columbia Basin of Oregon and Washington. From 2010 to 2013, 251 isolates of Rhizoctonia or Rhizoctonia-like spp. were obtained from soil and onion plant samples collected from Oregon and Washington. Sequence analysis ...

Effect of deep vs. shallow tillage on onion stunting and onion bulb yield, 2012

USDA-ARS?s Scientific Manuscript database

A field experiment was conducted at a site inoculated with R. solani AG 8 at the Oregon State University Hermiston Agricultural Research and Extension Center in Hermiston, OR to determine the effect of plowing (deep tillage) vs. rototilling (shallow tillage) on onion stunting caused by R. solani AG ...

Stunting of southern pine seedlings by a needle nematode (Longidorus sp.)

Treesearch

M.M. Cram; S.W. Fraedrich; J. Fields

2003-01-01

An undescribed needle nematode (Longidorus sp.) was consistently associated with stunted loblolly pine seedlings at the Flint River Nursery in south Georgia. Seedlings in affected areas had root systems that were greatly reduced in size, and lacked lateral and fine roots. In a growth chamber experiment, the needle nematode significantly reduced the...

Characterization of a new tymovirus causing stunting and chlorotic mosaic in naranjilla (Solanum quitoense)

USDA-ARS?s Scientific Manuscript database

Naranjilla (“little orange”), also known as lulo (Solanum quitoense Lam.), is a perennial shrub species cultivated in the Andes for fresh fruit and juice production. In 2015, a naranjilla plant exhibiting stunting, mosaic, and chlorotic spots was sampled in the Pastaza province of Ecuador and mainta...

Decreasing stunting, anemia, and vitamin A deficiency in Peru: results of the Good Start in Life Program.

PubMed

Lechtig, Aarón; Cornale, Guido; Ugaz, María Elena; Arias, Lena

2009-03-01

The rates of stunting, iron-deficiency anemia, and vitamin A deficiency in Peru are among the highest in South America. There is little scaled-up experience on how to solve these problems countrywide. To evaluate the Good Start in Life Program during the period from 2000 to 2004. Data on weight, height, hemoglobin, serum retinol, urinary iodine, and age were obtained from children under 3 years of age during two transverse surveys in 2000 and 2004. In 2004, the program covered 75,000 children, 35,000 mothers, and 1 million inhabitants from 223 poor communities. The rate of stunting decreased from 54.1% to 36.9%, the rate of iron-deficiency anemia decreased from 76.0% to 52.3%, and the rate of vitamin A deficiency decreased from 30.4% to 5.3% (p < .01). The annual cost per child was US$116.50. Adaptations of this participative program could contribute to decreased stunting, iron-deficiency anemia, and vitamin A deficiency at the national scale in Peru and many other countries.

Social determinants of malnutrition among Serbian children aged <5 years: ethnic and regional disparities.

PubMed

Brcanski, Jelena; Jović-Vraneš, Aleksandra; Marinković, Jelena; Favre, Dragana

2014-10-01

To assess the association between growth indicators of Serbian children aged <5 years of Roma and non-Roma populations and social determinants of health. This study used a cross-sectional secondary data analysis design to measure national and Roma population samples from the MICS 4 (UNICEF) performed in 2010 in Serbia. A total of 4,978 questionnaires were observed with children aged <5 years. Logistic regression analysis was performed to identify association between social determinants of health and growth indicators. Roma children were more than three times more likely to exhibit stunted and/or severely stunted than non-Roma children from the lowest wealth quintile. Non-Roma children residing outside of the Belgrade region had a lower risk of stunted compared to children residing within the Belgrade region, while the risk of stunted among Roma children was nearly twofold greater than those residing in southern and eastern Serbia than in the Belgrade region. Our findings clarified the necessity to establish ethnically and regionally sensitive programs to solve the malnutrition problems.

[Poverty and indigenous origin as risk factors of nutritional problems among children who enroll in school].

PubMed

Bustos, Patricia; Muñoz, Sergio; Vargas, Claudio; Amigo, Hugo

2009-01-01

To estimate the effect of indigenous ancestry and poverty on nutritional outcomes in Chilean schoolchildren. We used the national database of children entering to the public educational system in 1997-2004. This includes anthropometric assessment, socioeconomic status and parental surnames, used to derive the ethnic origin. Logistic regression models related poverty and ethnicity on stunting and obesity were done, controlling for sex, age and calendar year. Data convey 1,580,103 children being 7.4% indigenous; 2.9% had stunting and around 16.0% were obese. Stratifying by poverty, it was shown that the poorest had higher risk of stunting both in indigenous (OR= 2.30; CI95%=2.27-2.33) and non indigenous (OR= 2.29; CI95%= 2.28-2.30). Conversely, poverty was a 'protective factor' for obesity (OR= 0.63; CI95%= 0.62-0.64). Indigenous origin showed a significant OR slightly over the null. In Chilean children, poverty is a risk factor for stunting but still protects from obesity, independent of indigenous origin.

Life after eruption VII: A search for stunted outbursts in thirteen post-novae

NASA Astrophysics Data System (ADS)

Vogt, N.; Tappert, C.; Puebla, E. C.; Fuentes-Morales, I.; Ederoclite, A.; Schmidtobreick, L.

2018-06-01

The results of a photometric campaign during three observing seasons 2013 - 2016 at the Cerro Tololo International Observatory (1.3-meter SMARTS telescope) are presented. The aim was to detect "stunted" outbursts in a total of 13 post novae more than 38 years after maximum brightness registered in their nova eruption light curve. In six of the targets (V728 Sco 1862, V1059 Sgr 1898, V849 Oph 1919, V363 Sgr 1927, HS Pup 1963 and V2572 Sgr 1969) we detected such dwarf nova-like mini-outbursts, with mean amplitudes between 0.2m and 2.2m and typical FWHM of 4-11 days, repeating every 9-32 days. The most regular outburst behavior is present in the eclipsing post-nova V728 Sco. In our sample there is no significant correlation between the occurrences of stunted outbursts and the time passed since the nova eruption maximum. However, considering all 15 post-novae that have been reported to show stunted outbursts we found a possible tendency for increasing outburst amplitudes at the rate 0.52 ± 0.23 mag/century during 30 - 250 years after nova eruption. This tendency is still doubtful due to the low number of cases available. If the stunted outburst activity is related to the mass transfer rate \\dot{M}, we conclude that the secular decrease of \\dot{M} predicted by the hibernation scenario must be at much longer time scales than ˜200 years actually covered with post-nova observations.

Prevalence of stunting and its associated factors among children 6-59 months of age in Libo-Kemekem district, Northwest Ethiopia; A community based cross sectional study.

PubMed

Geberselassie, Selamawit Bekele; Abebe, Solomon Mekonnen; Melsew, Yayehirad Alemu; Mutuku, Shadrack Mulinge; Wassie, Molla Mesele

2018-01-01

Children in developing countries are highly vulnerable to impaired physical growth because of poor dietary intake, lack of appropriate care, and repeated infections. This study aimed at assessing the prevalence of stunting and associated factors among children 6-59 months of age in Libo-kemekem district, northwest Ethiopia. A community based cross sectional study was conducted in Libo-Kemekem from October 15 to December 15, 2015. The multistage sampling technique was employed to select 1,320 children aged 6-59months. Data were collected by trained community health extension workers under regular supervision. Data were entered into EPI-Info version 3.5.1, and height for age was converted to Z-score with ENA-SMART software. Data were then exported to SPSS version 20 for descriptive and binary logistic regression analysees. The significance of associations was determined at p<0.05. Out of 1287 children included in the analysis, 49.4% (95% CI: 46.7%-52.3%) were found to be stunted. In the multivariate analysis, increased child age [AOR = 6.31, 95%CI: (3.65, 10.91)], family size of six and above [AOR = 1.77, 95%CI: (1.35, 2.32)] were positively associated with stunting, while, fathers with secondary school education [AOR = 0.50, 95%CI: (0.30, 0.81)], farmers as household heads [AOR = 0.56, 95%CI: (0.38, 0.84)] and self-employed parents as household head [AOR = 0.45, 95% CI: (0.28, 0.72)] were found to be preventive factors. The prevalence of stunting was high in the study area. We found that stunting was significantly correlated with child age, occupational status of household head, family size, and fathers' education. Therefore, intervention focusing on supporting housewives, family planning, and education on child feeding and nutrition should be implemented.

Undernutrition among children under 5 years of age in Yemen: Role of adequate childcare provided by adults under conditions of food insecurity

PubMed Central

Al-Sobaihi, Saber; Nakamura, Keiko; Kizuki, Masashi

2016-01-01

Objective: This study examined the associations between the adequacy of childcare provided by adult caretakers and childhood undernutrition in rural Yemen, independent of household wealth and food consumption. Methods: We analyzed data of 3,549 children under the age of 5 years living in rural areas of Yemen based on the 2013 Yemen Baseline Survey of Mother and Child Health. Nutritional status was evaluated by the presence of underweight, stunting, and wasting according to the World Health Organization child growth standards. The impact of childcare including leaving children alone, putting older children into labor force, and the use of antenatal care while pregnant on child undernutrition was assessed and adjusted for food consumption by children, household composition, demographic and educational background of caretakers, and household wealth. Results: The prevalence of underweight, stunting, and wasting was 46.2%, 62.6%, and 11.1%, respectively. Not leaving children alone, keeping children out of the labor force, and use of antenatal care were associated with a lower risk of underweight (odds ratio [OR] = 0.84, P = 0.016; OR = 0.84, P = 0.036; and OR = 0.85, P = 0.042) and stunting (OR = 0.80, P = 0.004; OR = 0.82, P = 0.024; and OR = 0.78, P = 0.003). After further adjustment for food consumption, the associations between adequate childcare indicators and lower odds of stunting remained significant (OR = 0.73, P = 0.025; OR = 0.72, P = 0.046; and OR = 0.76, P = 0.038). Conclusions: A marked prevalence of stunting among rural children in Yemen was observed. Adequate childcare by adult caretakers in families is associated with a lower incidence of underweight and stunting among children under 5 years of age. Promoting adequate childcare by adult household members is a feasible option for reducing undernutrition among children in rural Yemen. PMID:27928456

Undernutrition among children under 5 years of age in Yemen: Role of adequate childcare provided by adults under conditions of food insecurity.

PubMed

Al-Sobaihi, Saber; Nakamura, Keiko; Kizuki, Masashi

2016-01-01

Objective: This study examined the associations between the adequacy of childcare provided by adult caretakers and childhood undernutrition in rural Yemen, independent of household wealth and food consumption. Methods: We analyzed data of 3,549 children under the age of 5 years living in rural areas of Yemen based on the 2013 Yemen Baseline Survey of Mother and Child Health. Nutritional status was evaluated by the presence of underweight, stunting, and wasting according to the World Health Organization child growth standards. The impact of childcare including leaving children alone, putting older children into labor force, and the use of antenatal care while pregnant on child undernutrition was assessed and adjusted for food consumption by children, household composition, demographic and educational background of caretakers, and household wealth. Results: The prevalence of underweight, stunting, and wasting was 46.2%, 62.6%, and 11.1%, respectively. Not leaving children alone, keeping children out of the labor force, and use of antenatal care were associated with a lower risk of underweight (odds ratio [OR] = 0.84, P = 0.016; OR = 0.84, P = 0.036; and OR = 0.85, P = 0.042) and stunting (OR = 0.80, P = 0.004; OR = 0.82, P = 0.024; and OR = 0.78, P = 0.003). After further adjustment for food consumption, the associations between adequate childcare indicators and lower odds of stunting remained significant (OR = 0.73, P = 0.025; OR = 0.72, P = 0.046; and OR = 0.76, P = 0.038). Conclusions: A marked prevalence of stunting among rural children in Yemen was observed. Adequate childcare by adult caretakers in families is associated with a lower incidence of underweight and stunting among children under 5 years of age. Promoting adequate childcare by adult household members is a feasible option for reducing undernutrition among children in rural Yemen.

Cost-effectiveness of prenatal food and micronutrient interventions on under-five mortality and stunting: Analysis of data from the MINIMat randomized trial, Bangladesh

PubMed Central

Selling, Katarina Ekholm; Shaheen, Rubina; Khan, Ashraful Islam; Persson, Lars-Åke; Lindholm, Lars

2018-01-01

Introduction Nutrition interventions may have favourable as well as unfavourable effects. The Maternal and Infant Nutrition Interventions in Matlab (MINIMat), with early prenatal food and micronutrient supplementation, reduced infant mortality and were reported to be very cost-effective. However, the multiple micronutrients (MMS) supplement was associated with an increased risk of stunted growth in infancy and early childhood. This unfavourable outcome was not included in the previous cost-effectiveness analysis. The aim of this study is to evaluate whether the MINIMat interventions remain cost-effective in view of both favourable (decreased under-five-years mortality) and unfavourable (increased stunting) outcomes. Method Pregnant women in rural Bangladesh, where food insecurity still is prevalent, were randomized to early (E) or usual (U) invitation to be given food supplementation and daily doses of 30 mg, or 60 mg iron with 400 μg of folic acid, or MMS with 15 micronutrients including 30 mg iron and 400 μg of folic acid. E reduced stunting at 4.5 years compared with U, MMS increased stunting at 4.5 years compared with Fe60, while the combination EMMS reduced infant mortality compared with UFe60. The outcome measure used was disability adjusted life years (DALYs), a measure of overall disease burden that combines years of life lost due to premature mortality (under five-year mortality) and years lived with disability (stunting). Incremental cost effectiveness ratios were calculated using cost data from already published studies. Results By incrementing UFe60 (standard practice) to EMMS, one DALY could be averted at a cost of US$24. Conclusion When both favourable and unfavourable outcomes were included in the analysis, early prenatal food and multiple micronutrient interventions remained highly cost effective and seem to be meaningful from a public health perspective. PMID:29447176

A dynamic model for predicting growth in zinc-deficient stunted infants given supplemental zinc.

PubMed

Wastney, Meryl E; McDonald, Christine M; King, Janet C

2018-05-01

Zinc deficiency limits infant growth and increases susceptibility to infections, which further compromises growth. Zinc supplementation improves the growth of zinc-deficient stunted infants, but the amount, frequency, and duration of zinc supplementation required to restore growth in an individual child is unknown. A dynamic model of zinc metabolism that predicts changes in weight and length of zinc-deficient, stunted infants with dietary zinc would be useful to define effective zinc supplementation regimens. The aims of this study were to develop a dynamic model for zinc metabolism in stunted, zinc-deficient infants and to use that model to predict the growth response when those infants are given zinc supplements. A model of zinc metabolism was developed using data on zinc kinetics, tissue zinc, and growth requirements for healthy 9-mo-old infants. The kinetic model was converted to a dynamic model by replacing the rate constants for zinc absorption and excretion with functions for these processes that change with zinc intake. Predictions of the dynamic model, parameterized for zinc-deficient, stunted infants, were compared with the results of 5 published zinc intervention trials. The model was then used to predict the results for zinc supplementation regimes that varied in the amount, frequency, and duration of zinc dosing. Model predictions agreed with published changes in plasma zinc after zinc supplementation. Predictions of weight and length agreed with 2 studies, but overpredicted values from a third study in which other nutrient deficiencies may have been growth limiting; the model predicted that zinc absorption was impaired in that study. The model suggests that frequent, smaller doses (5-10 mg Zn/d) are more effective for increasing growth in stunted, zinc-deficient 9-mo-old infants than are larger, less-frequent doses. The dose amount affects the duration of dosing necessary to restore and maintain plasma zinc concentration and growth.

Earlier introduction of aguitas is associated with higher risk of stunting in infants and toddlers in the Western Highlands of Guatemala.

PubMed

Doak, Colleen M; van der Starre, Robine E; van Beusekom, Ilse; Campos Ponce, Maiza; Vossenaar, Marieke; Solomons, Noel W

2013-03-01

In many cultures, simple herbal infusions, thin gruels, or sweetened water (agüitas in Guatemalan parlance) are given to infants and toddlers. Formative research has shown that the use of agüitas in early child feeding is deeply embedded in Guatemalan culture. We examined the prevalence and timing of the introduction of agüitas during early life in a low-income population of metropolitan Quetzaltenango in relation to stunting in children. Responses from 456 mothers of children aged 5-23 mo were analyzed by using logistic regression to explore relations between linear growth (stunting), diarrhea, and age at the first introduction of agüitas. A total of 358 of 456 infants (79%) were agüita users independent of sex or ethnicity. Of infants given agüitas, one-fourth of subjects were introduced to agüitas within the first 2.9 wk of age, and one-half of subjects were introduced to agüitas within the first 9 wk of age. Subjects introduced to agüitas before 2.9 wk of age were 1.8 times more likely to be stunted (95% CI: 1.1, 2.8; P = 0.03) irrespective of ethnicity. Children who had ever been given agüitas were twice as likely to have also had diarrhea (OR: 2.1; 95% CI: 1.3, 3.3) and more likely to have needed medical attention for diarrhea (OR: 2.1; 95% CI: 1.1, 4.2), but diarrheal experience was independent of stunting. Because of the early introduction of agüitas and the high prevalence of stunting in Guatemala, longitudinal studies are urgently needed to clarify the causal relations. This trial was registered at Nederlands Trial register as NTR3273 for 5-mo-olds and Nederlands Trial register as NTR3292 for infants ≥6 mo.

Cost-effectiveness of prenatal food and micronutrient interventions on under-five mortality and stunting: Analysis of data from the MINIMat randomized trial, Bangladesh.

PubMed

Svefors, Pernilla; Selling, Katarina Ekholm; Shaheen, Rubina; Khan, Ashraful Islam; Persson, Lars-Åke; Lindholm, Lars

2018-01-01

Nutrition interventions may have favourable as well as unfavourable effects. The Maternal and Infant Nutrition Interventions in Matlab (MINIMat), with early prenatal food and micronutrient supplementation, reduced infant mortality and were reported to be very cost-effective. However, the multiple micronutrients (MMS) supplement was associated with an increased risk of stunted growth in infancy and early childhood. This unfavourable outcome was not included in the previous cost-effectiveness analysis. The aim of this study is to evaluate whether the MINIMat interventions remain cost-effective in view of both favourable (decreased under-five-years mortality) and unfavourable (increased stunting) outcomes. Pregnant women in rural Bangladesh, where food insecurity still is prevalent, were randomized to early (E) or usual (U) invitation to be given food supplementation and daily doses of 30 mg, or 60 mg iron with 400 μg of folic acid, or MMS with 15 micronutrients including 30 mg iron and 400 μg of folic acid. E reduced stunting at 4.5 years compared with U, MMS increased stunting at 4.5 years compared with Fe60, while the combination EMMS reduced infant mortality compared with UFe60. The outcome measure used was disability adjusted life years (DALYs), a measure of overall disease burden that combines years of life lost due to premature mortality (under five-year mortality) and years lived with disability (stunting). Incremental cost effectiveness ratios were calculated using cost data from already published studies. By incrementing UFe60 (standard practice) to EMMS, one DALY could be averted at a cost of US$24. When both favourable and unfavourable outcomes were included in the analysis, early prenatal food and multiple micronutrient interventions remained highly cost effective and seem to be meaningful from a public health perspective.

Household food insecurity is associated with higher child undernutrition in Bangladesh, Ethiopia, and Vietnam, but the effect is not mediated by child dietary diversity.

PubMed

Ali, Disha; Saha, Kuntal K; Nguyen, Phuong H; Diressie, Michael T; Ruel, Marie T; Menon, Purnima; Rawat, Rahul

2013-12-01

Household food insecurity (HFI) is a recognized underlying determinant of child undernutrition, but evidence of associations between HFI and child undernutrition is mixed. The purpose of this study was to investigate if HFI is associated with undernutrition in children aged 6-59.9 mo in Bangladesh (n = 2356), Ethiopia (n = 3422), and Vietnam (n = 3075) and if child dietary diversity (DD) mediated this effect. We used baseline survey data from the Alive & Thrive project. Logistic regression, adjusting for potential confounding factors, was used to determine the magnitude and significance of the association of HFI with stunting, underweight, and wasting. The mediating effect of child DD was tested by using a Sobel-Goodman mediation test. The prevalences of HFI were 66%, 40%, and 32% in Ethiopia, Vietnam, and Bangladesh, respectively. The prevalences of stunting, underweight, and wasting were higher in Bangladesh (47.1%, 43.7%, and 19.1%, respectively) and Ethiopia (50.7%, 27.5%, and 5.9%, respectively) than in Vietnam (20.7%, 15.8%, and 5%, respectively). In the adjusted models, the odds of being stunted or underweight were significantly higher for children in severely food-insecure households in Bangladesh (stunting OR: 1.36; 95% CI: 1.05, 1.76; underweight OR: 1.28; 95% CI: 0.99, 1.65) and Ethiopia (stunting OR: 1.48; 95% CI: 1.09, 2.00; underweight OR: 1.68; 95% CI: 1.22, 2.30) and in moderately food-insecure households in Vietnam (stunting OR: 1.39; 95% CI: 1.16, 1.65; underweight OR: 1.69; 95% CI: 1.28, 2.23). HFI was significantly associated with wasting in Bangladesh where close to 1 in 5 children demonstrated wasting. Child DD did not mediate the relation between HFI and undernutrition in any of the countries. Further research is recommended to investigate potential mediators in this pathway.

Looking upstream: enhancers of child nutritional status in post-flood rural settings.

PubMed

Rodriguez-Llanes, Jose Manuel; Ranjan-Dash, Shishir; Mukhopadhyay, Alok; Guha-Sapir, Debarati

2016-01-01

Background. Child undernutrition and flooding are highly prevalent public health issues in many developing countries, yet we have little understanding of preventive strategies for effective coping in these circumstances. Education has been recently highlighted as key to reduce the societal impacts of extreme weather events under climate change, but there is a lack of studies assessing to what extent parental education may prevent post-flood child undernutrition. Methods and Materials. One year after large floods in 2008, we conducted a two-stage cluster population-based survey of 6-59 months children inhabiting flooded and non-flooded communities of Jagatsinghpur district, Odisha (India), and collected anthropometric measurements on children along with child, parental and household level variables through face-to-face interviews. Using multivariate logistic regression models, we examined separately the effect of maternal and paternal education and other risk factors (mainly income, socio-demographic, and child and mother variables) on stunting and wasting in children from households inhabiting recurrently flooded communities (2006 and 2008; n = 299). As a comparison, separate analyses on children in non-flooded communities were carried out (n = 385). All analyses were adjusted by income as additional robustness check. Results. Overall, fathers with at least completed middle education (up to 14 years of age and compulsory in India) had an advantage in protecting their children from child wasting and stunting. For child stunting, the clearest result was a 100-200% lower prevalence associated with at least paternal secondary schooling (compared to no schooling) in flooded-areas. Again, only in flooded communities, an increase in per capita annual household income of 1,000 rupees was associated to a 4.7-4.9% lower prevalence of child stunting. For child wasting in flooded areas, delayed motherhood was associated to better nutritional outcomes (3.4% lower prevalence per year). In flooded communities, households dedicated to activities other than agriculture, a 50-51% lower prevalence of child wasting was estimated, suggesting farmers and fishermen as the most vulnerable livelihoods under flooding. In flooded areas, lower rank castes were at higher odds of both child wasting and stunting. Conclusions. In the short-term, protracted nutritional response in the aftermath of floods should be urgently implemented and target agricultural livelihoods and low-rank castes. Education promotion and schooling up to 14 years should have positive impacts on improving children nutritional health in the long run, especially under flooding. Policies effectively helping sustainable livelihood economic development and delayed motherhood are also recommended.

Mineral- and vitamin-enhanced micronutrient powder reduces stunting in full-term low-birth-weight infants receiving nutrition, health, and hygiene education: a 2 × 2 factorial, cluster-randomized trial in Bangladesh.

PubMed

Shafique, Sohana; Sellen, Daniel W; Lou, Wendy; Jalal, Chowdhury S; Jolly, Saira P; Zlotkin, Stanley H

2016-05-01

The causes of stunting are complex but likely include prenatal effects, inadequate postnatal nutrient intake, and recurrent infections. Low-birth-weight (LBW) infants are at high risk of stunting. More than 25% of live births in low- and middle-income countries are at full term with low birth weight (FT-LBW). Evidence on the efficacy of specific interventions to enhance growth in this vulnerable group remains scant. We investigated the independent and combined effects of a directed use of a water-based hand sanitizer (HS) and a mineral- and vitamin-enhanced micronutrient powder (MNP) (22 minerals and vitamins) to prevent infections and improve nutrient intake to reduce stunting in FT-LBW infants. The study was a prospective 2 × 2 factorial, cluster-randomized trial in 467 FT-LBW infants during 2 periods: from 0 to 5 mo postpartum (0-180 d postpartum) and from 6 to 12 mo postpartum (181-360 d postpartum) with the use of 48 clusters. All groups received the same general nutrition, health, and hygiene education (NHHE) at enrollment and throughout the 12 mo. Group assignments initially included the following 2 groups: no HS (control) group or HS from 0 to 5 mo postpartum. These assignments were followed by further divisions into the following 4 groups from 6 to 12 mo postpartum: 1) no HS and no MNP (control), 2) HS only, 3) MNP only, and 4) HS and MNP. When delivered in combination with NHHE, the use of an HS showed no additional benefit in reducing indicators of infection in the first or second half of infancy or the likelihood of stunting at 12 mo postpartum. FT-LBW infants who received the MNP (with or without the HS) were significantly less likely to be stunted at 12 mo than were controls (OR: 0.35; 95% CI: 0.15, 0.84; P = 0.017). The use of a mineral- and vitamin-enhanced MNP significantly reduced stunting in FT-LBW infants in this high-risk setting. The use of a water-based HS did not have an additive effect. This trial was registered at clinicaltrials.gov as NCT01455636. © 2016 American Society for Nutrition.

Baseline evaluation of nutritional status and government feeding programs in Chiclayo, Peru.

PubMed

Gross, Rainer; Lechtig, Aarón; López de Romaña, Daniel

2006-01-01

Because of the rapid growth of the urban population in Peru, food and nutrition insecurity will occur increasingly in this population. For appropriate policy setting and programming, the food and nutrition situation of the urban poor requires better understanding. To gain information about the nature, magnitude, severity, and causes of the nutritional problems of the population in low-income areas of the city of Chiclayo, Peru. A cross-sectional nutrition survey was conducted in 1,604 households, covering children under 5 years of age and their parents. The prevalence rates of stunting, wasting, overweight. and anemia in children were 15.4%, 1.3%, 4.6%, and 65.7%, respectively; one third of adults were overweight, and one tenth were obese; 2.1% of the mothers were underweight; and 34.3% of mothers and 12.2% of fathers had anemia. Governmental feeding programs did not address these problems adequately. Interventions must have adequate targeting; address appropriate responses at the household, community, and national levels; and reduce stunting, obesity, and iron-deficiency anemia.

Macro- and microlevel processes affect food choice and nutritional status in the republic of the marshall islands.

PubMed

Gittelsohn, Joel; Haberle, Heather; Vastine, Amy E; Dyckman, William; Palafox, Neal A

2003-01-01

Despite its relative isolation from the world stage and lack of resources, the Marshall Islands serve as an example of the interaction between global political power, macroeconomic forces and local cultural factors. At the national level, patterns of food importation and government programs encourage the consumption of high fat foods. These factors have fostered dependency on Western foods and a loss of traditional food practices. Beliefs come into play as microlevel factors that influence food choice and aspects of lifestyle. Nearly three quarters of women are overweight or obese in this setting. Obesity in women is associated with greater age, higher education and more imported food consumption. Over a third of children ages 1-5 y are stunted, with stunting associated with worse economic status, less active feeding, increased consumption of imported foods and urban residence. What can be done at the microlevel is constrained by macrolevel factors of disempowerment. In this way, issues of power and belief are played out in the bodies of individuals.

Child growth in urban deprived settings: Does household poverty status matter? At which stage of child development?

PubMed Central

Fotso, Jean Christophe; Madise, Nyovani; Baschieri, Angela; Cleland, John; Zulu, Eliya; Kavao Mutua, Martin; Essendi, Hildah

2012-01-01

This paper uses longitudinal data from two informal settlements of Nairobi, Kenya to examine patterns of child growth and how these are affected by four different dimensions of poverty at the household level namely, expenditures poverty, assets poverty, food poverty, and subjective poverty. The descriptive results show a grim picture, with the prevalence of overall stunting reaching nearly 60% in the age group 15–17 months and remaining almost constant thereafter. There is a strong association between food poverty and stunting among children aged 6–11 months (p<0.01), while assets poverty and subjective poverty have stronger relationships (p<0.01) with undernutrition at older age (24 months or older for assets poverty, and 12 months or older for subjective poverty). The effect of expenditures poverty does not reach statistical significant in any age group. These findings shed light on the degree of vulnerability of urban poor infants and children and on the influences of various aspects of poverty measures. PMID:22221652

PHYSICAL EDUCATION ACTIVITIES FOR THE ELEMENTARY SCHOOL.

ERIC Educational Resources Information Center

SMALLEY, JEANNETTE

PHYSICAL EDUCATION ACTIVITIES FOR USE IN GRADES ONE THROUGH SIX ARE ENUMERATED AND DESCRIBED IN THIS MANUAL. UNITS OF THE MANUAL WHICH ARE CONCERNED WITH SIDEWALK GAMES, SCHOOLROOM GAMES, BALL GAMES FOR GRADES ONE AND TWO, STUNTS AND STUNT GAMES, AND GAMES OF LOW ORGANIZATION ARE PRESENTED IN A FORMAT WHICH CONSISTS OF (1) A LISTING OF CRITERIA BY…

Common beans and cowpeas as complementary foods to reduce environmental enteric dysfunction and stunting in Malawian children: Study protocol for two randomized controlled trials

USDA-ARS?s Scientific Manuscript database

Interventions to decrease the burden of childhood malnutrition are urgently needed, as millions of children die annually owing to undernutrition and hundreds of millions more are left cognitively and physically stunted. Environmental enteric dysfunction (EED), a pervasive chronic subclinical inflamm...

Evaluation of Onion Genotypes for Resistance to Stunting Caused by Rhizoctonia solani AG 8

USDA-ARS?s Scientific Manuscript database

A total of 35 onion genotypes was evaluated for resistance to onion stunting caused by Rhizoctonia solani anastomosis group 8 (AG-8) under temperature-controlled greenhouse conditions (15 ± 1oC) in 2013. Each onion genotype was planted in a cone-tainer with and without inoculation with R. solani AG ...

Timing of glyphosate applications to wheat cover crops to reduce onion stunting caused by Rhizoctonia solani

USDA-ARS?s Scientific Manuscript database

Stunting caused by Rhizoctonia spp. is economically important in irrigated onion bulb crops in the semi-arid Columbia Basin of Oregon and Washington, where cereal winter cover crops commonly are planted the previous fall to prevent wind erosion of soil. The cover crop is killed with herbicide applic...

