A cross-sectional study on undernutrition among under-5 children living in the rural area of Hyderabad

Background: Undernutrition is a silent emergency and one of the most common causes of morbidity and mortality among under-5 children throughout the world. A serious public health concern and can have significant effect on child’s overall growth and development. The prevalence of undernutrition is two folds higher among rural area compared with urban area, therefore present study aims to study the prevalence of undernutrition and associated factors among under-5 children living in rural area of Hyderabad. Methods: A community based cross-sectional study was conducted between April 2023 to June 2023 in rural field practice area of a medical college in Hyderabad. A total of 364 under-5 children residing in study area were selected by simple random technique. Data about socio-demographic variables were collected by questionnaire and anthropometrics were measured using standard techniques. Results: In the present study, about 33% of under-5 children are underweight and 35% are stunted. The under-5 children belonged to lower socioeconomic class were significantly more likely to be underweight (40%) and stunted (42%). Family size >6 members were significantly underweight (48%) as well as stunted (47%). Children with low birth weight i.e. <2.5 kg had significantly higher rates of underweight (43%) as well as stunting (45%). Among the children with weaning age less than 6 months, 47% were underweight and 45.6% were stunted. Conclusions: Socio economic status, family size, birth weight, and weaning age are important determinants of undernutrition.

Childhood undernutrition and its determinants: a cross-sectional study among under-five children in a slum of Kolkata, West Bengal, India

Background: Undernutrition is an important risk for premature deaths and almost 45% of deaths in the under-five population are linked to undernutrition globally, where low- and middle-income countries (LMIC) bear a major share of it. This study aimed to measure the burden of such undernutrition and its determinants among the under-five children in a slum of Kolkata. Methods: A community-based cross-sectional study was conducted between Oct 2022-February 2023 among 164 children aged between 6-59 months. Participants were selected by probabilistic sampling method; Mothers were interviewed and anthropometry of the children were measured. Prevalence of undernutrition was assessed by the composite index of anthropometric failure (CIAF). Logistic regression analysis was done to find out the associates of undernutrition. Results: Median age of the study participants was 26.5 months, 54.3% of the participants being boy children. Regarding feeding of the child, 26.2% given prelecteal feeding, 17.7% didn’t receive colostrum, 33.5% had delayed initiation of breast feeding, only 57.9% child received exclusive breastfeeding. Of the participants, 11% child delivered by home delivery and 32.9% had low-birth-weights. According to CIAF 68.9% had undernutrition, while underweight, stunting, and wasting were reported as per conventional index 44.5%, 56.7%, and 16.5% respectively. In multivariable logistic analysis undernutrition have significant association with low birth weight and repeated episode of cough and running nose [aOR= 0.99(0.98-0.99). aOR=2.32(1.06-5.09)] respectively. Conclusions: Considerable proportion of children (two out of three) had undernutrition with CIAF. Preventive measures should include improvement in antenatal care, child feeding counselling and social determinants of health.

No time to waste for wasted children in Bihar: time to reset

Background: Severe acute malnutrition (SAM) with severe wasting remains a major killer of children. In Bihar, 48% of children are stunted, 21 % are wasted, and 7% are severely wasted. Even during the first six months of life, 31% are wasted. The objective of this study was to study wasting trends and contributing factors responsible for changes in Bihar among children 0-5 years. Methods: This cross-sectional study was done using a data of NFHS-5 survey in Bihar (N=35,834) conducted in all 38 districts of the state from July, 2019 to February, 2020. The Bihar NFHS-5 report and factsheets, including NFHS-4 data, were downloaded and converted to excel to enable data visualization and trend analysis. The outcome variable Wasting was measured using NFHS-5 relevant questionnaires given under nutrition category. We analyzed trends between NFHS-5 and NFHS-4 Bihar data for severe wasting/wasting, determinants, and coverage of interventions.Results: The prevalence of severe wasting has increased from 7% to 8.8%, while wasting increased from 20.8% to 22.9% (NFHS-5). The severe wasting and wasting has reversed or worsened in 27 districts. There is a mixed picture of infant feeding- early initiation of breastfeeding worsening and some improvements in exclusive breastfeeding and timely introduction of complementary feeding. Consistent improvement across districts for underlying determinants, but slight, in women抯 education, teenage pregnancy, and marriage before 18 years. Conclusions: Need to invest in improving maternal determinants-age at marriage, education, ANC coverage, and teenage pregnancy. It is imperative to focus on preventing, identifying, and treating wasting.

