Proposed New Anthropometric Indices of Childhood Undernutrition

The three conventional anthropometric indicators of childhood undernutrition are stunting (low height-for-age), underweight (low weight-for-age) and wasting (low weight-for-height). Recently a new composite index, namely the Composite Index of Anthropometric Failure (CIAF) has been proposed and utilised to study childhood undernutrition. In this paper, we have attempted to construct three new indices of undernutrition, relative to the CIAF. These three indices are: Stunting Index (SI) = Stunting / CIAF, Underweight Index (UI) = Underweight / CIAF and Wasting Index (WI) = Wasting / CIAF. Furthermore, we have calculated and compared these indices using our dataset as well as other existing datasets. Using our dataset, the sex-combined values of SI, UI and WI were 0.364, 0.866 and 0.684, respectively. The corresponding values among boys were 0.364, 0.866 and 0.729. Among girls, they were 0.380, 0.866 and 0.641, respectively. When applied to the all India dataset, the values of SI, UI and WI were 0.756, 0.788 and 0.266, respectively. Similar values (SI = 0.723, UI = 0.681, WI = 0.294) were observed when they were computed on data available from Coimbatore, South India. In conclusion, we suggest that these three new indices provide additional information on the prevalence of different forms of undernutrition relative to the total level of undernutrition in a particular population.

Mid-upper arm circumference based undernutrition among Bengalee children of Chapra, West Bengal, India

To investigate age and sex variations in undernutrition using mid-upper arm circumference [MUAC] cut-off values among 2016 [930 boys and 1086 girls], 3-5 years old rural children of Bengalee ethnicity at 66 Integrated Child Development Services [ICDS] Centers of Nadia District, West Bengal, India. In a cross sectional study in west Bengal of India, MUAC was measured using standard technique. A total of 2028 children [935 boys and 1093 girls] from 66 ICDS centers were enrolled in this study. The response rate was approximately 95%.Mean MUAC among boys was higher than girls at all ages except 5 years. Significant sex differences were not observed over ages. The age-combined rates of overall [moderate and severe] undernutrition among boys [38.49%] was higher than among girls [32.22%].The age-combined rates of moderate undernutrition were 36.34% and 31.03% among boys and girls, respectively. The rates of severe undernutrition were 2.15% and 1.20% among boys and girls, respectively. There were sex differences in both moderate and severe undernutrition. In general, there was an increasing trend in the rates of overall undernutrition from 3 to 5 years in both sexes. These children were experiencing severe nutritional stress

Assessment of overall prevalence of undernutrition using composite index of anthropometric failure [CIAF] among preschool children of West Bengal, India

Under-nutrition continues to be a primary cause of ill-health and premature mortality among children in developing countries. Present study attempted to assess the overall prevalence of undernutrition using composite index of anthropometric failure [CIAF] among rural preschool children of Arambag, Hooghly District, West Bengal, India. A total of 1012 rural children [498 boys; 514 girls] aged 2-6 years were measured. Three commonly used undernutrition indicators, ie, stunting, wasting and underweight, as well as the Composite Index of Anthropometric Failure [CIAF] were used to evaluate the nutritional status of the subjects following internationally accepted cut-off points. For assessing CIAF, Svedberg's model of six groups of children was used. Among the studied children, 26.6%, 50.0% and 63.3% were stunted, wasted and under weight, respectively. The CIAF showed a higher prevalence of undernutrition of 73.1% of the studied children suffering from anthropometric failure, in comparison to other three indicators [stunting, underweight and wasting]. Out of six subgroups of CIAF with undernourished children, group C [containing children who are wasted and underweight] is the highest [32.0%], more-or less one-third of the studied children and children of group F [stunted only] is the lowest [2.7%]. Group B [wasting only] and Y [underweight only] show the same prevalence ie 7.2% and 7.1% respectively. Children who simultaneously have wasting, stunting and underweight [ie group D] account for 10.7%. There was no significant age group difference between no failure and CIAF. We found that CIAF may be a better indicator of nutritional stress as compared to the traditional measures of stunting, underweight and wasting. The distinct advantage of the CIAF may be that it can highlight the seriousness and severity of overall undernutrition ie the actual load of undernutrition in a population