Epidemiology of Cucurbit yellow stunting disorder virus in the US Southwest and development of virus resistant melon

USDA-ARS?s Scientific Manuscript database

Cucurbit yellow stunting disorder virus (CYSDV), emerged in the Southwest USA in 2006, where it is transmitted by the MEAM1 cryptic species of Bemisia tabaci. The virus results in late-season infection of spring melon crops with limited economic impact; however, all summer and fall cucurbits become ...

The effect of fallow on Longidorus americanus, a nematode associated with stunting of loblolly pine seedlings in Georgia, USA

Treesearch

Stephen W. Fraedrich; Michelle M. Cram; Stanley J. Zarnoch

2005-01-01

Stunting of loblolly pine (Pinue taeda L.) seedlings, caused by Longidorus americanus, has been a problem at a Georgia (USA) nursery. Field and growth chamber studies were conducted to determine the survivability of the nematode in a fallow nursery soil. The population density of L. americanus decreased rapidly...

Rapid differentiation of citrus Hop stunt viroid variants by use of real-time RT-PCR and high resolution melting analysis

USDA-ARS?s Scientific Manuscript database

The RNA genome of Hop stunt viroid (HSVd) contains five to six nucleotides in a variable (V) domain, called the cachexia expression motif, which is associated with pathogenic and non-pathogenic variants in citrus. Current methods to differentiate HSVd variants rely on lengthy greenhouse biological i...

The Association of a Longidorus Species with Stunting and Root Damage of Loblolly Pine (Pinus taeda L.) Seedlings

Treesearch

Stephen W. Fraedrich; Michelle M. Cram

2002-01-01

A Longidorus species was consistently associated with patches of stunted and chlorotic loblolly pine seedlings at a forest-tree nursery in Georgia. Seedlings from affected areas had poorly developed root systems that lacked lateral and feeder roots. Longidorus population densities in composite soil samples from the margins of...

A systematic review of sub-national food insecurity research in South Africa: Missed opportunities for policy insights.

PubMed

Misselhorn, Alison; Hendriks, Sheryl L

2017-01-01

Food insecurity is an intractable problem in South Africa. The country has a tradition of evidence-based decision making, grounded in the findings of national surveys. However, the rich insights from sub-national surveys remain a largely untapped resource for understandings of the contextual experience of food insecurity. A web-based search identified 169 sub-national food insecurity studies conducted in the post-apartheid period between 1994 and 2014. The systematic review found that the studies used 27 different measures of food insecurity, confounding the comparative analysis of food insecurity at this level. While social grants have brought a measure of poverty relief at household level, unaffordable diets were the root cause of food insecurity. The increasing consumption of cheaper, more available and preferred 'globalised' foods with high energy content and low nutritional value lead to overweight and obesity alongside child stunting. Unless a comparable set of indicators is used in such surveys, they are not able to provide comparable information on the scope and scale of the problem. Policy makers should be engaging with researchers to learn from these studies, while researchers need to share this wealth of sub-national study findings with government to strengthen food security planning, monitoring, and evaluation at all levels.

A systematic review of sub-national food insecurity research in South Africa: Missed opportunities for policy insights

PubMed Central

Misselhorn, Alison

2017-01-01

Food insecurity is an intractable problem in South Africa. The country has a tradition of evidence-based decision making, grounded in the findings of national surveys. However, the rich insights from sub-national surveys remain a largely untapped resource for understandings of the contextual experience of food insecurity. A web-based search identified 169 sub-national food insecurity studies conducted in the post-apartheid period between 1994 and 2014. The systematic review found that the studies used 27 different measures of food insecurity, confounding the comparative analysis of food insecurity at this level. While social grants have brought a measure of poverty relief at household level, unaffordable diets were the root cause of food insecurity. The increasing consumption of cheaper, more available and preferred ‘globalised’ foods with high energy content and low nutritional value lead to overweight and obesity alongside child stunting. Unless a comparable set of indicators is used in such surveys, they are not able to provide comparable information on the scope and scale of the problem. Policy makers should be engaging with researchers to learn from these studies, while researchers need to share this wealth of sub-national study findings with government to strengthen food security planning, monitoring, and evaluation at all levels. PMID:28829787

Foliar nitrogen, phosphorus and potassium content in trees in environmentally toxic plastic industry area.

PubMed

Sett, Rupnarayan; Soni, Bhawna

2013-04-01

In plants, nitrogen deficiency causes stunted growth and chlorosis or yellowing of the leaves due to decreased levels of chlorophyll, while excess nitrogen uptake may cause dark green overly vigorous foliage which may have increased susceptibility to disease and insect attacks. Phosphorus is an important nutrient in crop production, since many soils in their native state do not have sufficient available phosphorus to maximize crop yield. Potassium deficiency may cause necrosis or interveinal chlorosis. Plastics are synthetic or semi-synthetic moldable organic solids that are organic polymers of high molecular mass, most commonly derived from petrochemicals; these polymers are based on chains of carbon atoms alone or with oxygen, sulfur, or nitrogen. Plastic is a non- biodegradable major toxic pollutant. It pollutes earth and leads to air pollution and water pollution. Merely there is any safe way to dispose the hazardous plastic wastes. The study was targeted to estimate foliar level of NPK content of three plant species, viz. Cassia tora (Herb), Ailanthus excelsa (Tree) and Dalbergia sissoo (Tree) from polluted areas associated to polythene-industries as well as control areas having least pollution, where all the parameters were found to be higher than the control experiments.

The Fight for the Village: Southern Afghanistan 2010

DTIC Science & Technology

2011-05-01

social kinships), which are not dogmatically oriented around tribes. In the violent district of Khas Oruzgan in northeast Oruzgan Province, one U.S...could promote common goals without the specter of perceived tribal advancement. In Khas Oruzgan, insurgent violence stunted con- flict resolution, so...successful village stability program such as the Khas Oruzgan effort will have limited effects when the district level governance is not capable or

Nutritional status of indigenous children younger than five years of age in Mexico: results of a national probabilistic survey.

PubMed

Rivera, Juan A; Monterrubio, Eric A; González-Cossío, Teresa; García-Feregrino, Raquel; García-Guerra, Armando; Sepúlveda-Amor, Jaime

2003-01-01

To compare the prevalence of undernutrition and anemia in indigenous and non-indigenous children < 5 years of age at the national level, by region and by urban and rural areas, and to evaluate the degree to which the socioeconomic condition of the family predicts the differences. A national probabilistic survey was conducted in Mexico in 1999. Indigenous families were identified as those in which at least one woman 12-49 years of age in the household spoke a native language. The prevalence of undernutrition (stunting, wasting and underweight) and anemia was compared between indigenous and non-indigenous children. Probability ratios (PR) were used to compare prevalences in indigenous and non-indigenous children adjusting for socioeconomic status (SES) of the family and for other covariates. The prevalences of stunting and underweight were greater in indigenous than in non-indigenous children. At the national level and in urban areas the prevalences were three times greater and in rural areas approximately 2 times greater (p < 0.05). No differences were found in the prevalence of wasting (p > 0.05). The prevalence of anemia in indigenous children was one third greater than in non-indigenous children at the national level (p < 0.05) and was between 30 and 60% greater in urban areas and in the regions studied (p < 0.05) but was not statistically significant (p > 0.05) in rural areas. These differences were reduced to about half when adjusting for SES but remained significantly higher in indigenous children (p < 0.05). Indigenous children have higher probabilities of stunting and underweight than non-indigenous children. The differences are larger in urban areas and in higher socioeconomic geographic regions and are explained mostly by socioeconomic factors. The overall difference in the probability of anemia is small, is higher only in urban relative to rural areas, and is explained to a lesser degree by socioeconomic factors. Policy and programs should be designed and implemented to reduce the dramatic differences in nutritional status between indigenous and non-indigenous children in Mexico. The English version of this paper is available too at: http://www.insp.mx/salud/index.html.

Women's work in farming, child feeding practices and nutritional status among under-five children in rural Rukwa, Tanzania.

PubMed

Nordang, Sunniva; Shoo, Tiransia; Holmboe-Ottesen, Gerd; Kinabo, Joyce; Wandel, Margareta

2015-11-28

Some progress has been achieved in reducing the prevalence of undernutrition among children under 5 years of age in Tanzania. In the Rukwa region (2010), the level of stunted and underweight children was 50·4 and 13·5 %, respectively. The aim of this study was to assess the nutritional status of children under 5 years of age, feeding practices and risk factors of undernutrition in a rural village in the Rukwa region, as well as to discuss the results in light of a similar study conducted in 1987/1988. This cross-sectional study was conducted in 152 households with children under 5 years of age. Data were obtained from the child's main caretaker and the household head, using a structured questionnaire and a 24 h dietary recall. Children's length/height and weight were measured. The prevalence of stunting and underweight was found to be 63·8 and 33·6 % (Z-score<-2 of WHO 2006 CGS), respectively. Sugar-water was given to 72·3 % of the children on the first day after birth. A thin gruel was introduced after a median of 2 months (25th-75th percentiles; 1-3). The time mothers spent farming was a significant risk factor for stunting (P=0·04). Illness, food shortage and dry-season cultivation were significant risk factors for underweight (P<0·01). Using the NCHS/WHO 1983 growth reference (<75 % of the median), the prevalence of underweight was 25·0 %, similar to that reported in 1987/1988 (26·4 %). In conclusion, the underweight prevalence was found to be at the same level in 2010 as was recorded in 1987/1988. Current child-feeding practices were not in line with WHO recommendations. Women working in farms, food shortage, dry-season cultivation and diseases partly explain the children's poor nutritional status.

The association between malaria parasitaemia, erythrocyte polymorphisms, malnutrition and anaemia in children less than 10 years in Senegal: a case control study.

PubMed

Tine, Roger C K; Ndiaye, Magatte; Hansson, Helle Holm; Ndour, Cheikh T; Faye, Babacar; Alifrangis, Michael; Sylla, K; Ndiaye, Jean L; Magnussen, Pascal; Bygbjerg, Ib C; Gaye, Oumar

2012-10-11

Malaria and anaemia (Haemoglobin <11 g/dl) remain frequent in tropical regions and are closely associated. Although anaemia aetiologies are known to be multi-factorial, most studies in malaria endemic areas have been confined to analysis of possible associations between anaemia and individual factors such as malaria. A case control study involving children aged from 1 to 10 years was conducted to assess some assumed contributors to anaemia in the area of Bonconto Health post in Senegal. Study participants were randomly selected from a list of children who participated in a survey in December 2010. Children aged from 1 to 10 years with haemoglobin level below 11 g/dl represented cases (anaemic children). Control participants were eligible if of same age group and their haemoglobin level was >= 11 g/dl. For each participant, a physical examination was done and anthropometric data collected prior to a biological assessment which included: malaria parasitaemia infection, intestinal worm carriage, G6PD deficiency, sickle cell disorders, and alpha-talassaemia. Three hundred and fifty two children < 10 years of age were enrolled (176 case and 176 controls). In a logistic regression analysis, anaemia was significantly associated with malaria parasitaemia (aOR=5.23, 95%CI[1.1-28.48]), sickle cell disorders (aOR=2.89, 95%CI[1,32-6.34]), alpha-thalassemia (aOR=1.82, 95%CI[1.2-3.35]), stunting (aOR=3.37, 95%CI[1.93-5.88], age ranged from 2 to 4 years (aOR=0.13, 95%CI[0.05-0.31]) and age > 5 years (aOR=0.03, 95%CI[0.01-0.08]). Stratified by age group, anaemia was significantly associated with stunting in children less than 5 years (aOR=3.1 95%CI[1.4 - 6.8]), with, sickle cell disorders (aOR=3.5 95%CI [1.4 - 9.0]), alpha-thalassemia (or=2.4 95%CI[1.1-5.3]) and stunting (aOR=3.6 95%CI [1.6-8.2]) for children above 5 years. No association was found between G6PD deficiency, intestinal worm carriage and children's gender. Malaria parasitaemia, stunting and haemoglobin genetic disorders represented the major causes of anaemia among study participants. Anaemia control in this area could be achieved by developing integrated interventions targeting both malaria and malnutrition.

The association between malaria parasitaemia, erythrocyte polymorphisms, malnutrition and anaemia in children less than 10 years in Senegal: a case control study

PubMed Central

2012-01-01

Background Malaria and anaemia (Haemoglobin <11 g/dl) remain frequent in tropical regions and are closely associated. Although anaemia aetiologies are known to be multi-factorial, most studies in malaria endemic areas have been confined to analysis of possible associations between anaemia and individual factors such as malaria. A case control study involving children aged from 1 to 10 years was conducted to assess some assumed contributors to anaemia in the area of Bonconto Health post in Senegal. Methods Study participants were randomly selected from a list of children who participated in a survey in December 2010. Children aged from 1 to 10 years with haemoglobin level below 11 g/dl represented cases (anaemic children). Control participants were eligible if of same age group and their haemoglobin level was >= 11 g/dl. For each participant, a physical examination was done and anthropometric data collected prior to a biological assessment which included: malaria parasitaemia infection, intestinal worm carriage, G6PD deficiency, sickle cell disorders, and alpha-talassaemia. Results Three hundred and fifty two children < 10 years of age were enrolled (176 case and 176 controls). In a logistic regression analysis, anaemia was significantly associated with malaria parasitaemia (aOR=5.23, 95%CI[1.1-28.48]), sickle cell disorders (aOR=2.89, 95%CI[1,32-6.34]), alpha-thalassemia (aOR=1.82, 95%CI[1.2-3.35]), stunting (aOR=3.37, 95%CI[1.93-5.88], age ranged from 2 to 4 years (aOR=0.13, 95%CI[0.05-0.31]) and age > 5 years (aOR=0.03, 95%CI[0.01-0.08]). Stratified by age group, anaemia was significantly associated with stunting in children less than 5 years (aOR=3.1 95%CI[1.4 – 6.8]), with, sickle cell disorders (aOR=3.5 95%CI [1.4 – 9.0]), alpha-thalassemia (or=2.4 95%CI[1.1–5.3]) and stunting (aOR=3.6 95%CI [1.6–8.2]) for children above 5 years. No association was found between G6PD deficiency, intestinal worm carriage and children’s gender. Conclusion Malaria parasitaemia, stunting and haemoglobin genetic disorders represented the major causes of anaemia among study participants. Anaemia control in this area could be achieved by developing integrated interventions targeting both malaria and malnutrition. PMID:23057857

Nutritional status of tribal children and adolescents in rural south India: the effect of an NGO delivered nutritional programme.

PubMed

Thomas, Richard; Srinivasan, Rohit; Sudarshan, Hanumappa

2013-10-01

To investigate the prevalence of malnutrition using anthropometric measures in a cohort of tribal students attending a school in rural south India. Children attending the school were offered three meals a day during attendance. Analysis of anthropometric data obtained aimed to determine the nutritional effect of the food provided. The nutritional status of 409 students were assessed by comparing anthropometric measurements to reference values according to WHO/NCHS guidelines. Height for age <3rd percentile was defined as stunting. BMI for age <5th percentile was defined as thinness. 'New' students were defined as attending the school for <1 y. 'Old' students were defined as being in attendance for ≥ 1 y. Comparison of thinness and stunting prevalence in these groups enabled evaluation of the meals provided by the organisation. Four hundred and nine students were included for analysis in the study. The prevalence of thinness was 39.4 %. 59.5 % of 'new' and 52.9 % of 'old' students at the school demonstrated thinness. 59.4 % of students were classified as stunted. 73.8 % of 'new' students and 52.9 % of 'old' students demonstrated stunting (p 0.091). Significantly (p 0.010) more 'new' female students had stunted growth. Acute and chronic measures of malnutrition were high amongst adolescent students attending the school. Comparison of 'new' and 'old' adolescent pupils at the school hints that the 'old' students were less malnourished than their 'new' counterparts. This study demonstrates the importance for NGOs to develop their nutritional programmes with a special focus on adolescents.

Infant and young child feeding practices in urban Philippines and their associations with stunting, anemia, and deficiencies of iron and vitamin A.

PubMed

Rohner, Fabian; Woodruff, Bradley A; Aaron, Grant J; Yakes, Elizabeth A; Lebanan, May Antonnette O; Rayco-Solon, Pura; Saniel, Ofelia P

2013-06-01

The prevalence of stunting, underweight, and micronutrient deficiencies are persistently high in young children in the Philippines, and among other factors, suboptimal infant and young child feeding behavior may contribute to these forms of malnutrition. To improve the understanding of contributors associated with the nutritional status of children 6 to 23 months of age living in urban areas of the Philippines. A cross-sectional survey was conducted covering five urban centers in the Philippines. Data on infant and young child feeding and nutritional status (including wasting, stunting, underweight, anemia, iron deficiency, and vitamin A deficiency) were collected for 1,784 children. Among children from urban and predominantly poor and very poor households, 26% were stunted, 18% were underweight, and 5% were wasted. Forty-two percent were anemic, 28% were iron deficient, and 3% were vitamin A deficient. About half of the children were breastfed within an hour after birth, were breastfed at the time of the survey, and had been continuously breastfed up to 1 year of age. Of the factors investigated, low socioeconomic status, use of cheaper cooking fuel, and nonuse of multivitamins were all independently associated with stunting. The prevalence of anemia, iron deficiency, and vitamin A deficiency were independently associated with the same factors and poorer sanitation facilities, lower maternal education, current unemployment, and inflammation. These factors merit attention in future programming and interventions may include promotion of the timely introduction of appropriate fortified complementary foods, the use of affordable multiple micronutrient preparations, and measures to reduce infections.

Conflict in Somalia: impact on child undernutrition

PubMed Central

Kinyoki, Damaris K; Moloney, Grainne M; Uthman, Olalekan A; Kandala, Ngianga-Bakwin; Odundo, Elijah O; Noor, Abdisalan M; Berkley, James A

2017-01-01

Introduction In Somalia, protracted conflict and drought have caused population displacement and livelihood destruction. There is also widespread childhood undernutrition. We aimed to determine the independent effects of conflict on wasting and stunting among children aged 6–59 months nationwide in Somalia. Methods Data were from household surveys during 2007–2010, including 73 778 children in 1066 clusters, the Armed Conflict Location and Event Data project database and remote sensing. We used Bayesian hierarchical spatial-temporal regression to examine the effects of conflict on wasting and stunting. Models included individual, household and environmental covariates and recent (<3 months) or longer term (3–12 months) conflict events. Results 15 355 (21%) and 22 739 (31%) observations were from wasted and stunted children, respectively. The conflict was associated with undernutrition independently of the individual, household and environmental factors, and its inclusion improved model performance. Recent conflict was associated with wasting (OR 1.37, 95% credible interval (CrI): (1.33, 1.42) and attributable fraction (AF) 7.6%)) and stunting (OR 1.21, 95% CrI (1.15, 1.28), AF 6.9%). Longer term conflict had greater effects on wasting (OR 1.76, 95% CrI (1.71, 1.81), AF 6.0%) and stunting (OR 1.88, 95% CrI = (1.83, 1.94), AF 7.4%). After controlling for conflict, the harmful effect of internal displacement and protective effects of rainfall and vegetation cover on undernutrition were enhanced. Conclusion Conflict and internal displacement have large effects on undernutrition in ways not fully captured by simply measuring individual, household and environmental factors or drought. PMID:28966793

Inadequate feeding practices and impaired growth among children from subsistence farming households in Sidama, Southern Ethiopia.

PubMed

Gibson, Rosalind S; Abebe, Yewelsew; Hambidge, K Michael; Arbide, Isabel; Teshome, Aklilu; Stoecker, Barbara J

2009-07-01

Whether current child feeding practices and behaviours among rural households in Sidama, Southern Ethiopia conform to the World Health Organization (WHO) guiding principles for complementary feeding is uncertain. We assessed socio-demographic status, anthropometry, breastfeeding, complementary feeding practices and behaviours, and motor development milestones in a convenience sample of 97 breastfed children aged 6-23 months from three rural Sidama communities. Energy and nutrient intakes from complementary foods were also calculated from 1-day in-home weighed records. Prevalence of stunting ranged from 25% for infants aged 6-8 months to 52% for children aged 12-23 months, whereas for wasting, the corresponding prevalence was 10% and 14%, respectively. Very few children were exclusively breastfed up to 6 months of age (n = 2), or received solids/semi-solids for the recommended minimum number of times containing the recommended number of food groups. Responsive feeding was not practised and no cellular animal products were consumed. Median intakes of energy, and intakes and densities of micronutrients from complementary foods (but not protein) were below WHO recommendations, assuming average breast milk intakes; greatest shortfalls were for retinol, vitamin C and calcium densities. Mothers of stunted children were shorter and lighter, and from households of lower socio-economic status than non-stunted children (P < 0.05). Acquisition of some motor development milestones was delayed in stunted infants compared with their non-stunted counter-parts. In conclusion, interventions that address the WHO guiding principles for complementary feeding practices and behaviours, as well as prenatal influences on growth, are urgently required in this setting.

VBP15, a novel dissociative steroid compound, reduces NFκB-induced expression of inflammatory cytokines in vitro and symptoms of murine trinitrobenzene sulfonic acid-induced colitis.

PubMed

Damsker, Jesse M; Conklin, Laurie S; Sadri, Soheil; Dillingham, Blythe C; Panchapakesan, Karuna; Heier, Christopher R; McCall, John M; Sandler, Anthony D

2016-09-01

The goal of this study was to assess the capacity of VBP15, a dissociative steroidal compound, to reduce pro-inflammatory cytokine expression in vitro, to reduce symptoms of colitis in the trinitrobenzene sulfonic acid-induced murine model, and to assess the effect of VBP15 on growth stunting in juvenile mice. In vitro studies were performed in primary human intestinal epithelial cells. Colitis was induced in mice by administering trinitrobenzene sulfonic acid. Growth stunting studies were performed in wild type outbred mice. Cells were treated with VBP15 or prednisolone (10 μM) for 24 h. Mice were subjected to 3 days of VBP15 (30 mg/kg) or prednisolone (30 mg/kg) in the colitis study. In the growth stunting study, mice were subjected to VBP15 (10, 30, 45 mg/kg) or prednisolone (10 mg/kg) for 5 weeks. Cytokines were measured by PCR and via Luminex. Colitis symptoms were evaluated by assessing weight loss, intestinal blood, and stool consistency. Growth stunting was assessed using an electronic caliper. VBP15 significantly reduced the in vitro production of CCL5 (p < 0.001) IL-6 (p < 0.001), IL-8 (p < 0.05) and reduced colitis symptoms (p < 0.05). VBP15 caused less growth stunting than prednisolone (p < 0.001) in juvenile mice. VBP15 may reduce symptoms of IBD, while decreasing or avoiding detrimental side effects.

Growth recovery and faltering through early adolescence in low- and middle-income countries: Determinants and implications for cognitive development.

PubMed

Georgiadis, Andreas; Benny, Liza; Duc, Le Thuc; Galab, Sheikh; Reddy, Prudhvikar; Woldehanna, Tassew

2017-04-01

Child chronic undernutrition, as measured by stunting, is prevalent in low- and middle-income countries and is among the major threats to child development. While stunting and its implications for cognitive development have been considered irreversible beyond early childhood there is a lack of consensus in the literature on this, as there is some evidence of recovery from stunting and that this recovery may be associated with improvements in cognition. Less is known however, about the drivers of growth recovery and the aspects of recovery linked to cognitive development. In this paper we investigate the factors associated with growth recovery and faltering through age 12 years and the implications of the incidence, timing, and persistence of post-infancy recovery from stunting for cognitive development using longitudinal data from Ethiopia, India, Peru, and Vietnam. We find that the factors most systematically associated with accelerated growth both before and after early childhood and across countries include mother's height, household living standards and shocks, community wages, food prices, and garbage collection. Our results suggest that post-infancy recovery from stunting is more likely to be systematically associated with higher achievement scores across countries when it is persistent and that associations between growth trajectories and cognitive achievement in middle childhood do not persist through early adolescence across countries. Overall, our findings indicate that growth after early childhood is responsive to changes in the household and community environments and that growth promotion after early childhood may yield improvements in child cognitive development. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

[Analysis the statue of growth and development of infants and young children aged 6- 23 months in poor rural areas of Hunan Province, China].

PubMed

Fang, Junqun; Luo, Jiayou; Liao, Kai; Wang, Hua; Zhou, Xu; Huang, Guangwen; Xie, Donghua; Peng, Zhonghua; Yang, Wenzhen

2016-11-01

To describe the statue of growth and development among infants and young children aged 6-23 months in poor rural areas of Hunan Province. A total of 15 248 rural infants and young children aged 6-23 months in 54 poor counties of Wuling Mountains and Luoxiao Mountains in Hunan Province were selected by Probability-Proportional-to-Size Sampling( PPS) between 2009 and 2015. Participants' length and weight were tested, WHZ, WAZ, HAZ and BMI Z score were calculated according to The WHO Child Growth Standards, and describe the rate of wasting, underweight, stunting and low BMI, and the physical growth level of children were evaluated according to the WHO standards. The average weight of girls aged 6-23 months in poor rural areas of Hunan Province were 9. 17 kg, lower than boys which were 9. 79 kg. The average length of girls aged 6-23 months were 75. 53 cm, lower than boys which were 77. 19 cm. The average BMI of girls aged 6-23 months were15. 96, lower than boys which were 16. 40( P < 0. 05). The curve of weight-for-length Z scores and weight-for-age Z scores and length-for-age Z scores of infants and young children aged 6-23 months were lower than the WHO standards( P < 0. 05). The rate of wasting, underweight, stunting and low BMI of infants and young children aged 6-23 months were 3. 9%, 5. 1%, 7. 2% and 3. 9%, and boys were higher than girls in the rate of underweight and stunting, the rate of underweight and stunting were increased with the growth of age( P < 0. 05). The problem of growth and development of infants and young children aged 6-23 months in poor rural areas of Hunan Province are serious, and there are lower than the WHO standards. To improve the nutrition and health of infants and young children in poor rural areas, the ability of child health care and the feeding knowledge of caregivers are need to be improved.

Nutritional Status of Under Five Children in Ethiopia: A Systematic Review and Meta-Analysis.

PubMed

Abdulahi, Ahmed; Shab-Bidar, Sakineh; Rezaei, Shahabeddin; Djafarian, Kurosh

2017-03-01

Undernutrition is the outcome of insufficient food intake and recurrent infectious diseases. The baseline levels of undernutrition remain so high that Ethiopia still needs to continue substantial investment in nutrition.Therefore, the aim of this study was to obtain estimates of over-time trends in the prevalence of undernutrition in Ethiopia and to determine risk factors for undernutrition among children of under five years of age. Cross-sectional studies published in English from 1997 to 2015 focusing the prevalence of stunting, wasting and underweight in children aged 0-5 years (n = 39,585) in Ethiopia were included in this systematic review and meta-analysis. We searched in PubMed and Scopus databases and other articles manually. Two review authors independently selected studies for inclusion, extracted data and assessed the risk of bias in the included studies. The protocol number of the study is PROSPERO 2015: CRD42015027940. Eighteen studies were included and the overall pooled prevalence estimate of stunting, underweight and wasting was 42.0% (95% CI: 37.0, 46.0), 33.0 % (95% CI: 27.0, 39.0) and 15.0% (95% CI: 12.0, 19.0), respectively. The sensitivity analyses resulted in the prevalence of stunting, 40% (95% CI: 32.0, 48.0; I2=99.19%), prevalence of underweight, 33%(95% CI: 24.0, 42.0; I 2 =99.34%) and wasting rate equal to 19%(95% CI: 14.0, 24.0; I2=99.19%). Cumulative analysis revealed a stabilization trend of stunting and underweight (1996-2010) followed by an upward trend (2010-2014). Child age, child sex, complementary food, poor dietary diversity, diarrheal diseases, maternal education, maternal height, residential area and socio- economic status were significant risk factors for undernutrition. The result of the meta-analysis of thes observational studies revealed that the trend of undernutrition in Ethiopia indicates that there is an increment of chronic malnutrition cases in recent years, and the prevalence of undernutrition remains extremely high. Thus, the implementation of policies to reverse child undernutrition should get maximum emphasis.

Influence of Tylenchorhynchus ewingi on growth of loblolly pine seedlings, and host suitability of legumes and small grains

Treesearch

Stephen W. Fraedrich; Michelle M. Cram; Zafar A. Handoo; Stanley J. Zarnoch

2012-01-01

Tylenchorhynchus ewingi, a stunt nematode, causes severe injury to slash pine seedlings and has been recently associated with stunting and chlorosis of loblolly pine seedlings at some forest tree nurseries in southern USA. Experiments confirmed that loblolly pine is a host for T. ewingi, and that the nematode is capable of causing...

Effect of arbuscular mycorrhizal fungi on onion growth and onion stunting caused by Rhizoctonia solani, 2013.

USDA-ARS?s Scientific Manuscript database

A preliminary study was conducted in a greenhouse (15 ± 1oC, with supplemental lights for 12 h/day) to determine the role of AMF on onion growth and for reducing the severity of onion stunting, using a commercial AMF inoculant, BioTerra Plus, that contains 104 propagules/g (ppg) of Glomus intraradic...

Suitability of Southern Pines, Other Selected Crops, and Nutsedge to a Longidorus sp. Associated with Stunting of Loblolly Pine Seedlings

Treesearch

S.W. Fraedrich; M.M. Cram; Z.A. Handoo

2003-01-01

An undescribed needle nematode (Longidorus sp.) has been associated with severely stunted loblolly pine seedlings at a south Georgia nursery. Containers with selected crop and weed species were infested with 100 or 200 adults and juveniles of the Longidorus individuals to evaluate host suitability. Nematode populations increased in...

Nutritional Status Of Under-Five Children In Libya; A National Population-Based Survey

PubMed Central

Adel, El Taguri; Marie-Françoise, Rolland-Cachera; Mahmud Salaheddin, M; Najeeb, Elmrzougi; Ahmed, Abdel Monem; Ibrahim, Betilmal; Gerard, Lenoir

2008-01-01

Aim To describe the nutritional status of children under-five years of age in Libya. Population and methods A secondary analysis of data of 5348 children taken from a national representative, two-stage, cluster-sample survey that was performed in 1995. Results: Prevalence rates of underweight, wasting, stunting, and overweight were determined using standard definitions in reference to newly established WHO growth charts. The study revealed that 4.3% of children were underweight, 3.7% wasted, 20.7% stunted, and 16.2% overweight. Seventy percent of children had normal weight. Undernutrition was more likely to be found in males, in rural areas, and in underprivileged groups. Overweight was more likely found in urban, privileged groups. Wasting was more common in arid regions; stunting was more common in mountainous regions of Al-Akhdar, Al-Gharbi, and in Sirt. Al-Akhdar had the highest prevalence of overweight. Conclusion The country had a low prevalence of underweight and wasting, moderate prevalence of stunting, and high prevalence of overweight. The country is in the early stages of transition with evidence of dual-burden in some regions. Similar surveys are needed to verify secular trends of these nutritional problems, particularly overweight. PMID:21499476

The impact of malnutrition on intelligence at 3 and 11 years of age: The mediating role of temperament.