Child undernutrition in Brazil: the wound that never healed

Abstract Objective To describe the scenario of child undernutrition in Brazil and its determinants. Data source Narrative review of the literature with inclusion of data from population surveys, surveillance and monitoring systems, and active search in favelas and underserved communities carried out by CREN. Data synthesis Household surveys carried out from 1974 to 2019 indicate that undernutrition (<5 years) decreased until 2006. Underweight (W/A ≤-2 Z) and stunting (H/A ≤-2 Z) showed a decrease of 17% to 3% and 37% to 7%, respectively. After 2006, there was an increase in underweight of 53% and 76% for wasting (BMI/A ≤-2 Z), with the prevalence of stunting being stagnant at around 7%. Active search data in favelas and underserved communities show that the prevalence of stunting is 11% in those <5 years. In 2021, 30% of the population lived in poverty, 73% of which were black or brown. Stunting in black and brown children <5 years old is, respectively, 9% and 12% higher when compared to white children. Poverty decreased between 2012 and 2015 (27 to 25%), but increased again (2016=26% to 2021=30%), in parallel with food insecurity, which decreased between 2004 and 2013 (12% to 6%), but reached its worst level in the historical series (2022:15%). Conclusion Despite advances, Brazil's social protection system was not able to reduce inequalities and the reversal of the trend towards decreasing child undernutrition could be observed from 2006 onwards.

Conmemorando los cincuenta años de Leche Purita: importancia de la leche en la erradicación de la desnutrición infantil en Chile

La desnutrición ocurre cuando hay una ingesta o asimilación deficiente de la energía y los nutrientes. Si esta se produce dentro de los primeros años de vida, las consecuencias para la salud son devastadoras. El tratamiento temprano de la desnutrición es clave para reducir estas consecuencias y en este proceso la leche tiene una participación destacada. La leche es un excelente alimento debido al contenido y calidad de sus macro- y micronutrientes, lo que ha llevado a que la investigación y el uso de la leche en el tratamiento de la desnutrición hayan aumentado sostenidamente desde comienzos del siglo XX. En Chile, la desnutrición infantil fue prácticamente erradicada entre los años 1960 y 1980 debido a la aplicación exitosa de una serie de políticas públicas materno-infantiles, dentro de las cuales la Leche Purita fue fundamental. Sin embargo, la historia de la leche como parte de las políticas nutricionales en Chile comenzó mucho antes. Conmemorando los cincuenta años desde el nacimiento de Leche Purita, el objetivo de este trabajo es realizar un breve repaso acerca de la importancia histórica de la leche en las políticas nutricionales en Chile, enfatizando la contribución realizada por la Leche Purita a la erradicación de la desnutrición infantil y a la disminución de la anemia en niños.

Undernutrition occurs when there is poor intake or assimilation of energy and nutrients. If undernutrition is established within the first years of life, the health consequences are devastating. Early treatment of undernutrition is critical to reduce these consequences and milk plays an important role in this treatment. Cow's milk is an excellent food due to the content and quality of its macro- and micronutrients. This has led to a steady increase in research and the use of milk in treating undernutrition since the beginning of the 20th century. In Chile, child undernutrition was practically eradicated between the decades of 1960 and 1980 due to the successful application of maternal and child public policies, within which the product Leche Purita was fundamental. However, the history of milk as part of nutritional policies in Chile began much earlier. Commemorating fifty years since the introduction of Leche Purita, we aim to summarize the historical importance of milk in Chile's nutritional policies. We emphasize Leche Purita's role in eradicating child undernutrition and reducing anemia among children.

Association between the RTS,S/AS01 malaria vaccine and under-nutrition in children aged 10 to 59 months in Siaya County, Kenya

Background: Under-nutrition is a global problem associated with infectious diseases including malaria. In this study, we explored the association between the newly introduced malaria vaccine, RTS,S/AS01 and measles vaccine with under-nutrition in children. Methods: We conducted a case-control study using anthropometric data for children aged between 10 and 59 months in Siaya County, Kenya collected from September to December 2021. Malaria and measles vaccines were the exposure variables, and under-nutrition, which is a composite variable including stunting and/or underweight was the outcome. Chi-square was used to test association between under-nutrition and the two vaccines. Further, a binary logistic regression was used to assess association between the vaccines, and independent variables with a confidence interval set at 95%. Results: From a total of 1,701 children, 185 (16.8%) were undernourished. Among the undernourished children, 121 (11.0%) were stunted and 64 (5.81%) were underweight. The undernourished children were matched with children of normal nutritional status at a ratio of 1:1 giving a total of 370. Malaria vaccine coverage was low at 21.1% (39/370) and 17.3% (32/370) among undernourished and children with normal nutritional status respectively. Similarly, the measles vaccine coverage was 30.8% (57/370) and 36.2% (67/370) among cases and controls respectively. Neither exposure to malaria nor measles vaccines showed a statistically significant difference between the cases and controls. Conclusions: We found no statistically significant association between malaria vaccine and under-nutrition in children. While malaria vaccine is important in protecting children from the malaria disease effects, it is not a proxy intervention for under-nutrition.

