Relationship between maternal characteristics and stunting in children aged 0 to 23 months in the Philippines

@#Introduction: Stunting is the most prevalent form of child malnutrition worldwide, and is the best overall indicator of growth. This study aimed to determine the relationship between maternal characteristics and nutritional status of children aged 0-23 months based on their length/height-for-age. Method: The study used data from the 2015 Updating Survey conducted by the Philippines’ Food and Nutrition Research Institute – Department of Science and Technology. It employed a stratified multi-stage sampling technique covering all regions in the Philippines. Mothers (n=5,254) of sampled children 0-23 months were the respondents of the Maternal Health and Nutrition survey. The length-for-age z-scores (LAZ) of children and maternal characteristics were analysed. Rao-Scott Chi-square test was used for association analysis. Logistic regression was performed for model fitting. Results: A quarter (25.2%) of children aged 0-23 months in the Philippines at the time of the survey were stunted, with the highest prevalence (36.2%) observed among 12-23 months. Children being stunted or normal in height was associated with prenatal services, maternal nutritional status, education, and duration of lactation. Maternal education (OR: 0.39; p=0.012), age-appropriate breastfeeding (OR: 0.63; p=0.042), and prenatal services like tetanus toxoid vaccination (OR: 0.67; p=0.011) and ultrasound (OR: 0.71; p=0.025) lowered the likelihood of a child being stunted. Conclusion: It is recommended to strengthen and intensify service delivery among pregnant and lactating women because of the implication of maternal factors to the length-for-age status of children 0-23 months.

Environmental enteric dysfunction, soil transmitted helminthiasis and stunting among 36- to 59-month-old children in Quezon Province, Philippines

@#Introduction: Environmental enteric dysfunction (EED) is relevant in public health as it is a potential cause of child stunting. In the Philippines, stunting affects 33.4% of children in 2015. As of date, no local studies on EED exist. This study primarily aimed to determine the prevalence of EED, soil transmitted helminthiasis (STH) and stunting; and their relationships. Methods: A cross-sectional study was conducted among 120 children aged 36-59 months old in Quezon Province, Philippines. EED was assessed via glucose hydrogen breath test with a cut-off of >20 ppm over baseline by 90 minutes suggestive of small intestinal bacterial overgrowth (SIBO), a biomarker of EED. Kato Katz Technique was used to determine STH. Stunting was determined using the 2006 World Health Organization Child Growth Standards. Descriptive and correlation analyses of data were done at 10% level of significance. The study received approval from the National Ethics Committee of PCHRD-DOST, Philippines. Results: Data on expired hydrogen level of <20ppm were documented. The prevalence of STH among children were 38.1% for Ascaris lumbricodes, 15.3% for Trichuris trichiura, and 1.7% for hookworm infections. A high rate of stunting at 40.0% was observed. There was a significant positive association between stunting and the presence of Ascaris (p=0.01). Conclusion: There was no case of EED detected in the study. The severity of stunting was high at 40.0%. Among the STH, the prevalence of 38.1% children having Ascaris lumbricodes was alarming in terms of morbidity control. Nutrition interventions including WASH practices and the use of anthelminthic drugs need to be intensified to address stunting and STH.

Maternal characteristics and weight-for-length status of young children aged 0-23 months in the Philippines

@#<p style="text-align: justify;"><strong>Introduction.</strong> Malnutrition in the forms of wasting and overweight among children ages 0 to 23 months is a continuing public health concern in the Philippines. Childhood malnutrition has lifelong consequences. For young children aged 0-23 months, maternal influences play a significant role in the realization of optimal nutritional status.</p><p style="text-align: justify;"><strong>Objective.</strong> This study aimed to identify maternal characteristics that may influence the nutritional status of children aged 0-23 months.</p><p style="text-align: justify;"><strong>Methods.</strong> This study utilized data from the 2015 Updating Survey from Department of Science and Technology-Food and Nutrition Research Institute. The association of maternal characteristics with the nutritional status of a child was determined using the Rao-Scott Chi-squared test statistic. Multinomial logistic regression was used to model a child's nutritional status using weight-for-length as an indicator.</p><p style="text-align: justify;"><strong>Results.</strong> A child whose mother was educated was less likely to be wasted. The odds of a child being wasted was observed to increase with underweight mothers, longer duration of lactation and higher wealth quintile. Alternatively, the odds of a child to be overweight is reduced if the mother had formal education, was in late lactation stage, and availed tetanus toxoid vaccine. The likelihood that a child will be overweight increased with higher family wealth quintile and obesity of the mother.</p><p style="text-align: justify;"><strong>Conclusion.</strong> Maternal nutritional status, education, duration of lactation, wealth quintile, and availment of prenatal services were found to be associated with the weight-for-height status of children 0-23 months. Incorporating the identified maternal factors when planning new interventions and policies is recommended to address wasting in young children.</p>