PubMed

Venables, Peter H; Raine, Adrian

2016-02-01

Previous work has shown that malnutrition has deleterious effects on both IQ and aspects of temperament. It is hypothesized that while malnutrition bears a direct relation to IQ, aspects of temperament are also involved in a mediating role so that they produce indirect associations between malnutrition and IQ. The study examines the association of 3 indices of malnutrition-stunting, anemia and wasting-to Verbal IQ (VIQ) and Performance IQ (PIQ) and temperament in 1,376 3-year-old and 11-year-old children in Mauritius. Two dimensions of temperament were extracted from ratings of behavior and were labeled as Uninhibited (UI) and Task Orientation (TO). At age 3 stunting had direct relations to Verbal IQ and Performance IQ and also indirect relations via the mediating effect of temperament (UI but not TO). In the case of anemia there were no direct relations to VIQ or PIQ but both temperament meditators were involved in indirect relations. For wasting, indirect but not direct relations were observed. When age 11 cognitive performance was examined, there were direct relations to stunting and anemia and indirect relations via UI, but not TO. The relations between malnutrition and IQ were graded and linear showing that it is not only when malnutrition is defined by its severest levels that it has an effect on cognitive performance. It is suggested that malnutrition affects those brain structures and functions that are involved in both cognitive behavior and temperament. PsycINFO Database Record (c) 2016 APA, all rights reserved.

Geographical accessibility to healthcare and malnutrition in Rwanda.

PubMed

Aoun, Nael; Matsuda, Hirotaka; Sekiyama, Makiko

2015-04-01

The prevalence of stunting in children less than five years of age is elevated in Rwanda. It is one of the main health challenges upon which the government is struggling to achieve progress. Health centers and district hospitals in Rwanda are expected to provide a package of health services including nutrition related activities, nutritional rehabilitation, education, and growth monitoring. They can hence play a potent role in alleviating malnutrition and stunting in Rwanda. This study tested whether travel time from household clusters to the nearest health center was significantly and negatively associated with the distribution of height-for-age z-scores of younger than five year old children in the eastern province of Rwanda. Data for 974 children was extracted from the Rwanda Demographic and Health Survey (DHS) database. However, since DHS does not contain any information on travel time to health centers, the latter was simulated using AccessMod 4.0, an extension to ArcGIS 9.3.1 that simulates health facilities' catchment areas and travel times to health facilities. Travel time was found to be negatively associated with height-for-age z-scores at the 5% level in a stepwise regression analysis that controlled for wealth index, mother's primary and secondary education, sex of the child, preceding birth interval, and birth order of the child. Field measurements are needed to validate travel time. If validated, results point to the importance of improved access to healthcare facilities as a potential pathway in reducing stunting in Rwanda. Copyright © 2015 Elsevier Ltd. All rights reserved.

The double burden of malnutrition and its risk factors in school children in Tunja.

PubMed

Galiano, Lirios Pastor; Abril, Fred Manrique; Ernert, Andrea; Bau, Anne-Madeleine

2012-06-01

Undernutrition and overnutrition are relevant Public Health problems in Colombia. We conducted a nutritional survey in the municipality of Tunja to quantify the problem in order to guide government interventions and serve as baseline for future evaluations. Schoolchildren were randomly selected among all private and public schools. Information on health status, socioeconomic and demographic characteristics of their families was collected using questionnaires, which also included the Colombian Household Food Security Scale. Anthropometric measurements of 1168 schoolchildren (5 to 19 years old) were obtained, analyzed with WHO Anthro-Plus, and associated with the mentioned variables by further statistic analysis. The overall prevalences of stunting, thinness and overweight were 11.3%, 1.7% and 17.6%, respectively. The highest prevalence of stunting was found in rural areas (23%). Children from rural areas, attending public schools and in female-headed households had higher risks of stunting. Overweight reached a percentage of 26.9% in children attending private schools, where the risk of overweight was double than in public ones. Within the studied households 48.6% had some level of food insecurity. In Tunja the prevalence of undernutrition was low, which could be an effect of government nutrition programs. However, it continues to be a problem in vulnerable population groups, mainly in rural areas. On the other hand, the rising prevalence of overweight, following the trend of countries in nutritional transition, is a new Public Health problem which should be addressed. Periodic controls are also needed to evaluate the impact of government nutrition programs on the nutritional status of the children.

Tomato bushy stunt virus (TBSV) infecting Lycopersicon esculentum.

PubMed

Hafez, El Sayed E; Saber, Ghada A; Fattouh, Faiza A

2010-01-01

Tomato bushy stunt virus (TBSV) was detected in tomato crop (Lycopersicon esculentum) in Egypt with characteristic mosaic leaf deformation, stunting, and bushy growth symptoms. TBSV infection was confirmed serologically by ELISA and calculated incidence was 25.5%. Basic physicochemical properties of a purified TBSV Egh isolate were identical to known properties of tombusviruses of isometric 30-nm diameter particles, 41-kDa coat protein and the genome of approximately 4800 nt. This is the first TBSV isolate reported in Egypt. Cloning and partial sequencing of the isolate showed that it is more closely related to TBSV-P and TBSV-Ch than TBSV-Nf and TBSV-S strains of the virus. However, it is distinct from the above strains and could be a new strain of the virus which further confirms the genetic diversity of tombusviruses.

Nasopharyngeal carriage of respiratory pathogens in Warao Amerindians: significant relationship with stunting.

PubMed

Verhagen, Lilly M; Hermsen, Meyke; Rivera-Olivero, Ismar A; Sisco, María Carolina; de Jonge, Marien I; Hermans, Peter W M; de Waard, Jacobus H

2017-04-01

To assess risk factors for nasopharyngeal carriage of potential pathogens in geographically isolated Warao Amerindians in Venezuela. In this point prevalence survey, nasopharyngeal swabs were obtained from 1064 Warao Amerindians: 504 children aged 0-4 years, 227 children aged 5-10 years and 333 caregivers. Written questionnaires were completed to obtain information on demographics and environmental risk factors. Anthropometric measurements were performed in children aged 0-4 years. Carriage rates of Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae and Moraxella catarrhalis were 51%, 7%, 1% and 13%, respectively. Crowding index, method of cooking and tobacco exposure were not associated with increased carriage. In multivariable analysis, an increase in height-for-age Z score (i.e. improved chronic nutritional status) was associated with decreased odds of S. pneumoniae colonisation (OR 0.76, 95% CI 0.70-0.83) in children aged 0-4 years. Better knowledge of demographic and environmental risk factors facilitates better understanding of the dynamics of colonisation with respiratory bacteria in an Amerindian population. Poor chronic nutritional status was associated with increased pathogen carriage in children <5 years of age. The high rates of stunting generally observed in indigenous children may fuel the acquisition of respiratory bacteria that can lead to respiratory and invasive disease. © 2017 John Wiley & Sons Ltd.

Persistent G. lamblia impairs growth in a murine malnutrition model.

PubMed

Bartelt, Luther A; Roche, James; Kolling, Glynis; Bolick, David; Noronha, Francisco; Naylor, Caitlin; Hoffman, Paul; Warren, Cirle; Singer, Steven; Guerrant, Richard

2013-06-01

Giardia lamblia infections are nearly universal among children in low-income countries and are syndemic with the triumvirate of malnutrition, diarrhea, and developmental growth delays. Amidst the morass of early childhood enteropathogen exposures in these populations, G. lamblia–specific associations with persistent diarrhea, cognitive deficits, stunting, and nutrient deficiencies have demonstrated conflicting results, placing endemic pediatric giardiasis in a state of equipoise. Many infections in endemic settings appear to be asymptomatic/ subclinical, further contributing to uncertainty regarding a causal link between G. lamblia infection and developmental delay. We used G. lamblia H3 cyst infection in a weaned mouse model of malnutrition to demonstrate that persistent giardiasis leads to epithelial cell apoptosis and crypt hyperplasia. Infection was associated with a Th2-biased inflammatory response and impaired growth. Malnutrition accentuated the severity of these growth decrements. Faltering malnourished mice exhibited impaired compensatory responses following infection and demonstrated an absence of crypt hyperplasia and subsequently blunted villus architecture. Concomitantly, severe malnutrition prevented increases in B220+ cells in the lamina propria as well as mucosal Il4 and Il5 mRNA in response to infection. These findings add insight into the potential role of G. lamblia as a "stunting" pathogen and suggest that, similarly, malnourished children may be at increased risk of G. lamblia– potentiated growth decrements.

Stunting Persists despite Optimal Feeding: Are Toilets Part of the Solution?

PubMed

Prendergast, Andrew J; Humphrey, Jean H

2015-01-01

Children in developing countries have an average length-for-age that is already below the World Health Organization standard at birth and show a further decline in linear growth over the first 24 months of life; however, complementary feeding interventions have only a modest impact on growth. Children living in conditions of poor sanitation and hygiene are frequently exposed to pathogenic microbes through feco-oral transmission. Acute diarrhea represents only the tip of the 'enteric disease iceberg', with a substantial underlying burden of chronic, subclinical enteropathy. Environmental enteric dysfunction (EED) is characterized by disturbance in small intestinal structure and impaired gut barrier function, enabling microbial translocation and chronic systemic inflammation, which may impair growth. Gut damage appears to arise early in infancy and markers of intestinal inflammation, intestinal permeability and systemic immune activation are inversely associated with linear growth. Reducing feco-oral microbial transmission by improving water, sanitation and hygiene (WASH) may theoretically prevent or ameliorate EED and improve linear growth; ongoing trials are exploring this hypothesis. Given the complex interplay of factors leading to stunting, multisectoral interventions are likely required. Improving WASH in addition to infant feeding may be one approach to improve the growth and developmental potential of infants in developing countries. © 2015 Nestec Ltd., Vevey/S. Karger AG, Basel.

Nutritional status and its association with physical fitness, physical activity and parasitological indicators in youths from rural Mozambique.

PubMed

Nhantumbo, Leonardo; Ribeiro Maia, José António; dos Santos, Fernanda Karina; Jani, Ilesh V; Gudo, Eduardo Samo; Katzmarzyk, Peter T; Prista, António

2013-01-01

Little information exists about the relationship of nutritional status and motor performance conditional on asymptomatic parasitemia in rural African children. The aims of this study were to (1) determine if malnourished youths from rural African areas have lower levels of physical fitness (PF) and physical activity (PA) compared to normal weight youths, (2) verify the biological relevance of anthropometric criteria used to classify nutritional status in youth, and (3) determine the prevalence of parasitological indicators, and its association with nutritional status and PF. The sample comprised 794 youths (6-17 years) from Calanga, a rural community in Mozambique. PF tests were selected from standardized test batteries, and PA was estimated by accelerometry. Nutritional status was defined according to WHO recommendations for stunting, wasting and normal weight. Parasitological indicators were determined based on stool specimens' analysis. In general terms the normal group out-performed the other nutritional groups (stunted and wasted) for PF. However, no significant differences were found for PA among nutritional groups. There were also no significant differences in prevalence of intestinal parasites. Nutritional status was not associated with PA levels or the prevalence of parasitological indicators in youth, but was related to physical performance. Copyright © 2013 Wiley Periodicals, Inc.

[Nutritional status of school children from indigenous and non indigenous ancestry].

PubMed

Amigo, H; Bustos, P; Erazo, M; Radrigán, M E

1999-08-01

The few studies in Chile assessing the nutritional status of indigenous children show a high prevalence of stunting, excess weight and feeding problems. To compare anthropometric indices in children from indigenous and non indigenous ancestry. School children aged 6 to 8 years old, living in locations with three clear cut levels of social vulnerability were studied. Children were considered indigenous if their last names, as well as those of their parents were of Mapuche origin. Non indigenous were those whose last names were of Spanish origin. Four hundred and fifty indigenous and 684 non indigenous children were studied. Indigenous children from high vulnerability communities were approximately 0.5 z score shorter than those of non indigenous origin. Heights of indigenous and non indigenous children were similar in communities with intermediate and low social vulnerability. The proportion of the lower segment followed the same trend. Weight/height ratios were higher among indigenous children in the three vulnerability levels. Among indigenous children coming from areas of low vulnerability arm circumference was 1 cm broader than that of their non indigenous counterparts. Stunting is prevalent among school children from areas of high socioeconomic vulnerability, mainly rural, and independent from ethnicity. Among indigenous school children overweight and a broader arm circumference are frequent. These results urgently call for located and specific nutrition interventions.

Emergence and epidemiology of Cucurbit yellow stunting disorder virus in the American desert southwest, and development of host plant resistance in melon

USDA-ARS?s Scientific Manuscript database

Cucurbit yellow stunting disorder virus (CYSDV), emerged in the Sonoran Desert region of the southwestern USA in 2006 and has become established. The virus is transmitted by the MEAM1 cryptic species of Bemisia tabaci, which has been present in the region since the early 1990s. CYSDV results in lat...

Stunt Barbie--A Laboratory Practicum Combining Constant Velocity and Constant Acceleration

ERIC Educational Resources Information Center

Hertting, Scott

2011-01-01

In preparing to teach the advanced physics course at my high school, I found it useful to work through the end of chapter problems in the book used by the advanced class. A problem on motion in one dimension involved a stunt woman in free fall from a tree limb onto a horse running beneath her. The problem presents a connected learning opportunity…

Stunt nematode (Tylenchorhynchus claytoni) impact on southern pine seedlings and response to a field test of cover crops

Treesearch

Michelle M. Cram; Stephen W. Fraedrich

2009-01-01

The stunt nematode, Tylenchorhynchus claytoni, was found to cause a reduction in root volume (cm3) of loblolly pine at population densities equivalent of 125 nematodes/100 cm3 (6 in3) soil and greater. The results of a host range test conducted in containers under controlled conditions determined that buckwheat cultivar (Fagopryum esculentum...

Peri-Urban, but Not Urban, Residence in Bolivia Is Associated with Higher Odds of Co-Occurrence of Overweight and Anemia among Young Children, and of Households with an Overweight Woman and Stunted Child.

PubMed

Jones, Andrew D; Hoey, Lesli; Blesh, Jennifer; Janda, Kathryn; Llanque, Ramiro; Aguilar, Ana María

2018-04-01

Urban populations have grown globally alongside emerging simultaneous burdens of undernutrition and obesity. Yet, how heterogeneous urban environments are associated with this nutritional double burden is poorly understood. We aimed to determine: 1) the prevalence of the nutritional double burden and its components in urban, peri-urban, and rural areas of Bolivia; and 2) the association of residence in these areas with the nutritional double burden and its components. We surveyed 3946 randomly selected households from 2 metropolitan regions of Bolivia. Census data and remotely sensed imagery were used to define urban, peri-urban, and rural districts along a transect in each region. We defined 5 nutritional double burdens: concurrent overweight and anemia among women of reproductive age (15-49 y), and children (6-59 mo), respectively; concurrent overweight and stunting among children; and households with an overweight woman and, respectively, an anemic or stunted child. Capillary hemoglobin concentrations were measured to assess anemia (women: hemoglobin <120 g/L; children: hemoglobin <110 g/L), and overweight and stunting were calculated from height, weight, and age data. In multiple logistic regression models, peri-urban, but not urban residence, was associated with higher odds of concurrent overweight and anemia among children (OR: 1.8; 95% CI; 1.0, 3.2) and of households with an overweight woman and stunted child (1.8; 1.2, 2.7). Examining the components of the double burden, peri-urban women and children, respectively, had higher odds of overweight than rural residents [women (1.5; 1.2, 1.8); children (1.5; 1.0, 2.4)], and children from peri-urban regions had higher odds of stunting (1.5; 1.1, 2.2). Peri-urban, but not urban, residence in Bolivia is associated with a higher risk of the nutritional double burden than rural areas. Understanding how heterogeneous urban environments influence nutrition outcomes could inform integrated policies that simultaneously address both undernutrition and obesity.

Disentangling nutritional factors and household characteristics related to child stunting and maternal overweight in Guatemala.

PubMed

Lee, Jounghee; Houser, Robert F; Must, Aviva; de Fulladolsa, Patricia Palma; Bermudez, Odilia I

2010-07-01

The aim of this study was to identify nutritional factors and households characteristics associated with child stunting, maternal overweight and the familial coexistence of both types of malnutrition. In Guatemala, 2000, with nationally representative data, we selected 2261 households with at least one child aged 12-60 months and his/her mother. Nutritional status was assessed in children (e.g., stunting as height-for-age Z-score<-2) and mothers (e.g., overweight as body mass index > or =25 kg/m(2)) and identified the presence of both, child stunting and maternal overweight in the same household (SCOM). With logistic regression models we assessed the association of the malnutrition indicators with individual and household socio-economic and health characteristics. SCOM was identified in 18% of households. Socio-economic status (SES) of SCOM households was significantly lower than SES of households with non-stunted children. SCOM households, compared to those with normal-stature children and normal weight mothers, were more likely to have mothers of short stature (adjusted odds ratio-OR+/-95% CI=3.1 (2.1-4.7)), higher parity (1.2 (1.1-1.3)), currently working (1.7 (1.1-2.6), and self-identified as indigenous (2.0 (1.3-3.1)). Factors associated with stunting in children such as poverty, maternal short stature and indigenousness, were predictors of SCOM. These findings support the notion that SCOM is an extension of the malnutrition spectrum in the most disadvantaged population groups in countries that are in the middle of their nutrition transitions such as Guatemala. At the same time it revealed that these populations are already in the stage of chronic, nutrition related diseases associated with less physical activity and more access to highly processed foods of low cost, high dietary energy and low nutrient density in important population groups. The challenge for the decision makers and service deliverers is to guide SCOM households to deal equally with both extremes of the malnutrition continuum. 2010 Elsevier B.V. All rights reserved.

Trends in socioeconomic inequalities in anthropometric status in a population undergoing the nutritional transition: data from 1982, 1993 and 2004 pelotas birth cohort studies

PubMed Central

2012-01-01

Background Socioeconomic inequalities in child nutrition may change rapidly over time, particularly in populations undergoing the nutrition transition. Yet, the few available studies are repeated cross-sectional surveys. By studying three prospective birth cohorts in the same city over a period of more than two decades, we describe secular trends in overweight and stunting at different ages, according to socioeconomic position. Methods Population-based birth cohort studies were launched in the city of Pelotas (Brazil) in 1982, 1993 and 2004, with follow-up visits at twelve, 24 and 48 months. Children were weighed and measured at every visit. Z-scores of length/height-for-age and body mass index-for-age were calculated using the WHO Child Growth Standards. The slope and relative indices of inequality, based on family income quintiles, were estimated for each follow-up visit. Results Between the 1982 and 2004 cohorts, stunting among four-year-olds declined (from 10.9% to 3.6%), while overweight increased (from 7.6% to 12.3%). In every visit, stunting prevalence was inversely related to income. Both absolute and relative inequalities declined over time; among four-year-olds stunting dropped from 26.0% in the 1982 cohort to 6.7% in the 2004 cohort in the poorest group, while in the richest group stunting prevalence dropped from 2.7% in 1982 to 1.1% in the 2004 cohort study. The secular trend towards increased overweight was evident for four-year-olds, in almost all socioeconomic groups, but not among one and two-year-olds. Among four-year old children, overweight prevalence increased in all income quintiles, by 130% in the middle-income group, 64% in the poorest and 41% in the richest group. Conclusions The decline in stunting is remarkable, but the increase in overweight among four-year olds – particularly among the poorest and the middle-income groups– requires concerted efforts to prevent the long term consequences of child overweight. PMID:22776157

Optima Nutrition: an allocative efficiency tool to reduce childhood stunting by better targeting of nutrition-related interventions.

PubMed

Pearson, Ruth; Killedar, Madhura; Petravic, Janka; Kakietek, Jakub J; Scott, Nick; Grantham, Kelsey L; Stuart, Robyn M; Kedziora, David J; Kerr, Cliff C; Skordis-Worrall, Jolene; Shekar, Meera; Wilson, David P

2018-03-20

Child stunting due to chronic malnutrition is a major problem in low- and middle-income countries due, in part, to inadequate nutrition-related practices and insufficient access to services. Limited budgets for nutritional interventions mean that available resources must be targeted in the most cost-effective manner to have the greatest impact. Quantitative tools can help guide budget allocation decisions. The Optima approach is an established framework to conduct resource allocation optimization analyses. We applied this approach to develop a new tool, 'Optima Nutrition', for conducting allocative efficiency analyses that address childhood stunting. At the core of the Optima approach is an epidemiological model for assessing the burden of disease; we use an adapted version of the Lives Saved Tool (LiST). Six nutritional interventions have been included in the first release of the tool: antenatal micronutrient supplementation, balanced energy-protein supplementation, exclusive breastfeeding promotion, promotion of improved infant and young child feeding (IYCF) practices, public provision of complementary foods, and vitamin A supplementation. To demonstrate the use of this tool, we applied it to evaluate the optimal allocation of resources in 7 districts in Bangladesh, using both publicly available data (such as through DHS) and data from a complementary costing study. Optima Nutrition can be used to estimate how to target resources to improve nutrition outcomes. Specifically, for the Bangladesh example, despite only limited nutrition-related funding available (an estimated $0.75 per person in need per year), even without any extra resources, better targeting of investments in nutrition programming could increase the cumulative number of children living without stunting by 1.3 million (an extra 5%) by 2030 compared to the current resource allocation. To minimize stunting, priority interventions should include promotion of improved IYCF practices as well as vitamin A supplementation. Once these programs are adequately funded, the public provision of complementary foods should be funded as the next priority. Programmatic efforts should give greatest emphasis to the regions of Dhaka and Chittagong, which have the greatest number of stunted children. A resource optimization tool can provide important guidance for targeting nutrition investments to achieve greater impact.

Factors associated with nutritional status of infants and young children in Somali Region, Ethiopia: a cross- sectional study.

PubMed

Fekadu, Yirgu; Mesfin, Addisalem; Haile, Demewoz; Stoecker, Barbara J

2015-09-02

Inadequate nutrition during the first two years of life may lead to childhood morbidity and mortality, as well as inadequate brain development. Infants are at increased risk of malnutrition by six months, when breast milk alone is no longer sufficient to meet their nutritional requirements. However the factors associated with nutritional status of infants after 6 months of age have received little attention in pastoralist communities of Ethiopia. Therefore this study aimed to identify the factors associated with nutritional status of infants and young children (6-23 months) in Filtu town, Somali Region, Ethiopia. A cross-sectional community-based study was conducted. Simple random sampling was employed to select 214 infants for the study. Univariable and multivariable logistic regressions models were used in the statistical analysis. The strength of association was measured by odds ratios with 95% confidence intervals. Both the crude (COR) and adjusted odds ratios (AOR) are reported. The prevalence of wasting, stunting and underweight among infants and young children were 17.5% (95% CI: 12.91-23.22), 22.9% (95% CI: 17.6-28.9) and 19.5% (95% CI: 14.58-25.3) respectively. The multivariable logistic regression model showed that breastfeeding was independently associated with reduced odds of wasting (AOR = 0.38(95% CI: 0.14-0.99)). Diarrhea in the past 15 days (AOR = 2.13 (95% CI: 1.55-4.69)) was also associated with increased odds for wasting. The independent predictors of reduced odds for stunting were dietary diversity score ≥ 4 (AOR = 0.45(95% CI: 0.21-0.95)) and introduction of complementary feeding at 6 months (AOR = 0.25 (95% CI: 0.09-0.66)). Bottle feeding was associated with increased odds of stunting (AOR = 3.83 (95% CI: 1.69-8.67)). Breastfeeding was associated with reduced odds of underweight (AOR = 0.24 (95% CI: 0.1-0.59)), while diarrheal disease in the past 15 days was associated with increased odds of underweight (AOR = 3.54 (95% CI: 1.17-7.72)). Under nutrition is a public health problem among infants and young children in Filtu town, Somali region Ethiopia. Breastfeeding was associated with lower odds of wasting and underweight while diarrheal disease was associated with higher odds of wasting and underweight. Low dietary diversity scores, inappropriate age of complementary feeding initiation and bottle feeding were identified to be significant predictors of stunting. Those factors should be considered for any intervention aimed to reduce under nutrition among infants and young children in Filitu town, Somali region, Ethiopia.

Maternal autonomy is inversely related to child stunting in Andhra Pradesh, India.

PubMed

Shroff, Monal; Griffiths, Paula; Adair, Linda; Suchindran, Chirayath; Bentley, Margaret

2009-01-01

Child stunting, an outcome of chronic undernutrition, contributes to poor quality of life, morbidity and mortality. In South Asia, the low status of women is thought to be one of the primary determinants of undernutrition across the lifespan. Low female status can result in compromised health outcomes for women, which in turn are related to lower infant birthweight and may affect the quality of infant care and nutrition. Maternal autonomy (defined as a woman's personal power in the household and her ability to influence and change her environment) is likely an important factor influencing child care and ultimately infant and child health outcomes. To examine the relationship between maternal autonomy and child stunting in Andhra Pradesh, India, we analysed data from National Family Health Survey (NFHS)-2. We used cross-sectional demographic, health and anthropometric information for mothers and their oldest child <36 months (n = 821) from NFHS-2. The main explanatory variables of autonomy are presented by four dimensions - decision making, permission to travel, attitude towards domestic violence and financial autonomy - constructed using seven binary variables. Logistic regression models were used to test associations between indicators of female autonomy and the risk of having a stunted child. Women with higher autonomy {indicated by access to money [odds ratio (OR) = 0.731; 95% confidence interval (CI) 0.546, 0.981] and freedom to choose to go to the market [OR = 0.593; 95% CI 0.376, 0.933]} were significantly less likely to have a stunted child, after controlling for household socio-economic status and mother's education. In this south Indian state, two dimensions of female autonomy have an independent effect on child growth, suggesting the need for interventions that increase women's financial and physical autonomy.

Influences of early child nutritional status and home learning environment on child development in Vietnam.

PubMed

Nguyen, Phuong H; DiGirolamo, Ann M; Gonzalez-Casanova, Ines; Young, Melissa; Kim, Nicole; Nguyen, Son; Martorell, Reynaldo; Ramakrishnan, Usha

2018-01-01

Early childhood development plays a key role in a child's future health, educational success, and economic status. However, suboptimal early development remains a global challenge. This study examines the influences of quality of the home learning environment (HOME) and child stunting in the first year of life on child development. We used data collected from a randomized controlled trial of preconceptional micronutrient supplementation in Vietnam (n = 1,458). The Bayley Scales of Infant Development-III were used to assess cognition, language, and motor development domains at 2 years. At 1 year, 14% of children were stunted, and 15%, 58%, and 28% of children lived in poor, medium, and high HOME environments, respectively. In multivariate generalized linear regression models, living in a high HOME environment was significantly associated with higher scores (0.10 to 0.13 SD) in each of the developmental domains. Stunted children scored significantly lower for cognitive, language, and motor development (-0.11 to -0.18), compared to nonstunted children. The negative associations between stunting on development were modified by HOME; the associations were strong among children living in homes with a poor learning environment whereas they were nonsignificant for those living in high-quality learning environments. In conclusion, child stunting the first year of life was negatively associated with child development at 2 years among children in Vietnam, but a high-quality HOME appeared to attenuate these associations. Early interventions aimed at improving early child growth as well as providing a stimulating home environment are critical to ensure optimal child development. © 2017 John Wiley & Sons Ltd.

What causes childhood stunting among children of San Vicente, Guatemala: Employing complimentary, system-analysis approaches.

PubMed

Voth-Gaeddert, Lee E; Stoker, Matthew; Cornell, Devin; Oerther, Daniel B

2018-04-01

Guatemala has the sixth worst stunting rate with 48% of children under five years of age classified as stunted according to World Health Organization standards. This study utilizes two different yet complimentary system-analysis approaches to analyze correlations among environmental and demographic variables, environmental enteric dysfunction (EED), and child height-for-age (stunting metric) in Guatemala. Two descriptive models constructed around applicable environmental and demographic factors on child height-for-age and EED were analyzed using Network Analysis (NA) and Structural Equation Modeling (SEM). Data from two populations of children between the age of three months and five years were used. The first population (n = 2103) was drawn from the Food for Peace Baseline Survey conducted by the US Agency for International Development (USAID) in 2012, and the second population (n = 372) was drawn from an independent survey conducted by the San Vicente Health Center in 2016. The results from the NA of the height-for-age model confirmed pathogen exposure, nutrition, and prenatal health as important, and the results from the NA of the EED model confirmed water source, water treatment, and type of sanitation as important. The results from the SEM of the height-for-age model confirmed a statistically significant correlation among child height-for-age and child-mother interaction (-0.092, p = 0.076) while the SEM of the EED model confirmed the statistically significant correlation among EED and type of water treatment (-0.115, p = 0.013). Our approach supports important efforts to understand the complex set of factors associated with child stunting among communities sharing similarities with San Vicente. Copyright © 2018 Elsevier GmbH. All rights reserved.

Obesity and undernutrition in a very-low-income population in the city of Maceió, northeastern Brazil.

PubMed

Florêncio, T M; Ferreira, H S; de França, A P; Cavalcante, J C; Sawaya, A L

2001-08-01

Obesity is the nutritional disorder which has shown the greatest increase in prevalence, even in those countries in which deficiency diseases represent a severe public health problem. The goal of the present study was to analyse the anthropometric profile of a community living in the outskirts of Maceió, capital of Alagoas (northeastern Brazil), and to investigate the hypothesis of a coexistence of undernutrition and obesity in a very low-income population. The survey was conducted on 315 families (1247 individuals). Among the children (aged < or =10 years), the prevalence of wasting, stunting and wasting plus stunting was 3.8, 8.3 and 8.7 % respectively. Wasting (10.2 %) was the most prevalent form of undernutrition among adolescents; nonetheless, a higher frequency of stunting (11 %) and overweight-obesity (5.5 %) was seen specifically in girls, in agreement with trends found in other studies. Adults exhibited a high prevalence of overweight-obesity (25 %), but stunting was also present (22 %). Of the stunted individuals, 30 % were overweight-obese and 16.3 % were underweight. There were eighty-six families with at least one parent who was underweight (27 %) and 104 families with at least one parent who was overweight (33 %). Underweight and overweight-obesity were both present in ninety-six households (30 %). These results may indicate that better living conditions in urban areas in a population 'adapted' to chronic famine might increase the susceptibility to obesity. Considering the harm caused by the cumulative effect of these two conditions (undernutrition in childhood and obesity in adult life) there is a clear need for new studies to uncover the determinant factors so that preventive measures can be implemented.