Malnutrition status among primary and middle school students in Yunfu City / 预防医学

Objective@#To investigate the nutritional status and its influencing factors among primary and middle school students in Yunfu City, Guangdong Province, so as to provide the basis for improving nutrition and health strategies for students.@*Methods@#Primary and middle school students from 26 schools in 5 counties (cities, districts) of Yunfu City were selected in 2022 through multi-stage stratified cluster random sampling method. Demographic information, dietary and exercise behaviors were collected using questionnaire surveys, and the prevalence of malnutrition were analyzed. Factors affecting malnutrition was evaluated using a multinomial logistic regression model.@*Results@#A total of 7 213 students were surveyed, including 3 881 boys (53.81%) and 3 332 girls (46.19%), and had a median age of 13.50 (interquartile range, 4.00) years. There were 2 667 primary school students (36.97%), 2 662 middle school students (36.91%) and 1 884 high school students (26.12%). There were 1 938 students suffered from malnutrition, with a detection rate of 26.87%. The detection rates for undernutrition, overweight and obesity were 11.66%, 9.75% and 5.46%, respectively. Multinomial logistic regression analysis showed that gender (boy, OR=2.227, 95%CI: 1.905-2.603), studying phase (primary school, OR=1.528, 95%CI: 1.239-1.884), ≥60 min/d of moderate/high-intensity exercise (0-1 d/week, OR=1.422, 95%CI: 1.153-1.753; 2-4 d/week, OR=1.280, 95%CI: 1.047-1.564) and frequency of having physical education (1-2 classes/week, OR=1.732, 95%CI: 1.084-2.767; 3-4 classes/week, OR=1.662, 95%CI: 1.026-2.693) were the influencing factors for undernutrition; gender (boy, OR=1.956, 95%CI: 1.656-2.311), frequency of sugary beverage intake (0 time/d, OR=0.721, 95%CI: 0.528-0.984) and frequency of having physical education (0 class/week, OR=2.087, 95%CI: 1.151-3.784; 1-2 classes/week, OR=1.644, 95%CI: 1.044-2.590; 3-4 classes/week, OR=1.685, 95%CI: 1.051-2.703) were the influencing factors for overweight; gender (boy, OR=2.459, 95%CI: 1.964-3.078) was the influencing factor for obesity among students.@*Conclusions@#Undernutrition, overweight and obesity coexist in primary and middle school students in Yunfu City. Gender, school phase, frequency of sugary beverage intake and frequency of having physical education are associated with malnutrition among primary and middle school students.

Dénutrition chez les patients en postopératoire de chirurgie digestive dans deux hôpitaux publics au Bénin en 2022 / Undernutrition in postoperative digestive surgery patients in two public hospitals in Benin in 2022

Objectif : Déterminer la fréquence et les facteurs associés à la dénutrition en postopératoire dans deux hôpitaux universitaires publics au Bénin. Méthode : Il s'agissait d'une étude observationnelle transversale descriptive et analytique, qui s'est déroulée de mai à juillet 2022. Un recrutement exhaustif des patients devant être pris en charge chirurgicalement pour une pathologie digestive et ayant consenti à l'étude, a été effectué. Des données anthropométriques et de consommation alimentaire, des données cliniques ont été recueillies grâce à un questionnaire standardisé. Résultats : Un total de 51 patients a été inclus, avec une prédominance d'adultes âgés de moins de 50 ans (70,6%), un sex-ratio de 0,9 ; 72,5% avait un niveau d'instruction ≥ secondaire, 60,8% vivait en couple. Le niveau de revenu était inférieur au salaire minimum interprofessionnel garanti (SMIG) dans 52,9% des cas. La fréquence de la dénutrition était de 29,4% à l'admission contre 54% en postopératoire. Seuls les patients dénutris avaient présenté des complications postopératoires (36%). L'évaluation de l'état nutritionnel n'avait été consignée dans aucun des dossiers médicaux. En analyse multivariée, l'insuffisance en apport protéique et un bas niveau de revenu étaient associées à la dénutrition postopératoire (p = 0,002). Conclusion : La dénutrition en chirurgie digestive est une réalité dans les hôpitaux publics du Bénin et constitue un facteur de risque de complications postopératoires. Son dépistage et sa prise en charge doivent être systématiques et consignés dans le dossier médical du malade