Acceptability of height measuring equipment of different materials among community nutrition and health workers and parents in Laguna Province, Philippines

@#<p style="text-align: justify;"><strong>OBJECTIVES:</strong> This study aimed to determine the acceptability of four height/length boards as measuring equipment, (1) NNC wooden height board (HB), (2) Allen's stick, (3) aluminum-acrylic height board, and (4) stadiometer, from the perspective of the community nutrition and health workers (CNHWs) and mothers/caregivers.</p><p style="text-align: justify;"><strong>METHODS:</strong> The study was conducted in two municipalities in the province of Laguna, Philippines. Respondents were 12 CNHWs and 22 parents/guardians of randomly selected children ages 1-5 years. Focus group discussions were also conducted among CNHWs to determine their perceptions, experiences, and feedback on the use of the equipment. Parents/guardians were interviewed about their views on the acceptability of the equipment.</p><p style="text-align: justify;"><strong>RESULTS AND CONCLUSION:</strong> In the urban area, Allen's stick was most favored by end-users, while in the rural area, the NNC wooden HB was the most acceptable. Meanwhile, guardians preferred the aluminum-acrylic HB in the rural area and Allen's stick in the urban area. It was concluded that the use of height boards to measure the height or length of children was acceptable to both CHNWs and parents. CHNWs preferred the stadiometer for height measurement and Allen's stick for length measurement. In contrast parents/guardians preferred the aluminum-acrylic HB and Allen's stick as these were deemed non-threatening, culturally acceptable, safe, comfortable for the children, and the procedures were easily understood.</p>

Factors influencing malnutrition in Filipino elderly

@#Introduction: The elderly population is susceptible to malnutrition due to the physiological and functional changes caused by ageing. Hence, to prevent the degenerative nutritional conditions of the elderly and improve their quality of life, this study aimed to determine the influencing factors of malnutrition among Filipino elderly. Methods: Anthropometric component data from the 8th National Nutrition Survey (NNS) were utilised along with the nutritional status of Filipino elderly, based on body mass index as the dependent variable and variables from the clinical and health, dietary, and socioeconomic components of NNS as explanatory factors. Multinomial logistic regression analysis was then performed in fitting models. Results: High magnitude and severity of malnutrition were observed among Filipino elderly – 20.2% were underweight and 24.8% were overweight. Significant influencing factors in estimating an elderly’s odds of being underweight were the elderly’s age group, presence of hypertension, presence of anaemia, and adequacy of vitamin A intake. Whereas, significant influencing factors in estimating an elderly’s odds of being overweight/obese included highest educational attainment, presence of anaemia, hypertension, diabetes, and dyslipidaemia. Conclusion: Knowing the influencing factors may help the elderly become more aware and conscious of their health, as well as to promote nutrient intakes to prevent malnutrition that can worsen their health conditions. Additionally, concerned institutions in the country could use the findings of this study as one of the bases in strengthening their approach and implementation or even provide relevant and timely policies and programmes that address malnutrition in the elderly of this country.

Effects of micronutrient powder and complementary food blend on growth and micronutrient status of Filipino rural children: a randomised controlled trial

@#Introduction: This study aimed to evaluate the effects of micronutrient powders (MNP) containing 15 versus nine nutrients, with or without complementary food blend (BigMo), on the nutritional status of rural young children in the Philippines. Methods: The study was conducted for 6 months among 126 rural children aged 6-17 months in four villages selected by cluster randomisation. Children were randomised into four groups: VitaMix with 15 micronutrients plus Bigas Mongo (BigMo) (n=31); VitaMix without BigMo (n=31); Micronutrient Growth Mix (MGM) with nine micronutrients plus BigMo (n=29); and MGM without BigMo (n=31). Blood samples were collected at baseline and endline to determine haemoglobin, ferritin, retinol, and zinc concentrations. Intervention compliance, weight, length, and dietary intakes were collected every month. One-way ANOVA was used to compare changes in the mean estimates across groups. McNemar and Pearson’s x2 tests were used to compare changes in the proportion estimates within groups and across groups, respectively. Results: Both VitaMix and MGM with or without BigMo improved haemoglobin concentrations and reduced anaemia (Hb<11g/dL). However, only VitaMix and MGM combined with BigMo had effects in reducing moderate anaemia (Hb<10g/dL), compared to groups without BigMo. Only MGM+BigMo group demonstrated significant reduction in the prevalence of moderate non-iron deficiency anaemia (IDA) (Hb<10g/dL and ferritin>12ug/L). A significant increase in the length-for-age z-scores was noted in the MGM with and without BigMo groups. Conclusion: Daily supplementation of MGM with nine micronutrients combined with complementary food blend may have a greater potential than MNP with 15 micronutrients in improving the nutritional status of young children.