Recilia banda Kramer (Hemiptera: Cicadellidae), a vector of Napier stunt phytoplasma in Kenya

NASA Astrophysics Data System (ADS)

Obura, Evans; Midega, Charles A. O.; Masiga, Daniel; Pickett, John A.; Hassan, Mohamed; Koji, Shinsaku; Khan, Zeyaur R.

2009-10-01

Napier grass ( Pennisetum purpureum) is the most important fodder crop in smallholder dairy production systems in East Africa, characterized by small zero-grazing units. It is also an important trap crop used in the management of cereal stemborers in maize in the region. However, production of Napier grass in the region is severely constrained by Napier stunt disease. The etiology of the disease is known to be a phytoplasma, 16SrXI strain. However, the putative insect vector was yet unknown. We sampled and identified five leafhopper and three planthopper species associated with Napier grass and used them as candidates in pathogen transmission experiments. Polymerase chain reaction (PCR), based on the highly conserved 16S gene, primed by P1/P6-R16F2n/R16R2 nested primer sets was used to diagnose phytoplasma on test plants and insects, before and after transmission experiments. Healthy plants were exposed for 60 days to insects that had fed on diseased plants and acquired phytoplasma. The plants were then incubated for another 30 days. Nested PCR analyses showed that 58.3% of plants exposed to Recilia banda Kramer (Hemiptera: Cicadellidae) were positive for phytoplasma and developed characteristic stunt disease symptoms while 60% of R. banda insect samples were similarly phytoplasma positive. We compared the nucleotide sequences of the phytoplasma isolated from R. banda, Napier grass on which these insects were fed, and Napier grass infected by R. banda, and found them to be virtually identical. The results confirm that R. banda transmits Napier stunt phytoplasma in western Kenya, and may be the key vector of Napier stunt disease in this region.

Narrowing socioeconomic inequality in child stunting: the Brazilian experience, 1974-2007.

PubMed

Monteiro, Carlos Augusto; Benicio, Maria Helena D'Aquino; Conde, Wolney Lisboa; Konno, Silvia; Lovadino, Ana Lucia; Barros, Aluisio J D; Victora, Cesar Gomes

2010-04-01

To assess trends in the prevalence and social distribution of child stunting in Brazil to evaluate the effect of income and basic service redistribution policies implemented in that country in the recent past. The prevalence of stunting (height-for-age z score below -2 using the Child Growth Standards of the World Health Organization) among children aged less than 5 years was estimated from data collected during national household surveys carried out in Brazil in 1974-75 (n = 34,409), 1989 (n = 7374), 1996 (n = 4149) and 2006-07 (n = 4414). Absolute and relative socioeconomic inequality in stunting was measured by means of the slope index and the concentration index of inequality, respectively. Over a 33-year period, we documented a steady decline in the national prevalence of stunting from 37.1% to 7.1%. Prevalence dropped from 59.0% to 11.2% in the poorest quintile and from 12.1% to 3.3% among the wealthiest quintile. The decline was particularly steep in the last 10 years of the period (1996 to 2007), when the gaps between poor and wealthy families with children under 5 were also reduced in terms of purchasing power; access to education, health care and water and sanitation services; and reproductive health indicators. In Brazil, socioeconomic development coupled with equity-oriented public policies have been accompanied by marked improvements in living conditions and a substantial decline in child undernutrition, as well as a reduction of the gap in nutritional status between children in the highest and lowest socioeconomic quintiles. Future studies will show whether these gains will be maintained under the current global economic crisis.

Narrowing socioeconomic inequality in child stunting: the Brazilian experience, 1974–2007

PubMed Central

Benicio, Maria Helena D’Aquino; Conde, Wolney Lisboa; Konno, Silvia; Lovadino, Ana Lucia; Barros, Aluisio JD; Victora, Cesar Gomes

2010-01-01

Abstract Objective To assess trends in the prevalence and social distribution of child stunting in Brazil to evaluate the effect of income and basic service redistribution policies implemented in that country in the recent past. Methods The prevalence of stunting (height-for-age z score below −2 using the Child Growth Standards of the World Health Organization) among children aged less than 5 years was estimated from data collected during national household surveys carried out in Brazil in 1974–75 (n = 34 409), 1989 (n = 7374), 1996 (n = 4149) and 2006–07 (n = 4414). Absolute and relative socioeconomic inequality in stunting was measured by means of the slope index and the concentration index of inequality, respectively. Findings Over a 33-year period, we documented a steady decline in the national prevalence of stunting from 37.1% to 7.1%. Prevalence dropped from 59.0% to 11.2% in the poorest quintile and from 12.1% to 3.3% among the wealthiest quintile. The decline was particularly steep in the last 10 years of the period (1996 to 2007), when the gaps between poor and wealthy families with children under 5 were also reduced in terms of purchasing power; access to education, health care and water and sanitation services; and reproductive health indicators. Conclusion In Brazil, socioeconomic development coupled with equity-oriented public policies have been accompanied by marked improvements in living conditions and a substantial decline in child undernutrition, as well as a reduction of the gap in nutritional status between children in the highest and lowest socioeconomic quintiles. Future studies will show whether these gains will be maintained under the current global economic crisis. PMID:20431795

Adoption of the WHO Child Growth Standards to classify Indonesian children under 2 years of age according to nutrition status: stronger indication for nutritional intervention.

PubMed

Julia, Madarina

2009-09-01

The National Center for Health Statistics/World Health Organization (NCHS/WHO) reference is considered unsuitable for assessing the nutritional status of breastfed children. It is gradually being replaced by the WHO Child Growth Standards in many countries. To assess the implications of adopting the WHO Child Growth Standards to classify Indonesian children according to nutrition status. Data were obtained from two cross-sectional surveys in two districts in Indonesia in 1998. Children under 2 years of age were randomly selected using a two-stage cluster sampling. Z-scores of weight-for-length (WLZ), length-for-age (LAZ), and weight-for-age (WAZ) were calculated based on both the NCHS/WHO reference and the WHO Child Growth Standards. Wasting, stunting, and underweight were defined as z-scores less than -2.0. We included 1,374 children, of whom 693 (50.4%) were male and 681 (49.6%) were female. Almost all of the children had initiated breastfeeding and were still being breastfed when the data were collected. According to the WHO Child Growth Standards, the prevalence of wasting did not change with age, but the prevalence rates of stunting and underweight rose steadily with age. Although the contribution of wasting to the classification of underweight was relatively constant, the contribution of stunting increased as the children grew. The WHO Child Growth Standards are a better tool for assessing the nutritional status of Indonesian children than the NCHS/WHO reference. However, low WAZ is not a suitable indicator for commencing an extra feeding program, because it reflects stunting instead of wasting. The high prevalence of stunting indicates the need to perform preventive nutritional intervention beginning earlier in life, i.e., in utero.

Association between socio-economic status and childhood undernutrition in Bangladesh; a comparison of possession score and poverty index.

PubMed

Mohsena, Masuda; Mascie-Taylor, C G Nicholas; Goto, Rie

2010-10-01

To determine how much of the variation in nutritional status of Bangladeshi children under 5 years old can be attributed to the socio-economic status of the family. Nutritional status used reference Z-scores of weight-for-age (WAZ), height-for-age (HAZ) and weight-for-height (WHZ). A 'possession score' was generated based on ownership of a radio, television, bicycle, motorcycle and telephone, and the availability of electricity, with categories of 0 to 4+ possessions. A five-point (quintile) 'poverty index' was created using principal component analysis. The Bangladesh Demographic and Health Survey 2004 was the source of data. A sample of 4891 children aged <5 years was obtained. Some 57.8 % of the sample was either stunted, wasted or underweight (7.7 % were stunted, wasted and underweight). Of those stunted (48.4 %), 25.7 % were also underweight. Underweight and wasting prevalences were 40.7 % and 14.3 %, respectively. Mean WAZ, HAZ and WHZ did not differ by sex. Children of mothers with no education or no possessions were, on average, about 1 sd more underweight and stunted than those with higher educated mothers or with 4+ possessions. The possession score provided much greater discrimination of undernutrition than the poverty index. Nearly 50 % of children from households with no possessions were stunted, wasted or underweight (only 27 % in the poorest quintile), compared with only 3-6 % of children from households with 4+ possessions (over 13 % in the richest quintile). Maternal education and possession score were the main predictors of a child's nutritional status. Possession score was a much better indicator of undernutrition than the poverty index.

Cram, Michelle M.; Fraedrich, Stephen W. 2009. Stunt nematode (Tylenchorhynchus claytoni) impact on southern pine seedlings and response to a field test of cover crops.

Treesearch

Michelle Cram; Stephen Fraedrich

2009-01-01

The stunt nematode, Tylenchorhynchus claytoni, was found to cause a reduction in root volume (cm3) of loblolly pine at population densities equivalent of 125 nematodes/100 cm3 (6 in3) soil and greater. The results of a host range test conducted in containers under controlled conditions determined that buckwheat cultivar (Fagopryum...

[Stunting, overweight and obesity during the nutrition transition in schoolchildren of Arandas, Jalisco, Mexico].

PubMed

Vásquez-Garibay, Edgar M; Miranda-Ríos, Lizette; Romero-Velarde, Enrique; Nuño-Cosío, María Eugenia; Campos-Barrera, Liliana; Nápoles-Rodríguez, Francisco; Caro-Sabido, Erika A; Ramírez-Díaz, Joanie

2018-01-01

Nutrition transition provokes changes in the nutritional status of individuals subjected to the interaction of various environmental factors; therefore, the aim was to demonstrate that nutrition transition is associated with socioeconomic changes, eating habits and physical activity, potentially involved in stunting, overweight and obesity of schoolchildren. Case-control study. 102 participants from the Instituto Alteño para el Desarrollo de Jalisco (cases) and 194 from the elementary school system (controls), aged 5 to 12 years, were included. Dependent variables were these indexes weight/age (Z), height/age (Z), BMI (Z). Independent variables were the socioeconomic and demographic characteristics. Student's t test, chi square, odds ratio (OR) and 95% confidence intervals (95% CI) were estimated. Family income was low (p = 0.031) and unstable job was higher in cases: OR = 4.1, 95% CI = 2.8-6.0. The frequency of stunting was higher in cases (9.9% vs. 5.9%). The combination of overweight/obesity was higher in controls (27.3% vs. 16.8%), OR = 1.85, 95% CI = 1.0-3.4. The nutritional status of children of Arandas, Jalisco, has been modified by an accelerate nutrition transition, provoked by socioeconomic, educational and demographic factors that might have influence on the persistence of stunting and an increasing prevalence of overweight/obesity.

Catch-up growth in stunted children: Definitions and predictors

PubMed Central

2017-01-01

This paper examines the incidence and correlates of linear growth catch up in early childhood among stunted children, using a range of definitions of catch up. Catch-up growth between two and five years of age is defined in both absolute terms (i.e. the centimetre height deficit from the healthy reference population mean is reduced) and relative terms (the height-for-age z-score improved or passed the -2SD or -1SD cut-off points). Data from a cohort study from urban South Africa are used to estimate the percentage of children who caught up and the predictors of catch-up growth according to these varying definitions. The results show that our sample of stunted children exhibits catch-up growth regardless of the definition used, however prevalence of catch up is highly sensitive to the way catch up is classified, ranging from 19%-93%. Of the biological, early growth, socioeconomic status and maternal reproductive variables included in the multivariate probit regressions, only a few were found to be consistent predictors of the incidence of catch-up growth. Mother’s height was positively correlated with the incidence of catch-up growth and early stunting at one year was associated with a lower likelihood of subsequent catch up. PMID:29236728

Catch-up growth in stunted children: Definitions and predictors.

PubMed

Desmond, Chris; Casale, Daniela

2017-01-01

This paper examines the incidence and correlates of linear growth catch up in early childhood among stunted children, using a range of definitions of catch up. Catch-up growth between two and five years of age is defined in both absolute terms (i.e. the centimetre height deficit from the healthy reference population mean is reduced) and relative terms (the height-for-age z-score improved or passed the -2SD or -1SD cut-off points). Data from a cohort study from urban South Africa are used to estimate the percentage of children who caught up and the predictors of catch-up growth according to these varying definitions. The results show that our sample of stunted children exhibits catch-up growth regardless of the definition used, however prevalence of catch up is highly sensitive to the way catch up is classified, ranging from 19%-93%. Of the biological, early growth, socioeconomic status and maternal reproductive variables included in the multivariate probit regressions, only a few were found to be consistent predictors of the incidence of catch-up growth. Mother's height was positively correlated with the incidence of catch-up growth and early stunting at one year was associated with a lower likelihood of subsequent catch up.

Nutritional catch-up growth.

PubMed

Gat-Yablonski, Galia; Pando, Rakefet; Phillip, Moshe

2013-01-01

Malnutrition, marked by variant nutrient deficiencies, is considered a leading cause of stunted growth worldwide. In developing countries, malnutrition is caused mainly by food shortage and infectious diseases. Malnutrition may also be found in the developed world, where it is due mostly to prematurity, chronic diseases, and anorexia nervosa. In most cases, when food consumption is corrected, spontaneous catch-up (CU) growth occurs. However, CU growth is not always complete, leading to growth deficits. Therefore, it is important to understand the mechanisms that govern this process. Using a rat model of food restriction followed by refeeding, we established a nutrition-induced CU growth model. Levels of leptin and insulin-like growth factor-1 were found to significantly decrease when food was restricted and to increase already 1 day after refeeding. Gene expression analysis of the growth plate revealed that food restriction specifically affects transcription factors such as the hypoxia inducible factor-1 and its downstream targets on the one hand, and global gene expression, indicating epigenetic regulation, on the other. Food restriction also reduced the level of several microRNAs, including the chondrocyte-specific miR-140, which led to an increase in its target, SIRT1, a class III histone deacetylase. These findings may explain the global changes in gene expression observed under nutritional manipulation. We suggest that multiple levels of regulation, including transcription factors, epigenetic mechanisms, and microRNAs respond to nutritional cues and offer a possible explanation for some of the effects of food restriction on epiphyseal growth plate growth. The means whereby these components sense changes in nutritional status are still unknown. Deciphering the role of epigenetic regulation in growth may pave the way for the development of new treatments for children with growth disorders. Copyright © 2013 S. Karger AG, Basel.

Effects of socio-economic and behavioural factors on childhood malnutrition in Yemen.

PubMed

Sunil, T S

2009-07-01

This study examined the effects of socio-economic and behavioural factors on childhood malnutrition in Yemen. The three anthropometric indicators such as height-for-age, weight-for-height and weight-for-age are used to examine the nutritional status of children aged less 5 years in Yemen. The independent variables include background characteristics, behavioural risk factors and illness characteristics. Data for the study come the most recent Yemen Demographic and Health Survey, a nationally representative sample, conducted in Yemen in 1997. Logistic regression analysis is used to estimate the odds of being malnourished. The three anthropometric indicators show high to very high levels of child malnutrition in Yemen. The prevalence of stunting and underweight is so widespread that almost every other child under the age of 5 is either stunted or underweight. Social, economic and behavioural factors show very significant association with childhood malnutrition. The study results indicate the importance of social and behavioural factors in describing childhood malnutrition in Yemen. The study results will help develop nutritional and health promotion policies in order to improve childhood malnutrition in this country.

Child growth in urban deprived settings: does household poverty status matter? At which stage of child development?

PubMed

Fotso, Jean Christophe; Madise, Nyovani; Baschieri, Angela; Cleland, John; Zulu, Eliya; Mutua, Martin Kavao; Essendi, Hildah

2012-03-01

This paper uses longitudinal data from two informal settlements of Nairobi, Kenya to examine patterns of child growth and how these are affected by four different dimensions of poverty at the household level namely, expenditures poverty, assets poverty, food poverty, and subjective poverty. The descriptive results show a grim picture, with the prevalence of overall stunting reaching nearly 60% in the age group 15-17 months and remaining almost constant thereafter. There is a strong association between food poverty and stunting among children aged 6-11 months (p<0.01), while assets poverty and subjective poverty have stronger relationships (p<0.01) with undernutrition at older age (24 months or older for assets poverty, and 12 months or older for subjective poverty). The effect of expenditures poverty does not reach statistical significant in any age group. These findings shed light on the degree of vulnerability of urban poor infants and children and on the influences of various aspects of poverty measures. Copyright © 2011 Elsevier Ltd. All rights reserved.

microRNA-mediated R gene regulation: molecular scabbards for double-edged swords.

PubMed

Deng, Yingtian; Liu, Minglei; Li, Xiaofei; Li, Feng

2018-02-01

Plant resistance (R) proteins are immune receptors that recognize pathogen effectors and trigger rapid defense responses, namely effector-triggered immunity. R protein-mediated pathogen resistance is usually race specific. During plant-pathogen coevolution, plant genomes accumulated large numbers of R genes. Even though plant R genes provide important natural resources for breeding disease-resistant crops, their presence in the plant genome comes at a cost. Misregulation of R genes leads to developmental defects, such as stunted growth and reduced fertility. In the past decade, many microRNAs (miRNAs) have been identified to target various R genes in plant genomes. miRNAs reduce R gene levels under normal conditions and allow induction of R gene expression under various stresses. For these reasons, we consider R genes to be double-edged "swords" and miRNAs as molecular "scabbards". In the present review, we summarize the contributions and potential problems of these "swords" and discuss the features and production of the "scabbards", as well as the mechanisms used to pull the "sword" from the "scabbard" when needed.

Water, Sanitation, and Hygiene Practices Associated with Nutritional Status of Under-Five Children in Semi-Pastoral Communities Tanzania.

PubMed

Mshida, Hoyce Amini; Kassim, Neema; Mpolya, Emmanuel; Kimanya, Martin

2018-05-01

Undernutrition among under-five children is a public health concern in developing countries and has been linked with poor water, sanitation, and hygiene (WASH) practices. This study aimed at assessing WASH practices and its association with nutritional status of under-five children in semi-pastoral communities of Arusha. The study was cross-sectional in design. Mother-child pairs from 310 households in four villages of Monduli and Longido were involved. Weight and height of children were measured using weighing scale and length/height board, respectively. Children's age was recorded using clinic cards. Hemoglobin level of each child was tested using Hemo Cue ® Hb 201 + photometer (HemoCue AB, Ängelholm, Sweden) machine. Structured questionnaire was used to gather information on WASH, child morbidity, demographic, and sociocultural characteristics. Prevalence of stunted, underweight, wasted, anemia, and diarrhea were 31.6%, 15.5%, 4.5% 61.2%, and 15.5%, respectively. Children with diarrhea 2 weeks preceding the survey ( P = 0.004), children using surface water for domestic purposes ( P < 0.001), and those with uneducated mothers ( P = 0.001) had increased risk of being stunted and underweight. Children introduced to complementary foods before 6 months of age ( P = 0.02) or belonging to polygamous families ( P = 0.03) had increased risk of being stunted. Consumption of cow's milk that is not boiled ( P = 0.05) or being a boy ( P = 0.03) was associated with underweight. Prevalence of undernutrition among under-five children in the population under study was alarming and it could be associated with poor WASH practices and other sociocultural factors. This study underlines the importance of incorporating WASH strategies in formulation of interventions targeting on promotion of nutrition and disease prevention in pastoral communities.

Impact of implementing performance-based financing on childhood malnutrition in Rwanda.

PubMed

Binagwaho, Agnes; Condo, Jeanine; Wagner, Claire; Ngabo, Fidele; Karema, Corine; Kanters, Steve; Forrest, Jamie I; Bizimana, Jean de Dieu

2014-11-04

Malnutrition remains a serious concern in Rwanda, particularly among children under-5 years. Performance-based financing (PBF), an innovative health systems financing strategy, has been implemented at the national level since 2008. This study aimed to assess the impact of PBF and other factors associated with the prevalence of three classifications of malnutrition (stunting, wasting and underweight) in children under-5 years in Rwanda. The study is a cross-sectional study comprising of 713 children under five years old from 557 households, whose anthropometric measurements (height, weight and age) had been obtained as part of the 2008 Rwanda General Health and HIV household survey. Z-scores for height-for-age, weight-for-age, weight-for-height, and body mass index-for-age were analyzed according to the World Health Organization 2006 Child Growth Standards. Random intercept logistic regression models were used to regress each anthropometric measure (WAZ, HAZ and WHZ) against child, maternal and household characteristics. Child participants ranged in age from 0 to 60 months, 20.2% of children were under 12 months and 5.1% were HIV positive. The prevalence of wasting was 8.8%; of stunting was 58.4%; and of underweight status was 20.7%. Maternal emotional and social wellbeing was protective of wasting in children under-5 years of age. Living in districts implementing PBF was protective of wasting (Adjusted Odds Ratio: 0.43; 95% confidence interval: 0.19-0.97). Living in a district with PBF was not found to be associated with either stunting or underweight status among children under-5. PBF may have a protective association with particular forms of malnutrition among children under-5 years in Rwanda. These findings warrant further investigation in relation to the impact of implementing innovative financing schemes on health outcomes.

Nutritional status and its correlates in Equatorial Guinean preschool children: results from a nationally representative survey.

PubMed

Custodio, Estefanía; Descalzo, Miguel Angel; Roche, Jesús; Sánchez, Ignacio; Molina, Laura; Lwanga, Magdalena; Bernis, Cristina; Villamor, Eduardo; Baylin, Ana

2008-03-01

In Equatorial Guinea, as a result of the recent growth of the oil industry, there is an opportunity to address important public health problems through public and private initiatives. To propose effective nutrition and public health strategies, it is important first to have reliable information on the nutritional status of the population and the underlying factors affecting it. To assess the nutritional status and the prevalence of anemia among Equatoguinean children in a nationally representative sample and to identify the risk factors associated with the nutritional problems detected. The study was a cross-sectional survey using a multistaged, stratified, cluster-selected sample. The survey included a sociodemographic, health, and dietary questionnaire and measurement of hematocrit and anthropometric features, from which nutritional indicators based on the National Center for Health Statistics (NCHS) reference and the World Health Organization (WHO) standards were calculated. Logistic regression models were used for the multivariate analysis. A total of 552 children aged 0 to 60 months were surveyed. The overall prevalence of stunting (< -2 height-for-age z-scores [HAZ]) was 29.7% based on the NCHS reference and 35.2% based on WHO standards; the risk factors associated with stunting were age (p < .0001), low socioeconomic status (p = .01), and fishing by a member of the household (p = .003) The prevalence of mild anemia (hemoglobin < 110 g/L) was 69.3%, and that of moderate or severe anemia (hemoglobin < 80 g/L) was 8.3%. The only significant risk factor associated with moderate to severe anemia was low household socioeducational level (p = .01). Stunting and anemia are public health problems in Equatorial Guinea. Integrated strategies, including fighting poverty and improving maternal education, should be undertaken.

Dietary patterns are associated with child, maternal and household-level characteristics and overweight/obesity among young Samoan children.

PubMed

Choy, Courtney C; Wang, Dongqing; Baylin, Ana; Soti-Ulberg, Christina; Naseri, Take; Reupena, Muagututia S; Thompson, Avery A; Duckham, Rachel L; Hawley, Nicola L

2018-05-01

Among young Samoan children, diet may not be optimal: in 2015, 16·1 % of 24-59-month-olds were overweight/obese, 20·3 % stunted and 34·1 % anaemic. The present study aimed to identify dietary patterns among 24-59-month-old Samoan children and evaluate their association with: (i) child, maternal and household characteristics; and (ii) nutritional status indicators (stunting, overweight/obesity, anaemia). A community-based, cross-sectional study. Principal component analysis on 117 FFQ items was used to identify empirical dietary patterns. Distributions of child, maternal and household characteristics were examined by factor score quintiles. The regression of nutritional status indicators v. these quintiles was performed using logistic regression models. Ten villages on the Samoan island of Upolu. A convenience sample of mother-child pairs (n 305). Two dietary patterns, modern and neo-traditional, emerged. The modern pattern was loaded with 'westernized' foods (red meat, condiments and snacks). The neo-traditional pattern included vegetables, local starches, coconuts, fish and poultry. Following the modern diet was associated with urban residence, greater maternal educational attainment, higher socio-economic status, lower vitamin C intake and higher sugar intake. Following the neo-traditional diet was associated with rural residence, lower socio-economic status, higher vitamin C intake and lower sugar intake. While dietary patterns were not related to stunting or anaemia, following the neo-traditional pattern was positively associated with child overweight/obesity (adjusted OR=4·23, 95 % CI 1·26, 14·17, for the highest quintile, P-trend=0·06). Further longitudinal monitoring and evaluation of early childhood growth and development are needed to understand the influences of early diet on child health in Samoa.

Nutritional status and dietary diversity of Kamea in Gulf Province, Papua New Guineas.

PubMed

Goris, Janny M; Zomerdijk, Nienke; Temple, Victor J

To assess the nutritional status of infants, children and non-pregnant women and underlying factors, dietary diversity and community food security, in the Kamea community in Gulf Province, Papua New Guinea. Prospective cross sectional study. Study population 69 infants (0-59 months), 151 children (6-12 years) and 79 non-pregnant women from 10 villages in Kotidanga Local Level Government, Kerema District, Gulf Province, Papua New Guinea. Among infants prevalence of moderate stunting, wasting and underweight were 38.9%, 8.3% and 44.4%, respectively; after adjusting Hb concentration for altitude, the anaemia prevalence was 53.8%. Among children prevalence of severe stunting was 21.2%; moderate stunting, wasting and underweight were 57.6%, 12.2% and 48.5%, respectively; anaemia was 30.3%; median urinary iodine concentration was 32.0 μg/L and iodine deficiency was prevalent among 88.1%. Among women, mean height, weight and BMI were 1.46±0.04 m, 43.9±5.91 kg and 20.4±2.32 kg/m2, respectively; low BMI (<18.5 kg/m2) and anaemia were prevalent among 22.8% and 35.4%, respectively; median urinary iodine concentration was 36.0 μg/L and iodine deficiency was prevalent among 80.3%. Exclusive breastfeeding was universal for young infants; complementary foods were limited in variety and frequency. Dietary diversity was limited, implementation of the universal salt iodisation strategy restricted and community food security was inadequate. The high prevalence of malnutrition and anaemia among the three age groups, including moderate status of iodine deficiency among women and children, are significant public health concerns. Improvements in dietary diversity, adequate use of iodised salt and community food security are needed.

Association between economic growth and early childhood undernutrition: evidence from 121 Demographic and Health Surveys from 36 low-income and middle-income countries.

PubMed

Vollmer, Sebastian; Harttgen, Kenneth; Subramanyam, Malavika A; Finlay, Jocelyn; Klasen, Stephan; Subramanian, S V

2014-04-01

Economic growth is widely regarded as a necessary, and often sufficient, condition for the improvement of population health. We aimed to assess whether macroeconomic growth was associated with reductions in early childhood undernutrition in low-income and middle-income countries. We analysed data from 121 Demographic and Health Surveys from 36 countries done between Jan 1, 1990, and Dec 31, 2011. The sample consisted of nationally representative cross-sectional surveys of children aged 0-35 months, and the outcome variables were stunting, underweight, and wasting. The main independent variable was per-head gross domestic product (GDP) in constant prices and adjusted for purchasing power parity. We used logistic regression models to estimate the association between changes in per-head GDP and changes in child undernutrition outcomes. Models were adjusted for country fixed effects, survey-year fixed effects, clustering, and demographic and socioeconomic covariates for the child, mother, and household. Sample sizes were 462,854 for stunting, 485,152 for underweight, and 459,538 for wasting. Overall, 35·6% (95% CI 35·4-35·9) of young children were stunted (ranging from 8·7% [7·6-9·7] in Jordan to 51·1% [49·1-53·1] in Niger), 22·7% (22·5-22·9) were underweight (ranging from 1·8% [1·3-2·3] in Jordan to 41·7% [41·1-42·3] in India), and 12·8% (12·6-12·9) were wasted (ranging from 1·2% [0·6-1·8] in Peru to 28·8% [27·5-30·0] in Burkina Faso). At the country level, no association was seen between average changes in the prevalence of child undernutrition outcomes and average growth of per-head GDP. In models adjusted only for country and survey-year fixed effects, a 5% increase in per-head GDP was associated with an odds ratio (OR) of 0·993 (95% CI 0·989-0·995) for stunting, 0·986 (0·982-0·990) for underweight, and 0·984 (0·981-0·986) for wasting. ORs after adjustment for the full set of covariates were 0·996 (0·993-1·000) for stunting, 0·989 (0·985-0·992) for underweight, and 0·983 (0·979-0·986) for wasting. These findings were consistent across various subsamples and for alternative variable specifications. Notably, no association was seen between per-head GDP and undernutrition in young children from the poorest household wealth quintile. ORs for the poorest wealth quintile were 0·997 (0·990-1·004) for stunting, 0·999 (0·991-1·008) for underweight, and 0·991 (0·978-1·004) for wasting. A quantitatively very small to null association was seen between increases in per-head GDP and reductions in early childhood undernutrition, emphasising the need for direct health investments to improve the nutritional status of children in low-income and middle-income countries. None. Copyright © 2014 Vollmer et al. Open Access article distributed under the terms of CC BY. Published by .. All rights reserved.

The span as a fundamental factor in airplane design

NASA Technical Reports Server (NTRS)

Lachmann, G

1928-01-01

Previous theoretical investigations of steady curvilinear flight did not afford a suitable criterion of "maneuverability," which is very important for judging combat, sport and stunt-flying airplanes. The idea of rolling ability, i.e., of the speed of rotation of the airplane about its X axis in rectilinear flight at constant speed and for a constant, suddenly produced deflection of the ailerons, is introduced and tested under simplified assumptions for the air-force distribution over the span. This leads to the following conclusions: the effect of the moment of inertia about the X axis is negligibly small, since the speed of rotation very quickly reaches a uniform value.

Mucopolysaccharidosis type VI in a juvenile miniature schnauzer dog with concurrent hypertriglyceridemia, necrotizing pancreatitis, and diabetic ketoacidosis.

PubMed

Pérez, Mayrim L; Kridel, Heather A; Gallagher, Alex; Sheppard, Barbara J; Reese, Shona; Kondo, Hirotaka; Alleman, Rick; Giger, Urs

2015-03-01

A 7-month-old, neutered male miniature schnauzer dog with a history of cryptorchidism and umbilical hernia was referred for diabetic ketoacidosis. Clinical evaluation revealed stunted growth, skeletal abnormalities, hypertriglyceridemia, diabetic ketoacidosis, and acute necrotizing pancreatitis. Further testing was diagnostic for mucopolysaccharidosis type VI causing the stunted growth and skeletal deformities, but no connection between mucopolysaccharidosis type VI, hypertriglyceridemia, and pancreatic diseases was found.