Prevalence of undernutrition of lodha children aged 1-14 years of paschim medinipur district, west bengal, india

Childhood undernutrition among tribal children is a serious public health problem in India. The present study was conducted to assess the prevalence of undernutrition [underweight, stunting and wasting] among Lodha children of Paschim Medinipur, West Bengal, India. This cross sectional study was conducted in a village of Paschim Medinipur district. A total of 165 [early childhood=74, late childhood=91] children aged 1-14 years were measured and included in the present study following simple random method. The children were further divided into two categories: early childhood: under 6 years [<72 months] and late childhood: ?72 months. Anthropometric measurements such as height and weight were made following standard techniques. Children were considered underweight, stunting and wasting as weight-for-age, height-for-age and weight-for-height Z-score below -2 standard deviation using the National Center for Health Statistics [NCHS] reference population. The prevalence of underweight, stunting and wasting was 33.9%, 26.1% and 19.4%, respectively. Of these, 9.1%, 9.7% and 3.6% children were found to be severely underweight, stunted and wasted. Moreover, the prevalence of underweight [47.3% vs 23.1%] and stunting [35.1% vs 18.7%] was significantly higher in early childhood compared to during late childhood. They had 2.05 [RR= 2.05; 95% confidence interval [CI]: 1.31- 3.20] and 1.88 [CI: 1.11-3.19] times greater chance to be underweight and stunted than during late childhood. Whereas, the prevalence of wasting was similar in both groups [20.3% vs 18.9%; RR=1.09; CI:0.58-2.02]. Similarly, the rates of severe underweight [early childhood vs late childhood: 16.2% vs 3.3%] and stunting [20.3% vs 1.1%] were significantly higher in early childhood. They had 4.92 [CI: 1.44-16.79] fold and 18.45 [CI: 2.49-136.42] fold more risk to be an underweight and stunted compared to during late childhood. The nutritional status of the Lodha children, especially during early childhood was unsatisfactory. There is an urgent requirement to improve the nutritional status of children in this ethnic group

Comparison of nutritional status between tuberculosis patients and controls: A study from North 24 Parganas district in West Bengal, India

The nutritional status of tuberculosis patients (TBP) and controls (CT) was compared among adult (> 20 years) Bengalees in Shyamnagar, Barrackpore, Naihati and Jagaddal of North 24 Parganas District, West Bengal, India. The subjects included 310 men (154 TBP and 156 CT) and 246 women (128 TBP and 118 CT). The mean ages of TBP men was 36.4 years (CT = 34.5) and that of TBP women was 26.4 years (CT = 25.6). Variables compared included weight, height, fat mass, fat mass index, mid-upper arm fat area, and skinfolds. Results revealed that TBP had significantly lower means for all variables (except for height in men) compared to CT in both sexes. In men, the highest percent differences between the two groups were observed for fat mass (FM: 60.1%), fat mass index (FMI: 59.2%) and suprailiac skinfold (SUPSF: 58.8%). In women, the highest percent differences between the two groups were observed for SUPSF (59.7), mid-upper arm fat area (MUAFA: 58.1), triceps skinfold (TSF: 51.4), biceps skinfold (BSF: 51.2), FM (51.2) and FMI (49.0). Regression analyses confirmed that tuberculosis status had significant impact (p < 0.0001) on all anthropometric and body composition characteristics compared (except for height in men) in both sexes. Among men, tuberculosis status explained the highest percent variation in percent body fat (PBF: 57.2%), FMI (56.0%) and FM (55.6%). In women, tuberculosis status explained the highest amount of variation in PBF (67.9), TSF (63.5%), BSF (62.8), FMI (61.0) and FM(60.7). Results of contingency chi-square tests revealed that there were significant differences in the frequency of undernutrition between TBP and CT in men (χ2 = 73.13361) and women (χ2 = 59.0000). The frequencies of undernutrition were significantly more common among TBP, in both men (56.5%) as well as women (51.6%). This study provided evidence that there was significant differential amount of loss in fat and muscle measures in tuberculosis patients.