Mucopolysaccharidosis type VI in a juvenile miniature schnauzer dog with concurrent hypertriglyceridemia, necrotizing pancreatitis, and diabetic ketoacidosis

PubMed Central

Pérez, Mayrim L.; Kridel, Heather A.; Gallagher, Alex; Sheppard, Barbara J.; Reese, Shona; Kondo, Hirotaka; Alleman, Rick; Giger, Urs

2015-01-01

A 7-month-old, neutered male miniature schnauzer dog with a history of cryptorchidism and umbilical hernia was referred for diabetic ketoacidosis. Clinical evaluation revealed stunted growth, skeletal abnormalities, hypertriglyceridemia, diabetic ketoacidosis, and acute necrotizing pancreatitis. Further testing was diagnostic for mucopolysaccharidosis type VI causing the stunted growth and skeletal deformities, but no connection between mucopolysaccharidosis type VI, hypertriglyceridemia, and pancreatic diseases was found. PMID:25750448

Higher Dietary Energy Density is Associated with Stunting but not Overweight and Obesity in a Sample of Urban Malaysian Children.

PubMed

Shariff, Zalilah Mohd; Lin, Khor Geok; Sariman, Sarina; Siew, Chin Yit; Yusof, Barakatun Nisak Mohd; Mun, Chan Yoke; Lee, Huang Soo; Mohamad, Maznorila

2016-01-01

Although diets with high energy density are associated with increased risk of overweight and obesity, it is not known whether such diets are associated with undernutrition. This study assessed the relationship between dietary energy density (ED) and nutritional status of 745 urban 1- to 10-year-old children. Dietary intakes were obtained using food recall and record for two days. Dietary energy density was based on food and caloric beverages. Higher dietary ED was associated with lower intakes of carbohydrate, sugar, vitamins C and D, and calcium but higher fat, fiber, iron, and folate intakes. While intakes of fruits and milk/dairy products decreased, meat, fish, and legume intakes increased with higher dietary ED. Stunting, but not other growth problems, was associated with higher dietary ED. Future studies should confirm the cause-and-effect relationship between higher dietary ED and stunting.

The impact of public expenditure on undernourishment distribution in Mexico.

PubMed

Moreno-Macías, Lidia; Palma-Solís, Marco; Zapata-Vázquez, Rita E

2013-09-01

The status of undernourishment in children under the age of five in Mexico is open to debate. Linked to poverty, underweight and stunting, the rates of undernourishment are reported to be diminishing, although poverty remains an incessant problem. This study was done to determine whether there is an association between public expenditure and underweight and stunting distribution in Mexico based on data from the 2006 health and population census and from macroeconomic, social, and demographic variables. We used principal component analysis to reduce the number of variables and analyze their behavior. Multiple regressions showed that underweight and stunting are significantly associated with the marginalization index, support from the Sistema Nacional para el Desarrollo Integral de la Familia (DIF) supplies and breakfast program, the gross domestic product per capita, and expenditure from the Opportunities program. Further, public expenditure aimed to combat undernourishment is inadequately oriented to address the needs of the poor.

Childhood stunting in relation to the pre- and postnatal environment during the first 2 years of life: The MAL-ED longitudinal birth cohort study

PubMed Central

2017-01-01

Background Stunting is the most prevalent manifestation of childhood malnutrition. To characterize factors that contribute to stunting in resource-poor settings, we studied a priori selected biological and social factors collected longitudinally in a cohort of newborns. Methods and findings We enrolled 1,868 children across 7 resource-poor settings in Bangladesh, Brazil, India, Nepal, Peru, South Africa, and Tanzania shortly after birth and followed them for 24 months between 2 November 2009 and 28 February 2014. We collected longitudinal anthropometry, sociodemographic factors, maternal-reported illnesses, and antibiotic use; child feeding practices; dietary intake starting at 9 months; and longitudinal blood, urine, and stool samples to investigate non-diarrheal enteropathogens, micronutrients, gut inflammation and permeability, and systemic inflammation. We categorized length-for-age Z-scores into 3 groups (not stunted, ≥−1; at risk, <−1 to −2; and stunted, <−2), and used multivariable ordinal logistic regression to model the cumulative odds of being in a lower length-for-age category (at risk or stunted). A total of 1,197 children with complete longitudinal data were available for analysis. The prevalence of having a length-for-age Z-score below −1 increased from 43% (range 37%–47% across sites) shortly after birth (mean 7.7 days post-delivery, range 0 to 17 days) to 74% (16%–96%) at 24 months. The prevalence of stunting increased 3-fold during this same time period. Factors that contributed to the odds of being in a lower length-for-age category at 24 months were lower enrollment weight-for-age (interquartile cumulative odds ratio = 1.82, 95% CI 1.49–2.23), shorter maternal height (2.38, 1.89–3.01), higher number of enteropathogens in non-diarrheal stools (1.36, 1.07–1.73), lower socioeconomic status (1.75, 1.20–2.55), and lower percent of energy from protein (1.39, 1.13–1.72). Site-specific analyses suggest that reported associations were similar across settings. While loss to follow-up and missing data are inevitable, some study sites had greater loss to follow-up and more missing data than others, which may limit the generalizability of the findings. Conclusions Neonatal and maternal factors were early determinants of lower length-for-age, and their contribution remained important throughout the first 24 months of life, whereas the average number of enteropathogens in non-diarrheal stools, socioeconomic status, and dietary intake became increasingly important contributors by 24 months relative to neonatal and maternal factors. PMID:29069076

Urbanization as a determinant of health: a socioepidemiological perspective.

PubMed

Patil, Rajan R

2014-01-01

Urbanization is a process that leads to the growth of cities due to industrialization and economic development and that leads to urban-specific changes. Urbanization is associated with profound changes in diet and exercise that in turn increase the prevalence of obesity with attendant increases in risk of type II diabetes and cardiovascular disease. The growing burden of disease among vulnerable populations and pervasive socioeconomic inequities within urban systems exaggerates the adverse impacts of urbanization on health. More than one half of children younger than age 5 of urban poor are stunted and/or underweight. More than one half of the child births occur at home, in slums, putting the life of the mother and newborn in serious risk. Inadequate reach of services due to illegality, social exclusion of slums, hidden slum pockets, and weak social fabric have resulted in a rapid proliferation of the unqualified private health sector, leading to high health expenditures and continuing a vicious cycle of poverty and ill health in urban slums.

Nodal signalling in Xenopus: the role of Xnr5 in left/right asymmetry and heart development.

PubMed

Tadjuidje, Emmanuel; Kofron, Matthew; Mir, Adnan; Wylie, Christopher; Heasman, Janet; Cha, Sang-Wook

2016-08-01

Nodal class TGF-β signalling molecules play essential roles in establishing the vertebrate body plan. In all vertebrates, nodal family members have specific waves of expression required for tissue specification and axis formation. In Xenopus laevis, six nodal genes are expressed before gastrulation, raising the question of whether they have specific roles or act redundantly with each other. Here, we examine the role of Xnr5. We find it acts at the late blastula stage as a mesoderm inducer and repressor of ectodermal gene expression, a role it shares with Vg1. However, unlike Vg1, Xnr5 depletion reduces the expression of the nodal family member xnr1 at the gastrula stage. It is also required for left/right laterality by controlling the expression of the laterality genes xnr1, antivin (lefty) and pitx2 at the tailbud stage. In Xnr5-depleted embryos, the heart field is established normally, but symmetrical reduction in Xnr5 levels causes a severely stunted midline heart, first evidenced by a reduction in cardiac troponin mRNA levels, while left-sided reduction leads to randomization of the left/right axis. This work identifies Xnr5 as the earliest step in the signalling pathway establishing normal heart laterality in Xenopus. © 2016 The Authors.

Effect of occupant behavior and air-conditioner controls on humidity in typical and high-efficiency homes

DOE PAGES

Winkler, Jon; Munk, Jeffrey; Woods, Jason

2018-04-01

Increasing insulation levels and improved windows are reducing sensible cooling loads in high-efficiency homes. This trend raises concerns that the resulting shift in the balance of sensible and latent cooling loads may result in higher indoor humidity, occupant discomfort, and stunted adoption of high-efficiency homes. This study utilizes established moisture-buffering and air-conditioner latent degradation models in conjunction with an approach to stochastically model internal gains. Building loads and indoor humidity levels are compared for simulations of typical new construction homes and high-efficiency homes in 10 US cities. The sensitivity of indoor humidity to changes in cooling set point, air-conditioner capacity,more » and blower control parameters are evaluated. The results show that high-efficiency homes in humid climates have cooling loads with a higher fraction of latent loads than the typical new construction home, resulting in higher indoor humidity. Reducing the cooling set point is the easiest method to reduce indoor humidity, but it is not energy efficient, and overcooling may lead to occupant discomfort. Eliminating the blower operation at the end of cooling cycles and reducing the cooling airflow rate also reduce indoor humidity and with a smaller impact on energy use and comfort.« less

Effect of occupant behavior and air-conditioner controls on humidity in typical and high-efficiency homes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Winkler, Jon; Munk, Jeffrey; Woods, Jason

Increasing insulation levels and improved windows are reducing sensible cooling loads in high-efficiency homes. This trend raises concerns that the resulting shift in the balance of sensible and latent cooling loads may result in higher indoor humidity, occupant discomfort, and stunted adoption of high-efficiency homes. This study utilizes established moisture-buffering and air-conditioner latent degradation models in conjunction with an approach to stochastically model internal gains. Building loads and indoor humidity levels are compared for simulations of typical new construction homes and high-efficiency homes in 10 US cities. The sensitivity of indoor humidity to changes in cooling set point, air-conditioner capacity,more » and blower control parameters are evaluated. The results show that high-efficiency homes in humid climates have cooling loads with a higher fraction of latent loads than the typical new construction home, resulting in higher indoor humidity. Reducing the cooling set point is the easiest method to reduce indoor humidity, but it is not energy efficient, and overcooling may lead to occupant discomfort. Eliminating the blower operation at the end of cooling cycles and reducing the cooling airflow rate also reduce indoor humidity and with a smaller impact on energy use and comfort.« less

Preventive Effects of Long-Term Supplementation with 2 Nutritious Food Supplements in Young Children in Niger.

PubMed

Sayyad-Neerkorn, Jessica; Langendorf, Céline; Roederer, Thomas; Doyon, Stéphane; Mamaty, Abdoul-Aziz; Woi-Messe, Lynda; Manzo, Mahamane L; Harouna, Souley; de Pee, Saskia; Grais, Rebecca F

2015-11-01

In nutritional crises, large-scale preventive distributions of specialized nutritious foods are recommended to prevent acute and chronic malnutrition in young children. Among the available specialized nutritious foods, the World Food Programme and UNICEF recommend lipid-based nutrient supplements (LNSs) and Super Cereal Plus (SC+). Although the effectiveness of short-term distributions for prevention of severe acute malnutrition (SAM) is well documented, evidence for long-term strategies and the role of distribution of specialized nutritious foods for prevention of stunting is weaker. The objective of this study was to compare long-term supplementation of LNSs and SC+ on the incidence of acute malnutrition and stunting in young children. We conducted two 15-mo-long supplementation interventions with the use of LNSs (500 kcal/d) and SC+ (810 kcal/d) and half rations during 5 mo of the nonlean season, for the prevention of acute malnutrition and stunting in children aged 6-23 mo. The study was designed as a prospective cohort in 11 villages in Madarounfa, Niger. We compared the incidence of acute malnutrition and stunting with the use of Cox proportional hazards models and report on sharing and use of these food supplements. Characteristics of children at baseline were similar across groups. A total of 1967 children were included in the analysis (845 in the SC+ group and 1122 in the LNS group). No significant differences in the incidence of moderate acute malnutrition (SC+ compared with LNS: adjusted HR: 0.79; 95% CI: 0.61, 1.02) or SAM (HR: 0.84; 95% CI: 0.52, 1.34) were found. No difference in the incidence of stunting (HR: 1.08; 95% CI: 0.95, 1.24) or severe stunting (HR: 0.94; 95% CI: 0.71, 1.22) over the follow-up period were found. These findings in young children in Niger suggest that both products should be considered when planning preventive distributions and choice of long-term supplementation should be guided by context-specific factors such as acceptability, cost, and operational feasibility, among others. Additional research is essential to improving child health. The study was registered at clinicaltrials.gov as NCT01828814. © 2015 American Society for Nutrition.

A community-based cluster randomised controlled trial to evaluate the effectiveness of different bundles of nutrition-specific interventions in improving mean length-for-age z score among children at 24 months of age in rural Bangladesh: study protocol.

PubMed

Billah, Sk Masum; Ferdous, Tarana E; Karim, Mohd Anisul; Dibley, Michael J; Raihana, Shahreen; Moinuddin, Md; Choudhury, Nuzhat; Ahmed, Tahmeed; Hoque, D M Emdadul; Menon, Purnima; Arifeen, Shams El

2017-05-02

Prevalence of stunting among under-five children in Bangladesh is 36%, varying with geographic and socio-economic characteristics. Previously, research groups statistically modelled the effect of 10 individual nutrition-specific interventions targeting the critical first 1000 days of life from conception, on lives saved and costs incurred in countries with the highest burden of stunted children. However, primary research on the combined effects of these interventions is limited. Our study directly addresses this gap by examining the effect of combinations of 5 preventive interventions on length-for-age z-scores (LAZ) among 2-years old children. This community-based cluster randomised trial (c-RCT) compares 4 intervention combinations against one comparison arm. Intervention combinations are: 1) Behaviour change communication (BCC) on maternal nutrition during pregnancy, exclusive breastfeeding, and complementary feeding, along with prenatal nutritional supplement (PNS) and complementary food supplement (CFS); 2) BCC with PNS; 3) BCC with CFS; and 4) BCC alone. The comparison arm receives only routine health and nutrition services. From a rural district, 125 clusters were selected and randomly assigned to any one of the five study arms by block randomisation. A bespoke automated tab-based system was developed linking data collection, intervention delivery and project supervision. Total sample size is 1500 pregnant women, with minimum 1050 resultant children expected to be retained, powered to detect a difference of at least 0.4 in the mean LAZ score of children at 24 months, the main outcome variable, between the comparison arm and each intervention arm. Length and other anthropometric measurements, nutritional intake and other relevant data on mother and children are being collected during enrolment, twice during pregnancy, postpartum monthly till 6 months, and every third month thereafter till 24 months. This c-RCT explores the effectiveness of bundles of preventive nutrition intervention approaches addressing the critical window of opportunity to mitigate childhood stunting. The results will provide robust evidence as to which bundle(s) can have significant effect on linear growth of children. Our study also will have policy-level implications for prioritising intervention(s) tackling stunting. The study was retrospectively registered on May 2, 2016 and is available online at ClinicalTrials.gov (ID: NCT02768181 ).

The costs of stunting in South Asia and the benefits of public investments in nutrition.

PubMed

Shekar, Meera; Dayton Eberwein, Julia; Kakietek, Jakub

2016-05-01

South Asia is home to the largest number of stunted children worldwide: 65 million or 37% of all South Asian children under 5 were stunted in 2014. The costs to society as a result of stunting during childhood are high and include increased mortality, increased morbidity (in childhood and later as adults), decreased cognitive ability, poor educational outcomes, lost earnings and losses to national economic productivity. Conversely, investing in nutrition provides many benefits for poverty reduction and economic growth. This article draws from analyses conducted in four sub-Saharan countries to demonstrate that investments in nutrition can also be very cost-effective in South Asian countries. Specifically, the analyses demonstrate that scaling up a set of 10 critical nutrition-specific interventions is highly cost-effective when considered as a package. Most of the interventions are also very cost-effective when considered individually. By modelling cost-effectiveness of different scale-up scenarios, the analysis offers insights into ways in which the impact of investing in nutrition interventions can be maximized under budget constraints. Rigorous estimations of the costs and benefits of nutrition investments, similar to those reported here for sub-Saharan countries, are an important next step for all South Asian countries in order to drive political commitment and action and to enhance allocative efficiency of nutrition resources. © 2016 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.

Nutritional status of children in two districts of the mountain region of Nepal.

PubMed

Thapa, M; Neopane, A K; Singh, U K; Aryal, N; Agrawal, K; Shrestha, B

2013-09-01

Nutritional status is a prime indicator of health. Generally, three anthropometric indicators are often used to assess nutritional status during childhood and adolescence: underweight (weight-for-age), stunting (height- for-age) and thinness (BMI-for-age). Malnutrition in children is a major public health problem in many developing countries. This study was conducted to assess nutritional status among children attending health camps in two mountainous districts in Nepal. Five hundred and seventy five children below 15 years of age attending the medical camp in Humla and Mugu districts in October 2011 were assessed for nutritional status. For children less than five years, weight for age, weight for height and height for age as per WHO classification, and for children between five to 15 years age specific values of height, weight and Body Mass Index (BMI) were calculated. In Humla district, 28.2% children were undernourished, 8.8% wasted and 22.4% stunted in less than five years. In the same age group, 31.7% children were undernourished, 9.4% wasted and 29.4% stunted in Mugu district. In the age group five to 15 years, thinness was seen in 22.4% and 29.4% children in Humla and Mugu respectively. Malnutrition (underweight, stunting, wasting and thinness) still constitutes a major health problem among Nepalese children, particularly in mountainous regions.

Household Food Insecurity as a Predictor of Stunted Children and Overweight/Obese Mothers (SCOWT) in Urban Indonesia.

PubMed

Mahmudiono, Trias; Nindya, Triska Susila; Andrias, Dini Ririn; Megatsari, Hario; Rosenkranz, Richard R

2018-04-26

(1) Background : The double burden of malnutrition has been increasing in countries experiencing the nutrition transition. This study aimed to determine the relationship between household food insecurity and the double burden of malnutrition, defined as within-household stunted child and an overweight/obese mother (SCOWT). (2) Methods : A cross-sectional survey was conducted in the urban city of Surabaya, Indonesia in April and May 2015. (3) Results : The prevalence of child stunting in urban Surabaya was 36.4%, maternal overweight/obesity was 70.2%, and SCOWT was 24.7%. Although many households were food secure (42%), there were high proportions of mild (22.9%), moderate (15.3%) and severe (19.7%) food insecurity. In a multivariate logistic regression, the household food insecurity access scale (HFIAS) category significantly correlated with child stunting and SCOWT. Compared to food secure households, mildly food insecure households had the greatest odds of SCOWT (adjusted odds ratio (aOR) = 2.789; 95% confidence interval (CI) = 1.540⁻5.083), followed by moderately food insecure (aOR = 2.530; 95% CI = 1.286⁻4.980) and severely food insecure households (aOR = 2.045; 95% CI = 1.087⁻3.848). (4) Conclusions : These results support the hypothesis that the double burden of malnutrition is related to food insecurity, and the HFIAS category is a predictor of SCOWT.

Soil-transmitted helminth infections and nutritional status in Ecuador: findings from a national survey and implications for control strategies.

PubMed

Moncayo, Ana L; Lovato, Raquel; Cooper, Philip J

2018-04-28

The estimation of prevalence and intensity of soil-transmitted helminth (STH) infections at a country-level is an essential prerequisite for the implementation of a rational control programme. The aim of this present study was to estimate the prevalence and distribution of STH infections and malnutrition in school-age children in rural areas of Ecuador. Cross-sectional study from October 2011 to May 2012. Eighteen rural schools were randomly selected from the three ecological regions of Ecuador (coastal, highlands and Amazon basin). 920 children aged 6-16 years. Prevalence and intensity of STH infections associated with malnutrition (thinness/wasting or stunting). The results showed that 257 (27.9%) children were infected with at least one STH parasite. The prevalence of Trichuris trichiura , Ascaris lumbricoides and hookworm was 19.3%, 18.5% and 5.0%, respectively. Malnutrition was present in 14.2% of children and most common was stunting (12.3%). Compared with other regions, schoolchildren in the Amazon region had the highest STH prevalence (58.9%) of which a greater proportion of infections were moderate/heavy intensity (45.6%) and had the highest prevalence of malnutrition (20.4%). A positive association was observed between moderate to heavy infections with A. lumbricoides and malnutrition (adjusted OR 1.85, 95% CI 1.04 to 3.31, p=0.037). Our estimate of the prevalence of STH infections of 27.9% at a national level in Ecuador is lower than suggested by previous studies. Our data indicate that schoolchildren living in the Amazon region have a greater risk of STH infection and stunting compared with children from other regions. The implementation of school-based preventive chemotherapy and nutritional supplement programmes within the Amazon region should be prioritised. Long-term control strategies require improvements in water, sanitation and hygiene. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Teratogenic versus mutagenic abnormalities in chironomid larvae exposed to zinc and lead.

PubMed

Martinez, Edward A; Moore, Barry C; Schaumloffel, John; Dasgupta, Nairanjana

2004-08-01

Before chironomid mouthpart deformities can be utilized as indicators of aquatic metal pollution with certainty, it must first be established that deformities are teratogenic and not mutagenic. A laboratory experiment was conducted to assess this question using Zn and Pb as causative agents. Parent populations were reared in sediments spiked with zinc (Zn) or lead (Pb) and their resulting offspring (F1 generation) were reared in clean sediments. The proportions of mouthpart deformities in C. tentans larvae were compared via logistic regression, accounting for time of exposure, between parent and offspring populations. Results indicate that 14% of chironomids from Zn-spiked sediment contained deformed menta and/or mandibles. However, the F1-Zn generation displayed a deformity of 1.7%. Larvae reared in Pb-spiked sediments displayed a deformity frequency of 9% and the F1 generations (F1-Pb a and F1-Pb b) had deformity proportion of 7 and 6%, respectively. We concluded that the deformities caused by Zn stress were morphological because the resulting F1 deformity frequencies declined to control levels. However, deformities caused by Pb appear to be genetic since F1 deformity percentages did not differ from the parent deformity frequency. Because larvae reared in Zn- and Pb-spiked sediments were larger than larvae reared in uncontaminated sediments, we could not conclude that Zn and Pb in the sediments stunted the development of C. tentans.

Are urban children really healthier? Evidence from 47 developing countries.

PubMed

Van de Poel, Ellen; O'Donnell, Owen; Van Doorslaer, Eddy

2007-11-01

On average, child health outcomes are better in urban than in rural areas of developing countries. Understanding the nature and the causes of this rural-urban disparity is essential in contemplating the health consequences of the rapid urbanization taking place throughout the developing world and in targeting resources appropriately to raise population health. Using micro-data on child health taken from the most recent Demographic and Health Surveys for 47 developing countries, the purpose of this paper is threefold. First, we document the magnitude of rural-urban disparities in child nutritional status and under-5 mortality across all 47 developing countries. Second, we adjust these disparities for differences in population characteristics across urban and rural settings. Third, we examine rural-urban differences in the degree of socioeconomic inequality in these health outcomes. The results demonstrate that there are considerable rural-urban differences in mean child health outcomes in the entire developing world. The rural-urban gap in stunting does not entirely mirror the gap in under-5 mortality. The most striking difference between the two is in the Latin American and Caribbean region, where the gap in growth stunting is more than 1.5 times higher than that in mortality. On average, the rural-urban risk ratios of stunting and under-5 mortality fall by, respectively, 53% and 59% after controlling for household wealth. Controlling thereafter for socio-demographic factors reduces the risk ratios by another 22% and 25%. We confirm earlier findings of higher socioeconomic inequality in stunting in urban areas and demonstrate that this also holds for under-5 mortality. In a considerable number of countries, the urban poor actually have higher rates of stunting and mortality than their rural counterparts. The findings imply that there is a need for programs that target the urban poor, and that this is becoming more necessary as the size of the urban population grows.

The Double Burden of Obesity and Malnutrition in a Protracted Emergency Setting: A Cross-Sectional Study of Western Sahara Refugees

PubMed Central

Grijalva-Eternod, Carlos S.; Wells, Jonathan C. K.; Cortina-Borja, Mario; Salse-Ubach, Nuria; Tondeur, Mélody C.; Dolan, Carmen; Meziani, Chafik; Wilkinson, Caroline; Spiegel, Paul; Seal, Andrew J.

2012-01-01

Background Households from vulnerable groups experiencing epidemiological transitions are known to be affected concomitantly by under-nutrition and obesity. Yet, it is unknown to what extent this double burden affects refugee populations dependent on food assistance. We assessed the double burden of malnutrition among Western Sahara refugees living in a protracted emergency. Methods and Findings We implemented a stratified nutrition survey in October–November 2010 in the four Western Sahara refugee camps in Algeria. We sampled 2,005 households, collecting anthropometric measurements (weight, height, and waist circumference) in 1,608 children (6–59 mo) and 1,781 women (15–49 y). We estimated the prevalence of global acute malnutrition (GAM), stunting, underweight, and overweight in children; and stunting, underweight, overweight, and central obesity in women. To assess the burden of malnutrition within households, households were first classified according to the presence of each type of malnutrition. Households were then classified as undernourished, overweight, or affected by the double burden if they presented members with under-nutrition, overweight, or both, respectively. The prevalence of GAM in children was 9.1%, 29.1% were stunted, 18.6% were underweight, and 2.4% were overweight; among the women, 14.8% were stunted, 53.7% were overweight or obese, and 71.4% had central obesity. Central obesity (47.2%) and overweight (38.8%) in women affected a higher proportion of households than did GAM (7.0%), stunting (19.5%), or underweight (13.3%) in children. Overall, households classified as overweight (31.5%) were most common, followed by undernourished (25.8%), and then double burden–affected (24.7%). Conclusions The double burden of obesity and under-nutrition is highly prevalent in households among Western Sahara refugees. The results highlight the need to focus more attention on non-communicable diseases in this population and balance obesity prevention and management with interventions to tackle under-nutrition. Please see later in the article for the Editors' Summary PMID:23055833

Malnutrition and some related factors in primary school children, Semnan, Iran.

PubMed

Karimi, Batool; Ghorbani, Raheb; Niaki, Mehri A

2016-12-01

Malnutrition places a direct and indirect burden on individuals, especially children and communities. Malnutrition or growth failure can occur because of various reasons. This study aimed to determine the prevalence of thinness, underweight, stunting, and their related factors in students aged 6-12 years in Semnan province, central Iran. Using multistage sampling, a total of 2195 primary students in Semnan province, between November 2012 and March 2013, were selected randomly and the prevalences of wasting, underweight, and stunting among the students were estimated. Students' weights were measured using a Burer digital scale (Germany), with an accuracy of 100 g. Students' heights were measured using a nonstretchable tape measure. The BMI was calculated. Using the CDC 2000 standards, values less than the fifth percentile of BMI, weight-for-age, and height-for-age were defined as thinness, underweight, and stunting, respectively. In the total sample, 12.5, 9.2, and 9.0% of the students, respectively, were affected by thinness, underweight, and stunting. Lack of access to a computer increased the odds ratio (OR) of thinness by 1.38 times [OR=1.38, 95% confidence interval (CI): 1.06-1.78, P=0.015). Other variables (including age) did not show a significant association with the prevalence of thinness. Similarly, of all the variables studied, only access to a computer showed a significant association with the prevalence of underweight (OR=1.37, 95% CI: 1.02-1.84, P=0.036). The prevalence of stunting was associated significantly with a history of parasitic infection (OR=2.32, 95% CI: 1.53-3.51, P<0.001) and living in rural areas (OR=1.57, 95% CI: 1.15-2.16, P=0.005). The prevalence of malnutrition among students is high. Hence, families and stakeholders must pay special attention to various measures including healthcare services to improve the condition. Education, health, and support programs must be strengthened and continued.

Effect of fortified complementary food supplementation on child growth in rural Bangladesh: a cluster-randomized trial

PubMed Central

Christian, Parul; Shaikh, Saijuddin; Shamim, Abu Ahmed; Mehra, Sucheta; Wu, Lee; Mitra, Maithilee; Ali, Hasmot; Merrill, Rebecca D; Choudhury, Nuzhat; Parveen, Monira; Fuli, Rachel D; Hossain, Md Iqbal; Islam, Md Munirul; Klemm, Rolf; Schulze, Kerry; Labrique, Alain; de Pee, Saskia; Ahmed, Tahmeed; West, Keith P

2015-01-01

Background: Growth faltering in the first 2 years of life is high in South Asia where prevalence of stunting is estimated at 40–50%. Although nutrition counselling has shown modest benefits, few intervention trials of food supplementation exist showing improvements in growth and prevention of stunting. Methods: A cluster-randomized controlled trial was conducted in rural Bangladesh to test the effect of two local, ready-to-use foods (chickpea and rice-lentil based) and a fortified blended food (wheat-soy-blend++, WSB++) compared with Plumpy’doz, all with nutrition counselling vs nutrition counselling alone (control) on outcomes of linear growth (length and length-for-age z-score, LAZ), stunting (LAZ < −2), weight-for-length z-score (WLZ) and wasting (WLZ < −2) in children 6–18 months of age. Children (n = 5536) were enrolled at 6 months of age and, in the food groups, provided with one of the allocated supplements daily for a year. Results: Growth deceleration occurred from 6 to 18 months of age but deceleration in LAZ was lower (by 0.02–0.04/month) in the Plumpy’doz (P = 0.02), rice-lentil (< 0.01), and chickpea (< 0.01) groups relative to control, whereas WLZ decline was lower only in Plumpy’doz and chickpea groups. WSB++ did not impact on these outcomes. The prevalence of stunting was 44% at 18 months in the control group, but lower by 5–6% (P ≤ 0.01) in those receiving Plumpy’doz and chickpea. Mean length and LAZ at 18 months were higher by 0.27–0.30 cm and 0.07–0.10 (all P < 0.05), respectively, in all four food groups relative to the control. Conclusions: In rural Bangladesh, small amounts of daily fortified complementary foods, provided for a year in addition to nutrition counselling, modestly increased linear growth and reduced stunting at 18 months of age. PMID:26275453

Effectiveness of complementary food supplements and dietary counselling on anaemia and stunting in children aged 6-23 months in poor areas of Qinghai Province, China: a controlled interventional study.

PubMed

Zhang, Yanfeng; Wu, Qiong; Wang, Wei; van Velthoven, Michelle Helena; Chang, Suying; Han, Huijun; Xing, Min; Chen, Li; Scherpbier, Robert W

2016-10-31

To assess the effectiveness of dietary counselling and complementary food supplements on anaemia and stunting prevalence in children aged 6-23 months. A controlled intervention study with measurements of height and haemoglobin levels, and cross-sectional surveys in August 2012 (baseline), 2013 (mid-term) and 2014 (end-line). One intervention county and one control county in rural Qinghai Province, China. Complementary food supplements (containing protein, fat, carbohydrate, vitamin A, B 1 , B 2 , B 12 , D 3 , folic acid, iron, zinc and calcium) and complementary feeding counselling were given in the intervention county. Caregivers and their children aged 6-23 months. Effect of the interventions on the prevalence of anaemia (haemoglobin <110 g/L) and stunting (z-score of height-for-age <-2.0) (controlled for differences between the counties), and on infant feeding practices. The surveys were conducted on 1804, 2187 and 2186 children aged 6-23 months in the intervention county in August 2012, 2013 and 2014, respectively, and 804, 680 and 790 children in the control county, respectively. Between the baseline and end-line surveys, anaemia prevalence decreased more in the intervention county than in the control county (71.1% to 47.8% vs 86.3% to 75.3%, respectively; p<0.0001). There was no difference in the decrease in stunting prevalence between the counties (9.7% to 7.1% vs 17.0% to 15.0%; p=0.7954). The proportions of children given iron-rich or iron-fortified food, introduced to (semi-) solid food at 6-8 months, and given food with minimum dietary diversity increased from 43.2% to 88.8% (p<0.0001), 81.4% to 96% (p=0.0470) and 53.0% to 59.8% (p<0.0001), respectively in the intervention county. We found much higher anaemia prevalence in poor rural areas of Qinghai Province compared with the national data. Community-based complementary food supplements combined with dietary counselling can improve feeding practices and reduce anaemia prevalence. Future studies should use longer follow-up to assess the effects on stunting. We included a large number of participants and assessed a combined complementary food supplements and dietary counselling intervention in a poor rural area in China with high anaemia prevalence. Although the study took place in only one intervention county and one control county, we conducted an analysis that controlled for differences between the two counties. Also, although we made significant efforts to train village doctors, their education was not systematically assessed after training and thus their delivery of the interventions may have been variable. ChiCTRPRC12002444; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Effectiveness of complementary food supplements and dietary counselling on anaemia and stunting in children aged 6–23 months in poor areas of Qinghai Province, China: a controlled interventional study

PubMed Central

Zhang, Yanfeng; Wu, Qiong; Wang, Wei; van Velthoven, Michelle Helena; Chang, Suying; Han, Huijun; Xing, Min; Chen, Li; Scherpbier, Robert W.

2016-01-01

Objective To assess the effectiveness of dietary counselling and complementary food supplements on anaemia and stunting prevalence in children aged 6–23 months. Design A controlled intervention study with measurements of height and haemoglobin levels, and cross-sectional surveys in August 2012 (baseline), 2013 (mid-term) and 2014 (end-line). Setting One intervention county and one control county in rural Qinghai Province, China. Intervention Complementary food supplements (containing protein, fat, carbohydrate, vitamin A, B1, B2, B12, D3, folic acid, iron, zinc and calcium) and complementary feeding counselling were given in the intervention county. Participants Caregivers and their children aged 6–23 months. Primary and secondary outcome measures Effect of the interventions on the prevalence of anaemia (haemoglobin <110 g/L) and stunting (z-score of height-for-age <−2.0) (controlled for differences between the counties), and on infant feeding practices. Results The surveys were conducted on 1804, 2187 and 2186 children aged 6–23 months in the intervention county in August 2012, 2013 and 2014, respectively, and 804, 680 and 790 children in the control county, respectively. Between the baseline and end-line surveys, anaemia prevalence decreased more in the intervention county than in the control county (71.1% to 47.8% vs 86.3% to 75.3%, respectively; p<0.0001). There was no difference in the decrease in stunting prevalence between the counties (9.7% to 7.1% vs 17.0% to 15.0%; p=0.7954). The proportions of children given iron-rich or iron-fortified food, introduced to (semi-) solid food at 6–8 months, and given food with minimum dietary diversity increased from 43.2% to 88.8% (p<0.0001), 81.4% to 96% (p=0.0470) and 53.0% to 59.8% (p<0.0001), respectively in the intervention county. Conclusions We found much higher anaemia prevalence in poor rural areas of Qinghai Province compared with the national data. Community-based complementary food supplements combined with dietary counselling can improve feeding practices and reduce anaemia prevalence. Future studies should use longer follow-up to assess the effects on stunting. Strengths and limitations We included a large number of participants and assessed a combined complementary food supplements and dietary counselling intervention in a poor rural area in China with high anaemia prevalence. Although the study took place in only one intervention county and one control county, we conducted an analysis that controlled for differences between the two counties. Also, although we made significant efforts to train village doctors, their education was not systematically assessed after training and thus their delivery of the interventions may have been variable. Trial registration number ChiCTRPRC12002444; Pre-results. PMID:27799239

The nutritional impacts of soil-transmitted helminths infections among Orang Asli schoolchildren in rural Malaysia

PubMed Central

2012-01-01

Background Soil-transmitted helminths (STH) infections, anaemia and malnutrition are major public health problems in school-age children in developing countries. This study was conducted on 289 Orang Asli (aboriginal) schoolchildren in order to assess the current prevalence and predictors of anaemia and malnutrition, as well as the nutritional impacts of STH infections among these children. Methods A cross-sectional study was combined with a longitudinal follow-up three months after treatment with anthelminthic drugs. Blood samples were collected from the children to measure haemoglobin (Hb) level. Anthropometric and socioeconomic data were also collected and the children were screened for STH. Results The baseline findings revealed that the prevalence of anaemia, significant stunting, underweight and wasting among the children were 41.0%, 28.0%, 29.2% and 12.5%, respectively. Overall, the prevalence of trichuriasis, ascariasis and hookworm infections were 84.6%, 47.6% and 3.9%, respectively. Haemoglobin level was significantly lower among the moderate-to-heavy infected children compared to the negative-to-light infected children. Age <10years and moderate-to-heavy ascariasis were the predictors of anaemia. Stunting was associated with gender, age, moderate-to-heavy ascariasis and trichuriasis. Three months post-treatment assessment showed that the moderate-to-heavy infected children gained significant increment in their mean Hb level compared to the negative-to-light infected children (0.44 g/dL compared to 0.08 g/dL). However, no difference was found in the mean increments in growth indices between the groups. Conclusion STH infections, anaemia and malnutrition are still prevalent and a matter of public health concern in Orang Asli communities in Malaysia. Sustainable deworming programme at school and community levels among these populations will help to improve their health and nutritional status. PMID:22704549

Childhood dual burden of under- and overnutrition in low- and middle-income countries: a critical review.

PubMed

Tzioumis, Emma; Adair, Linda S

2014-06-01

In low- and middle-income countries, the distribution of childhood nutritional diseases is shifting from a predominance of undernutrition to a dual burden of under- and overnutrition. This novel and complex problem challenges governments and health organizations to tackle opposite ends of the malnutrition spectrum. The dual burden may manifest within a community, household, or individual, but these different levels have not been addressed collectively. To critically review literature on the prevalence, trends, and predictors of the dual burden, with a focus on children from birth to 18 years of age. We reviewed literature since January 1, 1990, published in English, using the PubMed search terms nutrition transition, double burden, dual burden, nutrition status, obesity, overweight, underweight, stunting, body composition, and micronutrient deficiencies. The findings were classified and described according to dual burden level (community, household, or individual). Global trends indicate decreases in diseases of undernutrition, while overnutrition is increasing. On the community level, economic status may influence the extent of the dual burden, with obesity increasingly affecting the already undernourished poor. In a household, shared determinants of poor nutritional status among members can result in disparate nutritional status across generations. Within an individual, obesity may co-occur with stunting or anemia due to shared underlying determinants or physiologic links. The dual burden of malnutrition poses a threat to children's health in low- and middle-income countries. We must remain committed to reducing undernutrition while simultaneously preventing over-nutrition through integrated child health programs that incorporate prevention of infection, diet quality, and physical activity.

Childhood dual burden of under- and over-nutrition in low- and middle-income countries: a critical review

PubMed Central

Tzioumis, Emma; Adair, Linda S.

2015-01-01

Background In low- and middle income countries, the distribution of childhood nutritional diseases is shifting from a predominance of undernutrition to a dual burden of under- and overnutrition. This novel and complex problem challenges governments and health organizations to tackle opposite ends of the malnutrition spectrum. The dual burden may manifest within a community, household, or individual, but these different levels have not been addressed collectively. Objective To critically review literature on the prevalence, trends, and predictors of the dual burden, with a focus on children from birth to 18 years. Methods We reviewed literature since January 1, 1990, published in English, using the PubMed search terms: nutrition transition, double burden, dual burden, nutrition status, obesity, overweight, underweight, stunting, body composition, and micronutrient deficiencies. Findings were classified and described according to dual burden level (community, household, individual). Results Global trends indicate decreases in diseases of undernutrition, while overnutrition is increasing. On the community level, economic status may influence the dual burden’s extent, with obesity increasingly affecting the already undernourished poor. In a household, shared determinants of poor nutritional status among members can result in disparate nutritional status across generations. Within an individual, obesity may co-occur with stunting or anemia, due to shared underlying determinants or physiologic links. Conclusions The dual burden of malnutrition poses a threat to children’s health in low- and middle-income countries. We must remain committed to reducing undernutrition while simultaneously preventing overnutrition, through integrated child health programs that incorporate prevention of infection, diet quality, and physical activity. PMID:25076771

A rapid isothermal assay for the detection of Hop stunt viroid in hop plants (Humulus lupulus), and its application in disease surveys.

PubMed

Kappagantu, Madhu; Villamor, Dan Edward V; Bullock, Jeff M; Eastwell, Kenneth C

2017-07-01

Hop stunt disease caused by Hop stunt viroid (HSVd) is a growing threat to hop cultivation globally. HSVd spreads mainly by use of contaminated planting material and by mechanical means. Thorough testing of hop yards and removal of infected bines are critical components of efforts to control the spread of the disease. Reverse transcription-polymerase chain reaction (RT-PCR) has become the primary technique used for HSVd detection; however, sample handling and analysis are technically challenging. In this study, a robust reverse transcription-recombinase polymerase amplification (RT-RPA) assay was developed to facilitate analysis of multiple samples. The assay was optimized with all major variants of HSVd from other host species in addition to hop variants. Used in conjunction with sample collection cards, RT-RPA accommodates large sample numbers. Greenhouse and farm samples tested with RT-RPA were also tested with RT-PCR and a 100% correlation between the two techniques was found. Copyright © 2017. Published by Elsevier B.V.

The Philani Mentor Mothers Intervention: Neighbourhood wide impact on child growth in Cape Town's peri-urban settlements.

PubMed

Tomlinson, Mark; Hartley, Mary; le Roux, Ingrid; Rotheram-Borus, Mary Jane

2016-01-01

The purpose of this research was to determine whether or not routine home visiting (by the Philani Maternal Child Health and Nutrition Project) influences the prevalence of stunted, wasted and underweight children in Cape Town peri-urban settlements. The study was a cross-sectional cohort in which weight and height measurements were collected for all children from 24 matched neighbourhoods; three years earlier 12 of these neighbourhoods were randomized to receive the home visiting intervention and 12 did not. The research took place at all households located within the 24 neighbourhoods in Khayelitsha and Mfuleni peri-urban settlements. Participants included 8715 children aged 0-6 years old (4694 intervention; 4021 control). A total of 41.3% of children were stunted, 3.1% were underweight and 1.4% were wasted. Children in the intervention group were significantly less likely to be underweight or severely underweight for age than children in the control group. While the rates of stunting were also significantly lower in intervention areas, the effect was not clinically significant, and no significant differences were found between the study arms on the prevalence of wasting. The Philani model is effective in the prevention and rehabilitation of underweight children. Philani could strengthen their intervention by focussing specifically on screening for child stunting in addition to underweight children. The results also suggests that efforts to address the long-term adverse effects of undernutrition require structural and economic transformation, in addition to socio-medical intervention.

The relationship between preoperative nutritional state and adverse outcome following abdominal and thoracic surgery in children: Results from the NSQIP database.

PubMed

Alshehri, Abdullah; Afshar, Kourosh; Bedford, Julie; Hintz, Graeme; Skarsgard, Erik D

2018-05-01

Anthropometric measurements can be used to define pediatric malnutrition. Our study aims to: (1) characterize the preoperative nutritional status of children undergoing abdominal or thoracic surgery, and (2) describe the associations between WHO-defined acute (stunting) and chronic (wasting) undernutrition (Z-scores <-2) and obesity (BMI Z-scores >+2) with 30-day postoperative outcomes. We queried the Pediatric NSQIP Participant Use File and extracted data on patients' age 29days to 18years who underwent abdominal or thoracic procedures. Normalized anthropometric measures were calculated, including weight-for-height for <2years, BMI for ages ≥2years, and height for age. Logistic regression models were developed to assess nutritional outlier status as an independent predictor of postoperative outcome. 23,714 children (88% ≥2y) were evaluated. 4272 (18%) were obese, while 2640 (11.1%) and 904 (3.8%) were stunted and wasted, respectively, after controlling for gender, ASA/procedure/wound classification, preoperative steroid use, need for preoperative nutritional support, and obese children had higher odds of SSIs (OR 1.29, 95% CI 1.1-1.5, p=0.001), while stunted children were at increased risk of any 30-day postoperative complication (OR 1.16, 95% CI 1.0-1.3, p=0.036). Children who are stunted or obese are at increased risk of adverse outcome after abdominal or thoracic surgery. III. Copyright © 2018 Elsevier Inc. All rights reserved.

Micronutrient status and intervention programs in Malaysia.

PubMed

Khor, Geok Lin

2005-06-01

Approximately 70% of the world's malnourished children live in Asia, giving that region the highest concentration of childhood malnutrition worldwide. Prevalence of stunting and underweight are high especially in south Asia where one in every two preschool children is stunted. Iron-deficiency anemia affects 40%-50% of preschool and primary schoolchildren. Nearly half of all vitamin A deficiency and xerophthalmia in the world occurs in south and southeast Asia. Iodine deficiency disorders have resulted in high goiter rates in India, Pakistan, and parts of Indonesia. Compared with other developing countries in Asia, the nutrition situation in Malaysia is considerably better, owing to rapid economic and socioeconomic development that has occurred since Malaysia gained its independence in 1957. Prevalence of undernutrition and micronutrient deficiency is markedly lower in Malaysian children. Nonetheless, undernutrition in the form of underweight, stunting, and anemia can be found in poor communities throughout the country. A prevalence of 25% underweight and 35% stunting is reported among young children from poor rural households. Anemia and subclinical forms of vitamin A deficiency were reported in children under 5 years old. Typical of a country in nutrition transition, Malaysia faces the dual burden of malnutrition in children, with the persistence of under-nutrition problems especially among the poor and the emerging overweight problem especially in urban areas. Since 1996, nutrition programs of the government sector are coordinated under the National Plan of Action for Nutrition. These activities and other nutrition intervention efforts by other agencies are discussed in this paper.

The relationship of ethnicity, socio-economic factors and malnutrition in primary school children in north of Iran: a cross-sectional study.

PubMed

Veghari, Gholamreza

2012-05-29

The main objective of this study was to assess the malnutrition and some socio-economic related factors based on three ethnic groups among primary school children in north of Iran in 2010. This cross-sectional study was carried out through multistage cluster random sampling on 5698 subjects (2505 Fars-native, 2154 Turkman, and 1039 Sistani) in 112 schools. Well-trained staffs completed the questionnaire and measured students' weight and height. Malnutrition estimated the Z-score less than -2SD for underweight, stunting and wasting were calculated using the cutoffs from WHO references. Generally, malnutrition was observed in 3.20%, 4.93% and 5.13% based on underweight, stunting and wasting respectively. It was more common in girls than in boys and in Sistani than in other ethnic groups. The correlation between malnutrition based on underweight and stunting and ethnicity was statistically significant (P=0.001). Results of logistic regression analyses showed that the risk of malnutrition was in rural area 1.34 times more than urban area, in girls 1.17 times more than boys, in Sistani ethnic group 1.82 times more than Fars-native ethnic group, in low economic families 2.01 times more than high economic families. Underweight, stunting and wasting are the health problems in primary school children in north of Iran with a higher prevalence in girls, in rural areas, and in Sistani ethnic group.

Assessment of health and nutritional status of infants in relation to breast feeding practices in Karmouz area, Alexandria.

PubMed

Deghedi, B; Mahdy, N H; Abd, el-A H

1999-01-01

Infants are most precious part of nation's life. Infant health is a reflection of the health of the mother and it gives an indication of the health of the adult population of the future. The present work was designed to study the health and nutritional status of infants in Karmouz area in Alexandria as well as the effect of breast feeding practices on the health status of infants. Accordingly, a house to house survey was conducted through cluster sampling technique. The total sample amounted to 396 mothers and 409 infants. Data were collected about infants health status and their feeding practices. Weight and length were measured for all infants. Stool samples were collected and examined. The results revealed that 55.3% of infants had acute respiratory tract infections (ARI); 16.4% had bronchitis and 4.9% had pneumonia, 44% of the infants suffered from diarrhea, 13.2% were infected with parasites, Gardia lamblia was the most commonly found parasite (9.0%). High proportion of infants was found to be stunted (22.7%), 8.6% were wasted and 7.6% were underweight, 40.3% of mothers were in partial practice level. Infants below six months of age who received solid foods at three months or less had a significantly higher percentage of diarrhea (70.6%) compared to 51.5% among those of late weaning (four months or later). The diarrhea was significantly more common among infants aged 12 - < 18 months with about two times of risk relative to those aged < 6 months. A significantly higher risk of diarrhea was found for infants of bottle--or complementary feeding (OR = 2.05, 2.07 respectively, model X2 = 9.71, P < 0.01), in addition the protective effect of breast feeding persisted after adjustment of confounders by multiple logistic regression. High proportion of mothers (63.8%) continued to breast-feed their babies during diarrheal episodes. On the other hand breast-feeding was not significantly protective against the acute respiratory tract infection. Stunting of the infants increases rapidly with age from 12.6% among infants under six months to 30.4% among those aged from 9 - < 12 months. The percentage of stunted infants varied greatly by education of the mothers, it was doubled from 14.7% among those of mothers of high level of education to 28.9% of non educated mothers with a significant high risk of 2.31 times. The repeated attacks of diarrhea throughout the two years of life was still significantly associated with stunting even after adjustment of confounders by multiple logistic regression;, those with three attacks or more had about three times of risk relative to those without the disease (OR = 2.56, 95% CL = 1.12-5.81, model X2 = 19.03, P < 0.01). Health education program should be emphasized to all mothers to improve their knowledge and practice about breast-feeding and its importance in prevention of diarrhea.

Beet yellow stunt virus in cells of Sonchus oleraceus L. and its relation to host mitochondria.

PubMed

Esau, K

1979-10-15

In Sonchus oleraceus L. (Asteraceae) infected with the beet yellow stunt virus (BYSV) the virions are found in phloem cells, including the sieve elements. In parenchymatous phloem cells, the virus is present mainly in the cytoplasm. In some parenchymatous cells, containing massive accumulations of virus, the flexuous rodlike virus particles are found partly inserted into mitochondrial cristae. The mitochondrial envelope is absent where virus is present in the cristae. A similar relation between virus and host mitochondria apparently has not been recorded for any other plant virus.

Malnutrition Among Children Younger Than 5 Years-Old in Conflict Zones of Chiapas, Mexico

PubMed Central

Sánchez-Pérez, Héctor Javier; Hernán, Miguel A.; Ríos-González, Adriana; Arana-Cedeño, Marcos; Navarro, Albert; Ford, Douglas; Micek, Mark A.; Brentlinger, Paula

2007-01-01

We performed a cross-sectional, community-based survey, supplemented by interviews with community leaders in Chiapas, Mexico, to examine the prevalence and predictors of child malnutrition in regions affected by the Zapatista conflict. The prevalence rates of stunting, wasting, and underweight were 54.1%, 2.9%, and 20.3%, respectively, in 2666 children aged younger than 5 years. Stunting was associated with indigenous ethnicity, poverty, region of residence, and intracommunity division. The results indicate that malnutrition is a serious public health problem in the studied regions. PMID:17194868

Poor nutrition at age 3 and schizotypal personality at age 23: the mediating role of age 11 cognitive functioning.

PubMed

Venables, Peter H; Raine, Adrian

2012-08-01

Poor prenatal nutrition has been associated with schizophrenia spectrum disorders in the Netherlands and China, and it has been suggested that perinatal and postnatal nutritional factors lead to the development of schizophrenia and the exhibition of schizotypal traits later in life. There appears to be no prior research on the existence of possible factors that may mediate the relationship between malnutrition and schizophrenia spectrum disorders or whether this association is a direct one. The authors tested the hypothesis that low IQ mediates the relationship between early childhood malnutrition and adult schizotypal personality. Participants were drawn from a birth cohort of 1,795 boys and girls who were followed prospectively. Objective indicators of malnutrition (anemia and stunting) were assessed at age 3. Verbal and performance intelligence were assessed at age 11, and schizotypal personality was assessed at age 23. Both stunting and anemia at age 3 were associated with low IQ at age 11. Low performance IQ at age 11 was associated with increased interpersonal and disorganized features of schizotypal personality at age 23. Poor performance IQ was found to mediate the relationship between poor nutrition at age 3 and interpersonal and disorganized features of schizotypy at age 23. Findings in female participants were replicated in male participants. Given that poor nutrition is an alterable risk factor, these findings suggest that nutritional enhancements may improve brain functioning and possibly reduce some features of schizotypal personality disorder.

Females lead population collapse of the endangered Hawaii creeper.

PubMed

Freed, Leonard A; Cann, Rebecca L

2013-01-01

Population collapses result from drastic environmental changes, but the sexes may differ in vulnerability. Collapse of the endangered Hawaii creeper (Oreomystis mana) at Hakalau Forest National Wildlife Refuge resulted from food limitation associated with increased numbers of an introduced bird (Japanese white-eye, Zosterops japonicus), which competes with the creeper for food. Both creeper sexes had stunted bill growth and the greatest change in molt of native species in the community. With a surge in numbers of white-eyes, a recent cohort of adult females had very low survival after breeding, while adult males from the same cohort, and older females and males, continued to have high survival. Lower female survival resulted in a significantly more male-biased adult sex ratio. Recent low female survival was based on a great cost of reproduction, indicated by molt-breeding overlap that was previously avoided, and lower fat during the lengthy fledgling period. The difference in female survival between cohorts was associated with stunted bills from being reared in and then breeding in an increasingly poor food environment. Trend analysis of survey data indicate that the bird is declining throughout the refuge, with males being 72-80% of adults left six years after the white-eye increased. Competition over time was consistent with that previously documented over space on the Island of Hawaii. Adaptive management to recover the bird in this protected area needs to focus on improving both adult female survival and the adult sex ratio.

Females Lead Population Collapse of the Endangered Hawaii Creeper

PubMed Central

Freed, Leonard A.; Cann, Rebecca L.

2013-01-01

Population collapses result from drastic environmental changes, but the sexes may differ in vulnerability. Collapse of the endangered Hawaii creeper (Oreomystis mana) at Hakalau Forest National Wildlife Refuge resulted from food limitation associated with increased numbers of an introduced bird (Japanese white-eye, Zosterops japonicus), which competes with the creeper for food. Both creeper sexes had stunted bill growth and the greatest change in molt of native species in the community. With a surge in numbers of white-eyes, a recent cohort of adult females had very low survival after breeding, while adult males from the same cohort, and older females and males, continued to have high survival. Lower female survival resulted in a significantly more male-biased adult sex ratio. Recent low female survival was based on a great cost of reproduction, indicated by molt-breeding overlap that was previously avoided, and lower fat during the lengthy fledgling period. The difference in female survival between cohorts was associated with stunted bills from being reared in and then breeding in an increasingly poor food environment. Trend analysis of survey data indicate that the bird is declining throughout the refuge, with males being 72–80% of adults left six years after the white-eye increased. Competition over time was consistent with that previously documented over space on the Island of Hawaii. Adaptive management to recover the bird in this protected area needs to focus on improving both adult female survival and the adult sex ratio. PMID:23861831

The relationship between zinc intake and growth in children aged 1-8 years: a systematic review and meta-analysis.

PubMed

Stammers, A L; Lowe, N M; Medina, M W; Patel, S; Dykes, F; Pérez-Rodrigo, C; Serra-Majam, L; Nissensohn, M; Moran, V H

2015-02-01

It is estimated that zinc deficiency affects 17% of the world's population, and because of periods of rapid growth children are at an increased risk of deficiency, which may lead to stunting. This paper presents a systematic review and meta-analysis of the randomised controlled trials (RCTs) that assess zinc intake and growth in children aged 1-8 years. This review is part of a larger systematic review by the European Micronutrient Recommendations Aligned Network of Excellence that aims to harmonise the approach to setting micronutrient requirements for optimal health in European populations (www.eurreca.org). Searches were performed of literature published up to and including December 2013 using MEDLINE, Embase and the Cochrane Library databases. Included studies were RCTs in apparently healthy child populations aged from 1 to 8 years that supplied zinc supplements either as capsules or as part of a fortified meal. Pooled meta-analyses were performed when appropriate. Nine studies met the inclusion criteria. We found no significant effect of zinc supplementation of between 2 weeks and 12 months duration on weight gain, height for age, weight for age, length for age, weight for height (WHZ) or WHZ scores in children aged 1-8 years. Many of the children in the included studies were already stunted and may have been suffering from multiple micronutrient deficiencies, and therefore zinc supplementation alone may have only a limited effect on growth.

Protein energy malnutrition in India: the plight of our under five children.

PubMed

Bhutia, Dechenla Tshering

2014-01-01

Protein energy malnutrition (PEM) is a major public health problem in India. This affects the child at the most crucial period of time of development, which can lead to permanent impairment in later life. PEM is measured in terms of underweight (low weight for age), stunting (low height for age) and wasting (low weight for height). The prevalence of stunting among under five is 48% and wasting is 19.8% and with an underweight prevalence of 42.5%, it is the highest in the world. Undernutrition predisposes the child to infection and complements its effect in contributing to child mortality. Lalonde model (1974) is used to look into the various determinants of PEM in under five children and its interrelation in causation of PEM. The determinants of PEM are broadly classified under four distinct categories: Environmental factors including the physical and social environment, behavioral factors, health-care service related and biological factors. The socio-cultural factors play an important role wherein, it affects the attitude of the care giver in feeding and care practices. Faulty feeding practice in addition to poor nutritional status of the mother further worsens the situation. The vicious cycle of poor nutritional status of the mother leading to low birth weight child further exposes the child to susceptibility to infections which aggravates the situation. However, it is seen that percapita income of the family did not have much bearing on the poor nutritional status of the child rather lack of proper health-care services adversely contributed to poor nutritional status of the child. PEM is a critical problem with many determinants playing a role in causing this vicious cycle of undernutrition. With almost half of under five children undernourished in India, the Millennium Development Goal (MDG) of halving the prevalence of underweight by 2015 seems a distant dream.

Congenital cardiac disease in dogs.

PubMed

McCaw, D; Aronson, E

1984-07-01

Pulmonic stenosis is caused by a malformed pulmonic valve, stricture of the right ventricular outflow tract or stricture of the pulmonary artery. English Bulldogs, Beagles, Samoyeds, Fox Terriers and Chihuahuas are predisposed. Clinical signs in severely affected dogs include exercise intolerance, stunting, dyspnea, syncope and ascites. Auscultation reveals a high-frequency, crescendo-decrescendo murmur during systole, loudest over the left side of the thorax, near the sternal cardiac border. An ECG may reveal a right-axis deviation of greater than 120 degrees, S waves in leads I, II and III, deep S waves in CV6LL, CV6LU and V10, Q waves deeper than 0.5 mv in leads II, III and AVF, and positive T waves in lead V10. Plain film LAT thoracic radiographs reveal an elevated carina, increased sternal contact of the heart, loss of the cranial cardiac waist and a widened cardiac silhouette, with normal pulmonary vasculature. A DV projection reveals an inverted "D" shape of the right ventricle and a pulmonary artery bulge. A nonselective angiocardiogram reveals poststenotic dilation of the main pulmonary artery. Treatment involves surgical correction of the stenosis.

Normal cortisol response to cold pressor test, but lower free thyroxine, after recovery from undernutrition.

PubMed

Martins, Vinicius J B; Neves, Andrea P O; Garcia, Márcia C; Spadari, Regina C; Clemente, Ana Paula G; de Albuquerque, Maria P; Hoffman, Daniel J; Sawaya, Ana L

2016-01-14

Undernutrition is a stressor with long-term consequences, and the effect of nutritional recovery on cortisol and thyroid hormone status is unknown. To investigate basal thyroid hormones and the cortisol response to a cold pressor test in children recovered from undernutrition, a cross-sectional study was undertaken on children (6-16 years) separated into four groups: control (n 41), stunted (n 31), underweight (n 27) and recovered (n 31). Salivary cortisol was collected over the course of 10 h: upon awakening, before and after an unpleasant and a pleasant stimulus. Cortisol upon awakening was highest in the stunted and lowest in the underweight groups: control=5·05 (95% CI 3·71, 6·89) nmol/l, stunted=6·62 (95% CI 3·97, 11·02) nmol/l, underweight=2·51 (95% CI 1·75, 3·63) nmol/l and recovered=3·46 (95% CI 2·46, 4·90) nmol/l (P=0·005). Girls had higher cortisol concentrations upon awakening compared with boys (P=0·021). The undernourished groups showed an elevated cortisol response both to the unpleasant stimulus and at the last measurement (16.00 hours) compared with that of the recovered group: AUC, control=2·07 (95% CI 1·69, 2·45) nmol/l×30 min, stunted=2·48 (95% CI 1·91, 3·06) nmol/l×30 min, underweight=2·52 (95% CI 2·07, 2·97) nmol/l×30 min, recovered=1·68 (95% CI 1·26, 2·11) nmol/l×30 min (P=0·042); and control=2·03 (95% CI 1·75, 2·39) nmol/l×30 min, stunted=2·51 (95% CI 1·97, 3·19) nmol/l×30 min, underweight=2·61 (95% CI 2·16, 3·16) nmol/l×30 min, recovered=1·70 (95% CI 1·42, 2·03) nmol/l×30 min (P=0·009). Lower free thyroxine (T4) was found in the recovered and stunted groups: control=1·28 (95% CI 1·18, 1·39) pmol/l, stunted=0·98 (95% CI 0·87, 1·10) pmol/l, underweight=1·10 (95% CI 1·01, 1·21) pmol/l and recovered=0·90 (95% CI 0·83, 0·99) pmol/l (P<0·001). Multivariate analysis showed a lower cortisol concentration along 10 h (06.00-16.00 hours) in the recovered compared with the other groups (P=0·017), and similar concentrations between the recovered and control group. In conclusion, the children with recovery in weight and height had a cortisol stress response similar to control but a lower basal free T4. Longitudinal studies are warranted to determine the extent of these endocrine changes after recovery of undernutrition and in adulthood.

NUTRItion and CLIMate (NUTRICLIM): investigating the relationship between climate variables and childhood malnutrition through agriculture, an exploratory study in Burkina Faso.

PubMed

Sorgho, Raissa; Franke, Jonas; Simboro, Seraphin; Phalkey, Revati; Saeurborn, Rainer

Malnutrition remains a leading cause of death in children in low- and middle-income countries; this will be aggravated by climate change. Annually, 6.9 million deaths of children under 5 were attributable directly or indirectly to malnutrition. Although these figures have recently decreased, evidence shows that a world with a medium climate (local warming up to 3-4 °C) will create an additional 25.2 million malnourished children. This proof of concept study explores the relationships between childhood malnutrition (more specifically stunting), regional agricultural yields, and climate variables through the use of remote sensing (RS) satellite imaging along with algorithms to predict the effect of climate variability on agricultural yields and on malnutrition of children under 5. The success of this proof of purpose study, NUTRItion and CLIMate (NUTRICLIM), should encourage researchers to apply both concept and tools to study of the link between weather variability, crop yield, and malnutrition on a larger scale. It would also allow for linking such micro-level data to climate models and address the challenge of projecting the additional impact of childhood malnutrition from climate change to various policy relevant time horizons.

Role of RNase MRP in viral RNA degradation and RNA recombination.

PubMed

Jaag, Hannah M; Lu, Qiasheng; Schmitt, Mark E; Nagy, Peter D

2011-01-01

RNA degradation, together with RNA synthesis, controls the steady-state level of viral RNAs in infected cells. The endoribonucleolytic cleavage of viral RNA is important not only for viral RNA degradation but for RNA recombination as well, due to the participation of some RNA degradation products in the RNA recombination process. To identify host endoribonucleases involved in degradation of Tomato bushy stunt virus (TBSV) in a Saccharomyces cerevisiae model host, we tested eight known endoribonucleases. Here we report that downregulation of SNM1, encoding a component of the RNase MRP, and a temperature-sensitive mutation in the NME1 gene, coding for the RNA component of RNase MRP, lead to reduced production of the endoribonucleolytically cleaved TBSV RNA in yeast. We also show that the highly purified yeast RNase MRP cleaves the TBSV RNA in vitro, resulting in TBSV RNA degradation products similar in size to those observed in yeast cells. Knocking down the NME1 homolog in Nicotiana benthamiana also led to decreased production of the cleaved TBSV RNA, suggesting that in plants, RNase MRP is involved in TBSV RNA degradation. Altogether, this work suggests a role for the host endoribonuclease RNase MRP in viral RNA degradation and recombination.

Building a Stronger System for Tracking Nutrition-Sensitive Spending: A Methodology and Estimate of Global Spending for Nutrition-Sensitive Foreign Aid.

PubMed

Ickes, Scott B; Trichler, Rachel B; Parks, Bradley C

2015-12-01

There is growing awareness that the necessary solutions for improving nutrition outcomes are multisectorial. As such, investments are increasingly directed toward "nutrition-sensitive" approaches that not only address an underlying or basic determinant of nutrition but also seek to achieve an explicit nutrition goal or outcome. Understanding how and where official development assistance (ODA) for nutrition is invested remains an important but complex challenge, as development projects components vary in their application to nutrition outcomes. Currently, no systematic method exists for tracking nutrition-sensitive ODA. To develop a methodology for classifying and tracking nutrition-sensitive ODA and to produce estimates of the amount of nutrition-sensitive aid received by countries with a high burden of undernutrition. We analyzed all financial flows reported to the Organization for Economic Co-Operation and Development's Development Assistance Committee Creditor Reporting Service in 2010 to estimate these investments. We assessed the relationships between national stunting prevalence, stunting burden, under-5 mortality, and the amount of nutrition-specific and nutrition-sensitive ODA. We estimate that, in 2010, a total of $379·4 million (M) US dollars (USD) was committed to nutrition-specific projects and programs of which 25 designated beneficiaries (countries and regions) accounted for nearly 85% ($320 M). A total of $1.79 billion (B) was committed to nutrition-sensitive spending, of which the top 25 countries/regions accounted for $1.4 B (82%). Nine categories of development activities accounted for 75% of nutrition-sensitive spending, led by Reproductive Health Care (30·4%), Food Aid/Food Security Programs (14·1%), Emergency Food Aid (13·2%), and Basic Health Care (5·0%). Multivariate linear regression models indicate that the amount of nutrition-sensitive (P = .001) and total nutrition ODA was significantly predicted by stunting prevalence (P = .001). The size of the total population of stunted children significantly predicted the amount of nutrition-specific ODA (P < .001). The recipient profile of nutrition-specific and nutrition-sensitive ODA is related but distinct. Nutrition indicators are associated with the level of nutrition-related ODA commitments to recipient countries. A reliable estimate of nutrition spending is critical for effective planning by both donors and recipients and key for success, as the global development community recommits to a new round of goals to address the interrelated causes of undernutrition in low-income countries. © The Author(s) 2015.

Coinfection of intestinal schistosomiasis and malaria and association with haemoglobin levels and nutritional status in school children in Mara region, Northwestern Tanzania: a cross-sectional exploratory study.

PubMed

Kinung'hi, Safari M; Mazigo, Humphrey D; Dunne, David W; Kepha, Stella; Kaatano, Godfrey; Kishamawe, Coleman; Ndokeji, Samuel; Angelo, Teckla; Nuwaha, Fred

2017-11-09

Schistosomiasis represents a major public health problem in Tanzania despite ongoing national control efforts. This study examined whether intestinal schistosomiasis is associated with malaria and assessed the contribution of intestinal schistosomiasis and malaria on anaemia and undernutrition in school children in Mara region, North-western Tanzania. Stool samples were collected from each of 928 school children randomly selected from 5 schools and examined for intestinal schistosomiasis using the Kato Katz method. Finger prick blood samples were collected and examined for malaria parasites and haemoglobin concentrations using the Giemsa stain and Haemocue methods, respectively. Nutritional status was assessed by taking anthropometric measurements. The overall prevalence and infection intensity of S. mansoni was 85.6% (794/928) and 192 (100-278), respectively. The prevalence of malaria was 27.4% (254/928) with significant differences among villages (χ 2  = 96.11, p < 0.001). The prevalence of anaemia was 42.3% (392/928) with significant differences among villages (χ 2  = 39.61, p < 0.001). The prevalence of stunting, thinness and underweight was 21, 6.8 and 1.3%, respectively. Stunting varied significantly by sex (χ 2  = 267.8, p < 0.001), age group (χ 2  = 96.4, p < 0.001) and by village (χ 2  = 20.5, p < 0.001). Out of the 825 infected children, 217 (26.4%) had multiple parasite infections (two to three parasites). The prevalence of co-infections occurred more frequently in boys than in girls (χ 2  = 21.65, p = 0.010). Mean haemoglobin concentrations for co-infected children was significantly lower than that of children not co-infected (115.2 vs 119.6; t = 0.01, p = 0.002). Co-infected children were more likely to be stunted than children who were not co-infected (χ 2  = 11.6, p = 0.003). On multivariate analysis, age group, village of residence and severe anaemia were significant predictors of stunting after adjusting for sex and infection status. Intestinal schistosomiasis and malaria are prevalent in Mara region. Coinfections of these parasites as well as chronic undernutrition were also common. We recommend Mara region to be included in national schistosomiasis control programmes.

Nutritional status of children in a malaria meso endemic area: cross sectional study on prevalence, intensity, predictors, influence on malaria parasitaemia and anaemia severity.

PubMed

Sumbele, Irene Ule Ngole; Bopda, Orelien S Mtopi; Kimbi, Helen Kuokuo; Ning, Teh Rene; Nkuo-Akenji, Theresa

2015-11-05

The contradictory results on the interaction between nutritional status and malaria warrants further investigation in various epidemiological settings, to assert the antagonistic or synergistic relationship. This study examines the prevalence, severity and predictors of malnutrition and its influence on malaria parasitaemia and anaemia severity in children in the Mount Cameroon area. A cross-sectional study involving 454 children ≤ 14 years was carried out from February to May 2013 in Muea community. Anthropometric measures of malnutrition (z-scores < -2 standard deviations below mean) were obtained and spleen size assessed. The prevalence and density of malaria parasites were determined and haemoglobin concentration and white blood cell count obtained using an automated haematology analyzer. Univariate and multivariate analyses were used to evaluate influence of malnutrition on anaemia, malaria parasitaemia and predictors respectively. The overall prevalence of malnutrition was 22.8 %, with stunting being the most common form (17.1 %), followed by underweight (8.2 %) and wasting (5.5 %). Stunting was significantly higher (P < 0.01) in males (23.1 %) than in females (11.9 %). The prevalence of malnutrition was significantly highest (P = 0.03) in children ≤5 years old (29.5 %) than their counterparts. Severe stunting, wasting and underweight were prevalent in 4.9 %, 1.6 % and 1.8 % of the children respectively. Clinical malaria parasitaemia was significantly higher (P = 0.01) in children who were stunted (16.9 %) and underweight (21.6 %) than their normal counterparts (7.5 %; 8.2 % respectively). The model demonstrated sex (P = 0.006) and age group 1.1-3 years (P = 0.03) as significant predictors of malnutrition. In children who were malaria parasite negative, the prevalence of anaemia as well as severities were significantly higher (P = 0.04 and P = 0.001 respectively) in those malnourished. The presence of stunting in the community significantly augmented the prevalence and clinical presentation of Plasmodium infection. Malnutrition enhanced the severity of anaemia in malaria parasite negative children hence, their health and growth potential needs to be improved upon.

The association of serum choline with linear growth failure in young children from rural Malawi.

PubMed

Semba, Richard D; Zhang, Pingbo; Gonzalez-Freire, Marta; Moaddel, Ruin; Trehan, Indi; Maleta, Kenneth M; Ordiz, M Isabel; Ferrucci, Luigi; Manary, Mark J

2016-07-01

Choline is an essential nutrient for cell structure, cell signaling, neurotransmission, lipid transport, and bone formation. Choline can be irreversibly converted to betaine, a major source of methyl groups. Trimethylene N-oxide (TMAO), a proatherogenic molecule, is produced from the metabolism of dietary choline by the gut microbiome. The relation between serum choline and its closely related metabolites with linear growth in children is unknown. The aim was to characterize the relation between serum choline and its closely related metabolites, betaine and TMAO, with linear growth and stunting in young children. We measured serum choline, betaine, and TMAO concentrations by using liquid chromatography isotopic dilution tandem mass spectrometry in a cross-sectional study in 325 Malawian children, aged 12-59 mo, of whom 62% were stunted. Median (25th, 75th percentile) serum choline, betaine, and TMAO concentrations were 6.4 (4.8, 8.3), 12.4 (9.1, 16.3), and 1.2 (0.7, 1.8) μmol/L, respectively. Spearman correlation coefficients of age with serum choline, betaine, and TMAO were -0.57 (P < 0.0001), -0.26 (P < 0.0001), and -0.10 (P = 0.07), respectively. Correlation coefficients of height-for-age z score with serum choline, betaine-to-choline ratio, and TMAO-to-choline ratio were 0.31 (P < 0.0001), -0.24 (P < 0.0001), and -0.29 (P < 0.0001), respectively. Serum choline concentrations were strongly and significantly associated with stunting. Children with and without stunting had median (25th, 75th percentile) serum choline concentrations of 5.6 (4.4, 7.4) and 7.3 (5.9, 9.1) μmol/L (P < 0.0001). Linear growth failure in young children is associated with low serum choline and elevated betaine-to-choline and TMAO-to-choline ratios. Further work is needed to understand whether low dietary choline intake explains low circulating choline among stunted children living in low-income countries and whether increasing choline intake may correct choline deficiency and improve growth and development. This trial was registered in the ISRCTN registry (www.isrctn.com) as ISRCTN14597012. © 2016 American Society for Nutrition.

Risk factors for chronic undernutrition among children in India: Estimating relative importance, population attributable risk and fractions.

PubMed

Corsi, Daniel J; Mejía-Guevara, Iván; Subramanian, S V

2016-05-01

Nearly 40% of the world's stunted children live in India and the prevalence of undernutrition has been persistently high in recent decades. Given numerous available interventions for reducing undernutrition in children, it is not clear of the relative importance of each within a multifactorial framework. We assess the simultaneous contribution of 15 known risk factors for child chronic undernutrition in India. Data are from the 3rd Indian National Family Health Survey (NFHS-3), a nationally representative cross-sectional survey undertaken in 2005-2006. The study population consisted of children aged 6-59 months [n = 26,842 (stunting/low height-for-age), n = 27,483 (underweight/low weight-for-age)]. Risk factors examined for their association with undernutrition were: vitamin A supplementation, vaccination, use of iodized salt, household air quality, improved sanitary facilities, safe disposal of stools, improved drinking water, prevalence of infectious disease, initiation of breastfeeding, dietary diversity, age at marriage, maternal BMI, height, education, and household wealth. Age/sex-adjusted and multivariable adjusted effect sizes (odds ratios) were calculated for risk factors along with Population Attributable Risks (PAR) and Fractions (PAF) using logistic regression. In the mutually adjusted models, the five most important predictors of childhood stunting/underweight were short maternal stature, mother having no education, households in lowest wealth quintile, poor dietary diversity, and maternal underweight. These five factors had a combined PAR of 67.2% (95% CI: 63.3-70.7) and 69.7% (95% CI: 66.3-72.8) for stunting and underweight, respectively. The remaining factors were associated with a combined PAR of 11.7% (95% CI: 6.0-17.4) and 15.1% (95% CI: 8.9-21.3) for stunting and underweight, respectively. Implementing strategies focused on broader progress on social circumstances and infrastructural domains as well as investments in nutrition specific programs to promote dietary adequacy and diversity are required to ensure a long term trajectory of optimal child growth and development in India. Copyright © 2015 Elsevier Ltd. All rights reserved.

A Combined Intervention of Zinc, Multiple Micronutrients, and Albendazole Does Not Ameliorate Environmental Enteric Dysfunction or Stunting in Rural Malawian Children in a Double-Blind Randomized Controlled Trial.

PubMed

Wang, Alfred Z; Shulman, Robert J; Crocker, Audrey H; Thakwalakwa, Chrissie; Maleta, Kenneth M; Devaraj, Sridevi; Manary, Mark J; Trehan, Indi

2017-01-01

Environmental enteric dysfunction (EED) and linear growth stunting affect many rural agrarian children in the developing world and contribute to the persistently high rates of stunting that are observed worldwide. Effective interventions to consistently ameliorate EED are lacking. We tested whether a bundle of safe and affordable interventions would decrease EED and stunting over 12-24 wk in a cohort of rural Malawian children 12-35 mo old. This was a randomized, double-blind, placebo-controlled clinical trial in which the intervention group received a single dose of albendazole and 14 d of zinc at enrollment and after 20 wk. The intervention group also received a daily multiple micronutrient powder throughout the 24 wk of study. The primary outcomes were improvements in EED, as measured by the urinary lactulose-to-mannitol ratio (L:M ratio) from dual-sugar absorption testing, and linear growth. Urinary L:M ratios and anthropometric measurements were evaluated after 12 and 24 wk of intervention and compared with a placebo group that did not receive any of these interventions. A total of 254 children were enrolled at a mean age of 24 mo; 55% were female. Their mean weight-for-age z score was -1.5, and their mean length-for-age z score was -0.9. After 12 and 24 wk of study, increases in the L:M ratio did not differ between the intervention group (0.071 and 0.088 units, respectively) and the placebo group (0.073 and 0.080 units, respectively) (P = 0.87 and 0.19, respectively). Relative changes in length and weight also did not differ significantly between groups at any time point. The combined usage of albendazole, zinc, and a daily multiple micronutrient powder did not decrease EED or stunting in this population of agrarian children 12-35 mo old in rural Malawi. Alternative interventions to improve these diseases should be investigated. This trial was registered at clinicaltrials.gov as NCT02253095. © 2017 American Society for Nutrition.

Effect of fortified complementary food supplementation on child growth in rural Bangladesh: a cluster-randomized trial.

PubMed

Christian, Parul; Shaikh, Saijuddin; Shamim, Abu Ahmed; Mehra, Sucheta; Wu, Lee; Mitra, Maithilee; Ali, Hasmot; Merrill, Rebecca D; Choudhury, Nuzhat; Parveen, Monira; Fuli, Rachel D; Hossain, Md Iqbal; Islam, Md Munirul; Klemm, Rolf; Schulze, Kerry; Labrique, Alain; de Pee, Saskia; Ahmed, Tahmeed; West, Keith P

2015-12-01

Growth faltering in the first 2 years of life is high in South Asia where prevalence of stunting is estimated at 40-50%. Although nutrition counselling has shown modest benefits, few intervention trials of food supplementation exist showing improvements in growth and prevention of stunting. A cluster-randomized controlled trial was conducted in rural Bangladesh to test the effect of two local, ready-to-use foods (chickpea and rice-lentil based) and a fortified blended food (wheat-soy-blend++, WSB++) compared with Plumpy'doz, all with nutrition counselling vs nutrition counselling alone (control) on outcomes of linear growth (length and length-for-age z-score, LAZ), stunting (LAZ < -2), weight-for-length z-score (WLZ) and wasting (WLZ < -2) in children 6-18 months of age. Children (n = 5536) were enrolled at 6 months of age and, in the food groups, provided with one of the allocated supplements daily for a year. Growth deceleration occurred from 6 to 18 months of age but deceleration in LAZ was lower (by 0.02-0.04/month) in the Plumpy'doz (P = 0.02), rice-lentil (< 0.01), and chickpea (< 0.01) groups relative to control, whereas WLZ decline was lower only in Plumpy'doz and chickpea groups. WSB++ did not impact on these outcomes. The prevalence of stunting was 44% at 18 months in the control group, but lower by 5-6% (P ≤ 0.01) in those receiving Plumpy'doz and chickpea. Mean length and LAZ at 18 months were higher by 0.27-0.30 cm and 0.07-0.10 (all P < 0.05), respectively, in all four food groups relative to the control. In rural Bangladesh, small amounts of daily fortified complementary foods, provided for a year in addition to nutrition counselling, modestly increased linear growth and reduced stunting at 18 months of age. © The Author 2015. Published by Oxford University Press on behalf of the International Epidemiological Association.

Nutritional transition in children under five years and women of reproductive age: a 15-years trend analysis in Peru.

PubMed

Loret de Mola, Christian; Quispe, Renato; Valle, Giancarlo A; Poterico, Julio A

2014-01-01

Rapid urbanization, increase in food availability, and changes in diet and lifestyle patterns have been changing nutritional profiles in developing nations. We aimed to describe nutritional changes in children under 5 years and women of reproductive age in Peru, during a 15-year period of rapid economic development and social policy enhancement. Trend analyses of anthropometric measures in children of preschool age and women between 15-49 years, using the Peruvian National Demographic and Family Health Surveys (DHS) from 1996 to 2011. WHO growth curves were used to define stunting, underweight, wasting and overweight in children <5 y. We employed the WHO BMI-age standardized curves for teenagers between 15-19 y. In women >19 years, body mass index (BMI) was analyzed both categorically and as a continuous variable. To statistically analyze the trends, we used regression models: Linear and Poisson for continuous and binary outcomes, respectively. We analyzed data from 123 642 women and 64 135 children, from 1996 to 2011. Decreases over time were evidenced for underweight (p<0.001), wasting (p<0.001), and stunting (p<0.001) in children under 5 y. This effect was particularly noted in urban settings. Overweight levels in children reduced (p<0.001), however this reduction stopped, in urban settings, since 2005 (∼12%). Anemia decreased in children and women (p<0.001); with higher reduction in urban (↓43%) than in rural children (↓24%). BMI in women aged 15-19 years increased (p<0.001) across time, with noticeable BMI-curve shift in women older than 30 years. Moreover, obesity doubled during this period in women more than 19 y. Nutrition transition in Peru shows different patterns for urban and rural populations. Public policies should emphasize targeting both malnutrition conditions--undernutrition/stunting, overweight/obesity and anemia--considering age and place of residence in rapid developing societies like Peru.

Nutritional Transition in Children under Five Years and Women of Reproductive Age: A 15-Years Trend Analysis in Peru

PubMed Central

Loret de Mola, Christian; Quispe, Renato; Valle, Giancarlo A.; Poterico, Julio A.

2014-01-01

Background Rapid urbanization, increase in food availability, and changes in diet and lifestyle patterns have been changing nutritional profiles in developing nations. We aimed to describe nutritional changes in children under 5 years and women of reproductive age in Peru, during a 15-year period of rapid economic development and social policy enhancement. Materials and Methods Trend analyses of anthropometric measures in children of preschool age and women between 15–49 years, using the Peruvian National Demographic and Family Health Surveys (DHS) from 1996 to 2011. WHO growth curves were used to define stunting, underweight, wasting and overweight in children <5y. We employed the WHO BMI-age standardized curves for teenagers between 15–19y. In women >19 years, body mass index (BMI) was analyzed both categorically and as a continuous variable. To statistically analyze the trends, we used regression models: Linear and Poisson for continuous and binary outcomes, respectively. Results We analyzed data from 123 642 women and 64 135 children, from 1996 to 2011. Decreases over time were evidenced for underweight (p<0.001), wasting (p<0.001), and stunting (p<0.001) in children under 5y. This effect was particularly noted in urban settings. Overweight levels in children reduced (p<0.001), however this reduction stopped, in urban settings, since 2005 (∼12%). Anemia decreased in children and women (p<0.001); with higher reduction in urban (↓43%) than in rural children (↓24%). BMI in women aged 15–19 years increased (p<0.001) across time, with noticeable BMI-curve shift in women older than 30 years. Moreover, obesity doubled during this period in women more than 19y. Conclusion Nutrition transition in Peru shows different patterns for urban and rural populations. Public policies should emphasize targeting both malnutrition conditions—undernutrition/stunting, overweight/obesity and anemia—considering age and place of residence in rapid developing societies like Peru. PMID:24643049

The comparative cost-effectiveness of an equity-focused approach to child survival, health, and nutrition: a modelling approach.

PubMed

Carrera, Carlos; Azrack, Adeline; Begkoyian, Genevieve; Pfaffmann, Jerome; Ribaira, Eric; O'Connell, Thomas; Doughty, Patricia; Aung, Kyaw Myint; Prieto, Lorena; Rasanathan, Kumanan; Sharkey, Alyssa; Chopra, Mickey; Knippenberg, Rudolf

2012-10-13

Progress on child mortality and undernutrition has seen widening inequities and a concentration of child deaths and undernutrition in the most deprived communities, threatening the achievement of the Millennium Development Goals. Conversely, a series of recent process and technological innovations have provided effective and efficient options to reach the most deprived populations. These trends raise the possibility that the perceived trade-off between equity and efficiency no longer applies for child health--that prioritising services for the poorest and most marginalised is now more effective and cost effective than mainstream approaches. We tested this hypothesis with a mathematical-modelling approach by comparing the cost-effectiveness in terms of child deaths and stunting events averted between two approaches (from 2011-15 in 14 countries and one province): an equity-focused approach that prioritises the most deprived communities, and a mainstream approach that is representative of current strategies. We combined some existing models, notably the Marginal Budgeting for Bottlenecks Toolkit and the Lives Saved Tool, to do our analysis. We showed that, with the same level of investment, disproportionately higher effects are possible by prioritising the poorest and most marginalised populations, for averting both child mortality and stunting. Our results suggest that an equity-focused approach could result in sharper decreases in child mortality and stunting and higher cost-effectiveness than mainstream approaches, while reducing inequities in effective intervention coverage, health outcomes, and out-of-pocket spending between the most and least deprived groups and geographic areas within countries. Our findings should be interpreted with caution due to uncertainties around some of the model parameters and baseline data. Further research is needed to address some of these gaps in the evidence base. Strategies for improving child nutrition and survival, however, should account for an increasing prioritisation of the most deprived communities and the increased use of community-based interventions. Copyright © 2012 Elsevier Ltd. All rights reserved.

Soil-transmitted helminth infections and physical fitness in school-aged Bulang children in southwest China: results from a cross-sectional survey

PubMed Central

2012-01-01

Background Chronic soil-transmitted helminth (STH) infections have been associated with reduced physical fitness, but available evidence is limited. The aim of this cross-sectional survey was to assess the feasibility of measuring children's physical fitness and to relate it to STH infections. Our study was carried out among school-aged children of the Bulang ethnic group in rural southwest People's Republic of China (P.R. China). Standardized, quality-controlled methods were employed to determine STH infections (Kato-Katz technique), haemoglobin levels, anthropometry (body weight and height) and physical fitness (20-m shuttle run test). Results A compliance of 87% suggested good acceptance of the methods used. Among 69 children with complete data records, infection prevalence of Trichuris trichiura, Ascaris lumbricoides and hookworm were 81%, 44% and 6%, respectively. The maximum volume of oxygen that can be utilized within 1 min during exhaustive exercise (VO2 max estimate) of T. trichiura-infected children was 1.94 ml kg-1 min-1 lower than that of their non-infected counterparts (P = 0.005). Until exhaustion, T. trichiura-infected children had completed 6.14 20-m laps less (P = 0.004). Additionally, the mean VO2 max estimate of stunted children was lowered by 1.63 ml kg-1 min-1 (P = 0.002) and they completed 5.32 20-m laps less (P = 0.001) compared to children of normal stature. No significant association between stunting and infection with any STH species could be established. Conclusions Implementation of physical fitness tests in rural, resource-constraint settings is feasible. The physical fitness of children who are stunted or infected with STHs, particularly T. trichiura, is significantly impaired. We have launched a larger study and will determine the dynamics of school-aged children's physical fitness over a 7-month period after administration of anthelminthic drugs. PMID:22424138

Influence of malnutrition upon all-cause mortality among children in Swaziland.

PubMed

Acevedo, Paula; García Esteban, María Teresa; Lopez-Ejeda, Noemí; Gómez, Amador; Marrodán, María Dolores

2017-04-01

To analyze the effect of the type of malnutrition, sex, age and the presence of edema upon all-cause mortality in children under 5 years of age. A cross-sectional study was conducted during 2010 and 2011 in Swaziland. Sex, age, weight and height were taken to classify nutritional status according to the 2006 WHO growth standards: stunting (low height for age), wasting (low weight for height or low body mass index for age) and underweight (low weight for age). The sample (309 boys and 244 girls under 5 years of age) was analyzed by sex and age groups (under and equal/over 12 months). The association between variables was evaluated using the χ 2 test. Cox regression analysis (HR, 95% CI) was used to assess the likelihood of mortality. The mortality risk in malnourished children under one year of age was lower among females and increased in the presence of severe edema. Wasting combined with underweight increased the mortality risk in children under 12 months of age 5-fold, versus 11-fold in older children. The combination of stunting, wasting and underweight was closely associated to mortality. Stunting alone (not combined with wasting) did not significantly increase the mortality risk. Sex, severe edema and wasting are predictors of mortality in malnourished children. Regardless of these factors, children with deficiencies referred to weight for height and weight for age present a greater mortality risk in comparison with children who present stunting only. Copyright © 2017 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.

Improving women's nutrition imperative for rapid reduction of childhood stunting in South Asia: coupling of nutrition specific interventions with nutrition sensitive measures essential

PubMed Central

2016-01-01

Abstract The implications of direct nutrition interventions on women's nutrition, birth outcome and stunting rates in children in South Asia are indisputable and well documented. In the last decade, a number of studies present evidence of the role of non‐nutritional factors impacting on women's nutrition, birth outcome, caring practices and nutritional status of children. The implications of various dimensions of women's empowerment and gender inequality on child stunting is being increasingly recognised. Evidence reveals the crucial role of early age of marriage and conception, poor secondary education, domestic violence, inadequate decision‐making power, poor control over resources, strenuous agriculture activities, and increasing employment of women and of interventions such as cash transfer scheme and microfinance programme on undernutrition in children. Analysis of the nutrition situation of women and children in South Asia and programme findings emphasise the significance of reaching women during adolescence, pre‐conception and pregnancy stage. Ensuring women enter pregnancy with adequate height and weight and free from being anemic is crucial. Combining nutrition‐specific interventions with measures for empowerment of women is essential. Improvement in dietary intake and health services of women, prevention of early age marriage and conception, completion of secondary education, enhancement in purchasing power of women, reduction of work drudgery and elimination of domestic violence deserve special attention. A range of programme platforms dealing with health, education and empowerment of women could be strategically used for effectively reaching women prior to and during pregnancy to accelerate reduction in stunting rates in children in South Asia. PMID:27187909

Stunting, selenium deficiency and anemia are associated with poor cognitive performance in preschool children from rural Ethiopia.

PubMed

Gashu, Dawd; Stoecker, Barbara J; Bougma, Karim; Adish, Abdulaziz; Haki, Gulelat D; Marquis, Grace S

2016-04-12

Anthropometric characteristics and iron status affect cognitive performance in children. In addition, selenium can influence cognitive outcomes; protection of the brain from oxidative stress and its role in thyroid hormone metabolism are putative mechanisms. To investigate their association with cognitive performance, anthropometric indicators, iron biomarkers, and serum selenium of children (n = 541) of 54-60mo of age from rural Ethiopia were assessed. Cognitive assessment was conducted with the administration of two reasoning subtests of the Wechsler Preschool and Primary Scale of Intelligence and the school readiness test. Stunting was found in 41.4 % of children, 28.7 % were underweight, and 6.3 % were wasted. The mean score of stunted children was lower than that of non-stunted children on non-verbal reasoning (7.0 ± 3.2vs7.9 ± 3.1; p = 0.01) and the school readiness tests (4.3 ± 2.2 vs 3.3 ± 2.1; p < 0.001). Compared to non-anemic children, anemic children had lower score for the verbal reasoning test (9.5 ± 1.7 vs 8.9 ± 2.2; p = 0.02). However, except for hemoglobin, none of the iron biomarkers had significant associations with the cognitive score of the study children (p > 0.05). Selenium deficient children had lower scores on all cognitive tests than normal children (p < 0.05). The present study finding linking chronic undernutrition and micronutrient deficiency to cognitive deficits suggests the need for designing effective intervention programmes to control for protein energy malnutrition and micronutrient deficiency and address cognitive development in children.

Effect of prenatal and postnatal malnutrition on intellectual functioning in early school-aged children in rural western China.

PubMed

Li, Chao; Zhu, Ni; Zeng, Lingxia; Dang, Shaonong; Zhou, Jing; Yan, Hong

2016-08-01

The aim of this study was to evaluate the effect of prenatal and postnatal malnutrition on the intellectual functioning of early school-aged children. We followed the offspring of women who had participated in a trial of prenatal supplementation with different combinations of micronutrients and who remained resident in the study field. We measured their intellectual functioning using the Wechsler intelligence scale for children (WISC-IV). Height-for-age, weight-for-age, and body mass index (BMI)-for-age were used as anthropometric nutritional status indices. Four of the 5 composite scores derived from the WISC-IV, except for working memory index (WMI), were significantly lower in low birth weight children after adjusting for confounds. All 5 composite scores, including full-scale intelligence quotient (FSIQ), verbal comprehension index (VCI), WMI, perceptual reasoning index (PRI), and processing speed index (PSI) were significant lower in stunted and underweight children. The differences in the means of WISC-IV test scores were greatest between stunted and nonstunted children. The means for FSIQ, VCI, WMI, PRI, and PSI were as follows: 5.88 (95% confidence interval [CI]: 2.84-8.92), 5.08 (95% CI: 1.12-8.41), 4.71 (95% CI: 1.78-7.66), 6.13 (95% CI: 2.83-9.44), and 5.81 (95% CI: 2.61-9.00). These means were lower in stunted children after adjusting for confounds. Our results suggest the important influences of low birth weight and postnatal malnutrition (stunting, low body weight) on intellectual functioning in early school-aged children.

Information exposure and growth monitoring favour child nutrition in rural Indonesia.

PubMed

Sahanggamu, Paulus D; Purnomosari, Lupi; Dillon, Drupadi

2017-03-01

Malnutrition is a health problem among under-five children in Indonesia. The mothers' knowledge on nutrition and health in addition to growth monitoring program are essential components that may influence nutritional status of children under-five. The objective was to observe the importance of maternal information exposure along with growth monitoring program to the nutritional status of children in rural areas. A cross sectional study of 233 randomly selected mothers of under-five children from different geographical rural settings in Indonesia were interviewed and observed as to their exposure to nutrition and health information, growth monitoring program and nutritional status of the children. The prevalence of underweight, stunting, and wasting was 50.5%, 18.0%, and 28.4%, respectively. The mean of height-for-age z score was similar across villages, however, the mean of weight-for-age (p=0.039) and weightfor- height (p=0.047) were significantly lower in Kenduren compared with Karangrejo village. The possession of a growth monitoring card in Kenduren was significantly lower compared with Karangrejo (p<0.001) or Buko villages (p<0.001). The prevalence of underweight (p=0.001) or stunting (p=0.021) was higher among children who did not possess a growth monitoring card. The prevalence of stunting was higher among children who did not routinely go to Posyandu (Integrated Health Post) in the last 3 months (p=0.018). Maternal exposure to nutrition and health information, along with growth monitoring programs, contribute to the prevalence of underweight and stunting among rural children who are under-five years old.

Adult consequences of growth failure in early childhood123

PubMed Central

Hoddinott, John; Behrman, Jere R; Maluccio, John A; Melgar, Paul; Quisumbing, Agnes R; Ramirez-Zea, Manuel; Stein, Aryeh D; Yount, Kathryn M

2013-01-01

Background: Growth failure is associated with adverse consequences, but studies need to control adequately for confounding. Objective: We related height-for-age z scores (HAZs) and stunting at age 24 mo to adult human capital, marriage, fertility, health, and economic outcomes. Design: In 2002–2004, we collected data from 1338 Guatemalan adults (aged 25–42 y) who were studied as children in 1969–1977. We used instrumental variable regression to correct for estimation bias and adjusted for potentially confounding factors. Results: A 1-SD increase in HAZ was associated with more schooling (0.78 grades) and higher test scores for reading and nonverbal cognitive skills (0.28 and 0.25 SDs, respectively), characteristics of marriage partners (1.39 y older, 1.02 grade more schooling, and 1.01 cm taller) and, for women, a higher age at first birth (0.77 y) and fewer number of pregnancies and children (0.63 and 0.43, respectively). A 1-SD increase in HAZ was associated with increased household per capita expenditure (21%) and a lower probability of living in poverty (10 percentage points). Conversely, being stunted at 2 y was associated with less schooling, a lower test performance, a lower household per capita expenditure, and an increased probability of living in poverty. For women, stunting was associated with a lower age at first birth and higher number of pregnancies and children. There was little relation between either HAZ or stunting and adult health. Conclusion: Growth failure in early life has profound adverse consequences over the life course on human, social, and economic capital. PMID:24004889

Exploring the paradox: double burden of malnutrition in rural South Africa

PubMed Central

Kimani-Murage, Elizabeth W.

2013-01-01

Background This article is a review of the PhD thesis by Elizabeth Kimani-Murage that explores the double burden of malnutrition in rural South Africa. This is in the context of a worryingly rapid increase in obesity and obesity-related diseases in low- and middle-income countries (LMICs) including South Africa, and in the wake of on-going nutrition transition and lifestyle changes in these countries. Objective To understand the profiles of malnutrition among children and adolescents in a poor, high HIV prevalent, transitional society in a middle-income country. Methods A cross-sectional growth survey was conducted in 2007 targeting 4,000 children and adolescents aged 1–20 years. In addition, HIV testing was carried out on children aged 1–5 years and Tanner pubertal assessment among adolescents aged 9–20 years. Results The study shows stunting at an early age and adolescent obesity, particularly among girls, that co-exists in the same socio-geographic population. The study also shows that HIV is an independent modifiable risk factor for poor nutritional outcomes in children and makes a significant contribution to nutritional outcomes at the individual level. Significant predictors of undernutrition at an early age, documented at individual, household, and community levels, include child's HIV status, age and birth weight, maternal age, age of household head, and area of residence. Significant predictors of overweight/obesity and risk for metabolic disease during adolescence, documented at individual and household levels include child's age, sex, and pubertal development, household-level food security, socio-economic status, and household head's highest education level. Conclusions The combination of early stunting and adolescent obesity raises critical concerns in the wake of the rising public health importance of metabolic diseases in LMICs. This is because, both paediatric obesity and adult short stature are risk factors for metabolic syndrome and metabolic diseases in adulthood. Clearly, policies and interventions to address malnutrition in this and other transitional societies need to be double-pronged and gender-sensitive. PMID:23364082

Intergenerational influences on child growth and undernutrition.

PubMed

Martorell, Reynaldo; Zongrone, Amanda

2012-07-01

Intergenerational effects on linear growth are well documented. Several generations are necessary in animal models to 'wash out' effects of undernutrition, consistent with the unfolding of the secular trend in height in Europe and North America. Birthweight is correlated across generations and short maternal stature, which reflects intrauterine and infant growth failure, is associated with low birthweight, child stunting, delivery complications and increased child mortality, even after adjusting for socio-economic status. A nutrition intervention in Guatemala reduced childhood stunting; it also improved growth of the next generation, but only in the offspring of girls. Possible mechanisms explaining intergenerational effects on linear growth are not mutually exclusive and include, among others, shared genetic characteristics, epigenetic effects, programming of metabolic changes, and the mechanics of a reduced space for the fetus to grow. There are also socio-cultural factors at play that are important such as the intergenerational transmission of poverty and the fear of birthing a large baby, which leads to 'eating down' during pregnancy. It is not clear whether there is an upper limit for impact on intrauterine and infant linear growth that programmes in developing countries could achieve that is set by early childhood malnutrition in the mother. Substantial improvements in linear growth can be achieved through adoption and migration, and in a few selected countries, following rapid economic and social development. It would seem, despite clear documentation of intergenerational effects, that nearly normal lengths can be achieved in children born to mothers who were malnourished in childhood when profound improvements in health, nutrition and the environment take place before conception. To achieve similar levels of impact through public health programmes alone in poor countries is highly unlikely. The reality in poor countries limits the scope, quality and coverage of programmes that can be implemented and modest impact should be expected instead. The Lancet series on Maternal and Child Undernutrition estimated that implementation to scale of proven interventions in high burden countries would reduce stunting by one-third; this is perhaps a realistic upper bound for impact for high quality programmes, unless accompanied by sweeping improvements in social services and marked reductions in poverty. Finally, because so much can be achieved in a single generation, intergenerational influences are unlikely to be an important explanation for lack of programme impact aimed at the window of the first 1000 days. Failure to prevent linear growth failure in developing countries has serious consequences for short- and long-term health as well as for the formation of human capital. The nutrition transition has created a double burden by adding obesity and related chronic diseases to the public health agenda of countries still struggling with the 'old' problems of maternal and child undernutrition. The challenge ahead is to increase efforts to prevent linear growth failure while keeping child overweight at bay. © 2012 Blackwell Publishing Ltd.

Pathogenicity of Nectriaceous Fungi on Avocado in Australia.

PubMed

Parkinson, Louisamarie E; Shivas, Roger G; Dann, Elizabeth K

2017-12-01

Black root rot is a severe disease of young avocado trees in Australia causing black necrotic roots, tree stunting, and leaf drop prior to tree death. Nectriaceous fungi (Nectriaceae, Hypocreales), are commonly isolated from symptomatic roots. This research tested the pathogenicity of 19 isolates from Calonectria, Cylindrocladiella, Dactylonectria, Gliocladiopsis, and Ilyonectria, spp. collected from young avocado trees and other hosts. Glasshouse pathogenicity tests with 'Reed' avocado (Persea americana) seedlings confirmed that Calonectria ilicicola is a severe pathogen of avocado, causing stunting, wilting, and seedling death within 5 weeks of inoculation. Isolates of C. ilicicola from peanut, papaya, and custard apple were also shown to be aggressive pathogens of avocado, demonstrating a broad host range. An isolate of a Calonectria sp. from blueberry and avocado isolates of Dactylonectria macrodidyma, D. novozelandica, D. pauciseptata, and D. anthuriicola caused significant root rot but not stunting within 5 to 9 weeks of inoculation. An isolate of an Ilyonectria sp. from grapevine closely related to Ilyonectria liriodendri, and avocado isolates of Cylindrocladiella pseudoinfestans, Gliocladiopsis peggii, and an Ilyonectria sp. were not pathogenic to avocado.

Association between order of birth and chronic malnutrition of children: a study of nationally representative Bangladeshi sample.

PubMed

Rahman, Mosfequr

2016-02-01

This paper examines the net effect of birth order on child nutritional status in Bangladesh using data from the Bangladesh Demographic Health Survey, 2011 (BDHS). Analyses were restricted to 4,120 surviving, lastborn singleton children who were younger than 36 months at the time of the survey. Logistic regression was used to assess the association between birth order and child nutritional status. Results indicate 38.1% children are stunted and 8.2% children are fifth or higher order birth. Order of birth is one of the significant predictors of child being stunted. Third order, fourth order, and fifth or higher order children are 24%, 30%, and 72%, respectively, more likely to be stunted after adjusting for all other variables. Besides birth order, results also indicate that child age, size at birth, birth intention, maternal education, maternal body mass index, wealth index, place of residence and mass media access exert strong influences over child malnutrition. Reducing birth rates which limit number of births and birth order as well may reduce child malnutrition in Bangladesh.

Food Chain Mycotoxin Exposure, Gut Health, and Impaired Growth: A Conceptual Framework1

PubMed Central

Smith, Laura E.; Stoltzfus, Rebecca J.; Prendergast, Andrew

2012-01-01

Childhood stunting is an important and intractable public health problem that underlies ∼20% of deaths among children aged <5 y in developing countries. Environmental enteropathy (EE), a subclinical condition of the small intestine characterized by reduced absorptive capacity and increased intestinal permeability, is almost universal among children in developing countries and may mediate stunting. However, the etiology of EE is poorly understood. Mycotoxins are metabolites of fungi that frequently contaminate the staple foods of children living in developing countries. We review evidence from human and animal studies that exposure to mycotoxins, particularly aflatoxin (AF), fumonisin (FUM), and deoxynivaenol (DON), may impair child growth. Although these toxins have distinct actions, they all mediate intestinal damage through: 1) inhibition of protein synthesis (AF, DON); 2) an increase in systemic proinflammatory cytokines (DON); and 3) inhibition of ceramide synthase (FUM). The intestinal pathology that arises from mycotoxin exposure is very similar to that of EE. We propose that future studies should address the role of mycotoxins in the pathogenesis of EE and evaluate interventions to limit mycotoxin exposure and reduce childhood stunting. PMID:22797988

Molecular Characterization of Watermelon Chlorotic Stunt Virus (WmCSV) from Palestine

PubMed Central

Ali-Shtayeh, Mohammed S.; Jamous, Rana M.; Mallah, Omar B.; Abu-Zeitoun, Salam Y.

2014-01-01

The incidence of watermelon chlorotic stunt disease and molecular characterization of the Palestinian isolate of Watermelon chlorotic stunt virus (WmCSV-[PAL]) are described in this study. Symptomatic leaf samples obtained from watermelon Citrullus lanatus (Thunb.), and cucumber (Cucumis sativus L.) plants were tested for WmCSV-[PAL] infection by polymerase chain reaction (PCR) and Rolling Circle Amplification (RCA). Disease incidence ranged between 25%–98% in watermelon fields in the studied area, 77% of leaf samples collected from Jenin were found to be mixed infected with WmCSV-[PAL] and SLCV. The full-length DNA-A and DNA-B genomes of WmCSV-[PAL] were amplified and sequenced, and the sequences were deposited in the GenBank. Sequence analysis of virus genomes showed that DNA-A and DNA-B had 97.6%–99.42% and 93.16%–98.26% nucleotide identity with other virus isolates in the region, respectively. Sequence analysis also revealed that the Palestinian isolate of WmCSV shared the highest nucleotide identity with an isolate from Israel suggesting that the virus was introduced to Palestine from Israel. PMID:24956181

[Dietetic Determinants of Zinc Consumption in Stunted Children Under Five in Maya Communities From Guatemala].

PubMed

Monroy-Valle, Michele; Coyoy, Wendy; León, Jorge De; Flórez, Iván D

2017-01-01

The objective of the study was to identify the elements from feeding patterns that influence the intake and bioavailability of zinc in stunted children (SC) 1-5 years from Maya communities living in Huehuetenango, Guatemala. This descriptive, cross-sectional study was performed in 138 stunted children aged 1-5 years. It was applied: an inventory of zinc food sources availability, a Food Frequency Questionnaire, a questionnaire about living conditions. anthropometrics measurements and information on food intake habits, and information about disease prevalence. Twenty-eight food sources of zinc were available for consumption (54% low and 7% high zinc bioavailability). The consumption of foods with high bioavailability was low, while the antagonistic foods were high. On average the daily zinc consumption in diet 3 mg (95% CI: 2.65-3.35). Only 14.5% of the children met the zinc requirements, and 2.9% reached the daily recommendation. Episodes of diarrhea and respiratory infections were observed 15 days before the visit, in 29.71% and 45.6% of children, respectively. Most of children have a diet that does not cover the daily requirement.

Migration and nutritional status of Tarahumara schoolchildren from Chihuahua State (México).

PubMed

Benítez-Hernández, Zuliana Paola; De la Torre-Díaz, María de Lourdes; Cervantes-Borunda, Mónica; Hernández-Torres, Rosa Patricia; Cabañas, María Dolores; López-Ejeda, Noemí; Marrodán, María Dolores

2017-01-01

The Tarahumara ethnic group is composed of indigenous people from the Sierra Madre Occidental of Mexico. Conditions of isolation and poverty compel them to migrate to the city in search of better opportunities. This work aims to explore the influence of migration on the growth and nutritional status of Tarahumara schoolchildren. One hundred Tarahumara students were analyzed (50 rural with a mean age of 9.78 ± 1.25 years; 50 urban aged 10.0 ± 1.04 years), comparing anthropometric indicators and body composition (T-Student, U-Mann-Whitney Tests). Twenty percent of rural girls and 35% of rural boys showed stunted growth compared to only 9% of the urban girls (no stunted growth among urban boys). Migrants showed greater body size, skinfold thickness, and fat percentage. Weight excess, understood as an increase in the prevalence of overweight and obesity, was detected in 17.8% of urban boys and 13.6% of urban girls compared to 10.0% of boys and 3.3% of girls of the rural series. Migration reduces stunting and increases adiposity. © 2016 Wiley Periodicals, Inc.

Effect of iodine status and other nutritional factors on psychomotor and cognitive performance of Filipino schoolchildren.

PubMed

Amarra, Ma Sofia V; Bongga, Demetria C; Peñano-Ho, Leticia; Cruz, Federico B; Solis, José S; Barrios, Erniel B

2007-03-01

Until 1998, iodine deficiency was a public health problem in the Philippines. A law entitled "An Act Promoting Salt Iodization Nationwide" (ASIN) has been passed and implemented by the government to eliminate iodine deficiency. The contribution of salt iodization, as well as dietary, health, and environmental factors, to improving the intellectual performance of Filipino schoolchildren remains to be determined. The objectives of the study were to determine the relationship between iodine status and levels of psychomotor and cognitive performance in first-grade children aged 6 to 10 years, and to examine the extent to which dietary, biochemical, health, and environmental factors contribute to children's mental performance. Two hundred ninety children in six classroom sections from a public school in Manila were examined by measurement of urinary iodine excretion (UIE) and thyroid palpation. The median UIE level for each section was determined. Sixty-five children classified as iodine deficient (UIE < 90 microg/L with grade 1 goiter, n = 34) and non-iodine deficient (UIE > 100 microg/L without goiter, n = 31) were given psychomotor and cognitive function tests (Bender-Gestalt and Raven's Colored Progressive Matrices). Scores from the two tests were used to determine each child's general ability percentile rank. Other variables examined were dietary intake (% RDA of nutrients ingested based on two nonconsecutive 24-hour recalls); deficiencies in iron, vitamin A, and selenium; parasitic infection; coliform contamination of drinking water; household use of iodized salt; illness in the past 2 weeks; and wasting and stunting. Children whose general ability scores were at or above the 50th percentile had higher UIE levels, but the relationship was not significant. Children from sections with higher median UIE levels had higher percentile ranks for general ability (p = .002). Backward logistic regression showed that the variance in deficient and adequate mental performance was explained by dietary intakes that met > or = 80% of the RDA for energy, protein, thiamin, and riboflavin; the use of iodized salt; child's iodine status; and stunting (R2 = .520, p = .0016). Higher class median UIE was associated with better psychomotor and cognitive performance in children who were tested. Factors that contributed to better performance include higher intakes of energy, protein, thiamin, and riboflavin; household use of iodized salt; normal iodine status; and absence of stunting or chronic malnutrition. Salt iodization, accompanied by adequate intakes of energy, protein, and foods rich in thiamin and riboflavin, can contribute to improved mental performance in Filipino schoolchildren. Longer-term factors that can contribute to improved performance are achievement of normal iodine status and elimination of protein-energy malnutrition.

Gastrointestinal parasitic infection, anthropometrics, nutritional status, and physical work capacity in Colombian boys.

PubMed

Wilson, W.M.; Dufour, D.L.; Staten, L.K.; Barac-Nieto, M.; Reina, J.C.; Spurr, G.B.

1999-11-01

This article tests the hypothesis that the presence of gastrointestinal parasites in Colombian boys is negatively associated with anthropometric characteristics, physical work capacity, blood hemoglobin (Hb) levels, and nutritional status. Anthropometric, Hb, &Vdot;O(2) max, and parasite load data were collected on 1,016 boys in Cali, Colombia. The boys were classified as lower socioeconomic class (SEC) from either urban or rural environments, and upper SEC from an urban environment. Sixty-three percent of the boys were infected with gastrointestinal parasites and, of the infected boys, 80-95% had light parasite loads. Parasites found included Necator americanus, Ascaris lumbricoides, Entamoeba histolytica, Trichuris trichiura, Giardia spp., and Enterobius vermicularis. Infected boys had significantly lower weight, stature, weight-for-height (among 6-9-year-old boys), Hb levels, and &Vdot;O(2) max (ANCOVA, controlling for age and SEC). In terms of nutritional status, infected boys were 1.47 times more likely to be classified as iron deficient than noninfected boys (chi-square, P < 0.001), and 1.61 times more likely to be classified as stunted (P < 0.001). Infection was not associated with wasting in any SEC group. In conclusion, light to moderate gastrointestinal parasite loads were associated with significantly lower weight, stature, weight-for-height (in 6-9-year-old boys), Hb levels, and &Vdot;O(2) max, and a significantly higher frequency of IDA and stunting. These data suggest that comprehensive analyses of the nutritional status of populations in regions endemic for parasitic infection should include testing for the presence of infection. Am. J. Hum. Biol. 11:763-771, 1999. Copyright 1999 Wiley-Liss, Inc.

Melon Resistance to Cucurbit yellow stunting disorder virus Is Characterized by Reduced Virus Accumulation.

PubMed

Marco, Cristina F; Aguilar, Juan M; Abad, Jesús; Gómez-Guillamón, María Luisa; Aranda, Miguel A

2003-07-01

ABSTRACT The pattern of accumulation of Cucurbit yellow stunting disorder virus (CYSDV; genus Crinivirus, family Closteroviridae) RNA has been analyzed in several cucurbit accessions. In susceptible accessions of melon (Cucumis melo), cucumber (Cucumis sativus), marrow (Cucurbita maxima), and squash (Cucurbita pepo), CYSDV RNA accumulation peaked during the first to second week postinoculation in the first to third leaf above the inoculated one; younger leaves showed very low or undetectable levels of CYSDV. Three melon accessions previously shown to remain asymptomatic after CYSDV inoculation under natural conditions were also assayed for their susceptibility to CYSDV. Hybridization and reverse transcription-polymerase chain reaction (RT-PCR) analysis of noninoculated leaves showed that only one of these, C-105, remained virus-free for up to 6 weeks after whitefly inoculation. In this accession, very low CYSDV levels were detected by RT-PCR in whitefly-inoculated leaves, and therefore, multiplication or spread of CYSDV in C-105 plants appeared to remain restricted to the inoculated leaves. When C-105 plants were graft inoculated, CYSDV RNA could be detected in phloem tissues, but the systemic colonization of C-105 by CYSDV upon graft inoculation seemed to be seriously impeded. Additionally, in situ hybridization experiments showed that, after C-105 graft inoculation, only a portion of the vascular bundles in petioles and stems were colonized by CYSDV and virus could not be found in leaf veins. RT-PCR experiments using primers to specifically detect negative-sense CYSDV RNA were carried out and showed that CYSDV replication took place in graft-inoculated C-105 scions. Therefore, the resistance mechanism may involve a restriction of the virus movement in the vascular system of the plants and/or prevention of high levels of virus accumulation.

Effect of enteric parasitic infection on serum trace elements and nutritional status in upper Egyptian children

PubMed Central

Yones, Doaa A; Galal, Lamia A; Abdallah, Alameldin M; Zaghlol, Khaled S

2015-01-01

Introduction: Enteric parasitic infections still the cause of major health problems among Egyptian children as they have great morbid effect on their physical and cognitive development. Malnutrition makes children more prone to micronutrient deficiency and subsequently more vulnerable to parasitic infection. The present study aimed to identify the effect of intestinal parasitism on micronutrient serum level and children nutritional status. Materials and Methods: A case control study was carried out on children from 1 to 6 years old who were attending the Assiut University Children Hospital outpatient clinic, after parasitological stool examination they were divided into Group 1 (G1, n: 60) positive with enteric parasite and Group 2 (G2, n: 60) age and sex matched and free of parasites. Anthropometric measurements were expressed as weight for age (WFA), height for age (HFA), and weight for height (WFH) parameters. Serum zinc (Zn) and copper (Cu) were determined by atomic absorption spectrophotometer. Results: Intestinal parasitic infection rate was 55.7%; more commonly detected parasites were Giardia lamblia 28%, Cryptosporidium sp. 20%, and polyparasitism 18%. All children (G1 and G2) were underweight (WFA) while 63% of G1 were malnourished, either in the form of wasting (WFH) or stunting (HFA) or both aspects. Stunting and wasting were more dominant among children infected with G. lamblia and Cryptosporidium sp. and most of them were below 2 years old. Conclusions: Coincident decrease in serum Zn level and an increase of serum Cu was more prominent among G. lamblia and Cryptosporidium sp. patients. G. lamblia and Cryptosporidium sp. were found to be more associated with nonstandard children nutritional status beside to an altered micronutrient level. PMID:25709950

Long-term impact of changing childhood malnutrition on rotavirus diarrhoea: Two decades of adjusted association with climate and socio-demographic factors from urban Bangladesh.

PubMed

Das, Sumon Kumar; Chisti, Mohammod Jobayer; Sarker, Mohammad Habibur Rahman; Das, Jui; Ahmed, Shawnawaz; Shahunja, K M; Nahar, Shamsun; Gibbons, Nora; Ahmed, Tahmeed; Faruque, Abu Syed Golam; Rahman, Mustafizur; J Fuchs, George; Al Mamun, Abdullah; John Baker, Peter

2017-01-01

There is strong association between childhood rotavirus, diarrhoea, climate factors and malnutrition. Conversely, a significant nutritional transition (reduced under-nutrition) with a concurrent increasing trend of rotavirus infection in last decade was also observed among under 5 children, especially in developing countries including Bangladesh. Considering the pathophysiology of rotavirus, there might be an interaction of this nutrition transition which plays a pivotal role in increasing rotavirus infection in addition to climate and other man-made factors in urban areas such as Dhaka, Bangladesh. Relevant monthly data from 1993-2012 were extracted from the archive of the Diarrhoeal Disease Surveillance System of icddr, b and linked with data collected from the Dhaka station of the Bangladesh Meteorological Department (mean temperature, rainfall, sea level pressure and humidity). Seasonal autoregressive integrated moving average time series models were deployed to determine the association between the monthly proportion of rotavirus infection and underweight, stunting and wasting adjusting for climate, socio-demographic and sanitation factors. The proportion of rotavirus cases among all causes diarrhoea increased from 20% in 1993 to 43% in 2012 (Chi squared for trend p = 0.010). In contrast, underweight, stunting and wasting decreased from 59%-29% (p<0.001); 53%-21% (p<0.001) and 32%-22% (p<0.001) respectively over the same period. Mean ambient temperature increased from 25.76°C-26.62°C (p = 0.07); mean rainfall, sea level pressure and mean humidity decreased from 234.92-111.75 mm (p = 0.5), 1008.30-1006.61 mm of hg (p = 0.02) and 76.63%-70.26% (p<0.001), respectively. In the adjusted model, a decrease in monthly proportion of underweight [coef.: -0.189 (95% CI:-0.376, -0.003)] and wasting [-0.265 (-0.455, -0.075)] were significantly and inversely associated with rotavirus infection. However, an inverse but insignificant association was observed for stunting [-0.070 (-0.249, 0.109)]. The reduction of acute childhood malnutrition is significantly associated with increasing rotavirus diarrhoea among under-5 children. Thus mass vaccination in addition to interventions directed at man-made modifiable predictors for prevention and control is warranted.

Long-term impact of changing childhood malnutrition on rotavirus diarrhoea: Two decades of adjusted association with climate and socio-demographic factors from urban Bangladesh

PubMed Central

Das, Sumon Kumar; Chisti, Mohammod Jobayer; Sarker, Mohammad Habibur Rahman; Das, Jui; Ahmed, Shawnawaz; Shahunja, K. M.; Nahar, Shamsun; Gibbons, Nora; Ahmed, Tahmeed; Faruque, Abu Syed Golam; Rahman, Mustafizur; J Fuchs, George; Al Mamun, Abdullah; John Baker, Peter

2017-01-01

Background There is strong association between childhood rotavirus, diarrhoea, climate factors and malnutrition. Conversely, a significant nutritional transition (reduced under-nutrition) with a concurrent increasing trend of rotavirus infection in last decade was also observed among under 5 children, especially in developing countries including Bangladesh. Considering the pathophysiology of rotavirus, there might be an interaction of this nutrition transition which plays a pivotal role in increasing rotavirus infection in addition to climate and other man-made factors in urban areas such as Dhaka, Bangladesh. Methods Relevant monthly data from 1993–2012 were extracted from the archive of the Diarrhoeal Disease Surveillance System of icddr, b and linked with data collected from the Dhaka station of the Bangladesh Meteorological Department (mean temperature, rainfall, sea level pressure and humidity). Seasonal autoregressive integrated moving average time series models were deployed to determine the association between the monthly proportion of rotavirus infection and underweight, stunting and wasting adjusting for climate, socio-demographic and sanitation factors. Finding The proportion of rotavirus cases among all causes diarrhoea increased from 20% in 1993 to 43% in 2012 (Chi squared for trend p = 0.010). In contrast, underweight, stunting and wasting decreased from 59%-29% (p<0.001); 53%-21% (p<0.001) and 32%-22% (p<0.001) respectively over the same period. Mean ambient temperature increased from 25.76°C-26.62°C (p = 0.07); mean rainfall, sea level pressure and mean humidity decreased from 234.92–111.75 mm (p = 0.5), 1008.30–1006.61 mm of hg (p = 0.02) and 76.63%-70.26% (p<0.001), respectively. In the adjusted model, a decrease in monthly proportion of underweight [coef.: -0.189 (95% CI:-0.376, -0.003)] and wasting [-0.265 (-0.455, -0.075)] were significantly and inversely associated with rotavirus infection. However, an inverse but insignificant association was observed for stunting [-0.070 (-0.249, 0.109)]. Interpretation The reduction of acute childhood malnutrition is significantly associated with increasing rotavirus diarrhoea among under-5 children. Thus mass vaccination in addition to interventions directed at man-made modifiable predictors for prevention and control is warranted. PMID:28877163

Behavioral, environmental, metabolic and intergenerational components of early life undernutrition leading to later obesity in developing nations and in minority groups in the U.S.A.

PubMed

Varela-Silva, Maria Inês; Frisancho, A Roberto; Bogin, Barry; Chatkoff, David; Smith, Patricia K; Dickinson, Federico; Winham, Donna

2007-03-01

Nutritional transition, urbanization, and physical inactivity are primary factors responsible for the worldwide epidemic of overweight/obesity (OW/OB). However, these factors fail to explain the epidemic of OW/OB in developing countries and in recent-migrants to developed countries. Among these, OW/OB is associated with short/stunted stature and coexists with undernutrition at much higher rates than is statistically expected. Changes in metabolic pathways toward reduced fat oxidation and increased metabolism of carbohydrate may explain, in part, this phenomenon. Also, intergenerational consequences of malnutrition and poor health of the mothers may lead to impaired phenotypes in their offspring. We propose a novel methodology to assess the history of early life malnutrition by assessing the sitting height ratio of the mothers. The degree of "short leggedness" reflects undernutrition when the mother was an infant/child. Collectively, behavioral, environmental, metabolic and intergenerational components of early life undernutrition may provide a more satisfactory explanation for later life obesity.

Household Food Insecurity Is Associated with Nutritional Status among Iranian Children.

PubMed

Shahraki, Soudabeh Hamedi; Amirkhizi, Farshad; Amirkhizi, Behzad; Hamedi, Sousan

2016-01-01

This cross-sectional study was conducted to determine household food security status and sociodemographic factors influencing it and to examine whether food insecurity of household is a risk factor for underweight, stunting, and thinness in primary school children of Sistan and Baluchestan Province in southeastern Iran. A sample of 610 students aged 7-11 years was selected by a multistage cluster random sampling method during December 2013-May 2014. Using U.S. Department of Agriculture Food Security questionnaire, 42.3% of households showed some degree of food insecurity. Food insecurity was positively associated with household size (p = .002) and number of children per household (p = .001) and negatively associated with mother's and father's education level (p = .005 and p = .042, respectively), father's occupation status, and household income (p < .0001). Children living in food insecure with severe hunger households were 10.13, 10.07, and 4.54 times as likely to be underweight, stunted, and thin, respectively, as counterparts from food secure households. The findings showed food insecurity was prevalent and associated with sociodemographic factors among households with schoolchildren in southeastern Iran. Nutritional status of children was also associated with food security status of their households.