Objective: To determine the frequency and factors associated with postoperative undernutrition in two public teaching hospitals in Benin. Method: This was a descriptive and analytical cross-sectional observational study conducted from May to July 2022. An exhaustive recruitment of patients to be managed surgically for a digestive pathology and who consented to the study, was carried out. Anthropometric, food consumption and clinical data were collected using a standardized questionnaire. Results: A total of 51 patients were included, with a predominance of adults under 50 years of age (70.6%), a sex ratio of 0.9; 72.5% had an educational level ≥ secondary, 60.8% were living as a couple. Income was below the guaranteed minimum wage in 52.9% of cases. The incidence of undernutrition was 29.4% on admission, compared with 54% postoperatively. Only the undernourished patients (36%) presented postoperative complications. Assessment of nutritional status was not recorded in any of the medical register. In multivariate analysis, insufficient protein intake and low income were associated with postoperative undernutrition. Conclusion: Undernutrition in digestive surgery is a reality in public hospitals in Benin, and constitutes a risk factor for postoperative complications. Its detection and management must be systematic and recorded in the patient's medical register.

Nutritional status and morbidity pattern among school children in an urban slum of Kolkata, India

Background: Sickness and morbidity rates in Indian school going children are among the highest in the world. Poor health and sickness absenteeism results in school dropouts and it is more among the female children as compared to male children. Present study was conducted to study the nutritional status and morbidity pattern among children attending the school health clinics in an urban area of West Bengal India. Methods: A cross-sectional study was conducted in the field practice area of urban health centres (UHC) of AIIH and PH Kolkata, West Bengal. Children enrolled in class 1-10 were included in the study by using systematic random sampling technique. Data was collected by using semi-structured questionnaire, clinical history and physical examination was done. Results: Out of total 254 students, 129 (50.8%) were boys and 125 (49.2%) were girls. Dental caries and skin diseases like ringworm infection, cuts and fungal infection were most common types of morbidity found in school children. Dental caries and skin diseases both were more common in girls as compared to the boys. Underweight was found in more than 70% of the children and their BMI was significantly low as compare to the ICMR standard. Conclusions: The proportion of malnutrition is very high in the school children of the field practice area of UHC Chetla and there is need to create opportunities to increase the family income and awareness programme to increase the nutritive values of foods prepared at household level.

Under-nutrition and Associated Factors among Young Patients on AntiRetroviral Therapy in North Shoa, Oromia, Ethiopia, 2022: A Facility-Based Cross-Sectional Study

Background: Undernutrition and the Human Immunodeficiency Virus (HIV) are related in a complex and harmful way and are both exceedingly prevalent throughout the world, particularly in sub-Saharan Africa. In Ethiopia, the prevalence of undernutrition ranged from 12.3% to 43% and the prevalence of stunting and thinness among HIV-infected adolescents were 39% and 14% respectively. There is no study among young patients living with Human Immunodeficiency Virus and ART. Therefore, this study aims to assess the prevalence of undernutrition and its associated factor among young infected with HIV and following ART clinics at the north Shoa health facilities in Oromia, Ethiopia. Method: A facility-based cross-sectional study was conducted. A probability-proportional sampling method was used to select 387 participants and pretested, interview-administered questionnaires were used to collect the data. The information was entered into EpiData and analyzed with SPSS. A 95% confidence interval and a p-value less than 0.05 were used to identify predictor variables, and Adjusted Odds Ratio (AOR) was used to assess the strength of the association. Result: The prevalence of stunting and thinness in the study was 37% (95% CI: 32.0, 41.9) and 13.4% (95%, CI: 10.3, 16.9) respectively. Being male (AOR=1.5, 95% CI: 1.0, 2.4), educational level of caregiver (AOR=7.8, 95% CI: 3.5, 17.2), and having a family income <1500 ETB (AOR=7.8, 95% CI: 3.5, 17.2) were significantly associated with stunting while being male (AOR=2.59, 95% CI: 1.25, 5.40), nutritional counseling (AOR=4.05, 95% CI: 1.64, 10.02), Skipping meal (AOR=4.97, 95% CI: 2.08, 11.9) and educational level of caregiver (AOR=4.18, 95% CI: 1.82, 9.60) were significantly associated with thinness. Conclusion: The prevalence of stunting and thinness among HIV-infected adolescents and youth in the study area was consistent with EDHS and higher than the EDHS report respectively. Sex, skipping a meal, nutritional counseling, and family size were significantly associated with thinness and Sex, educational level of the caregiver, and family income was significantly associated with stunting.

Risk factors for stunting of under-five children in Myanmar

Background: This study aimed to identify risk factors and assess their significance concerning childhood stunting in Myanmar. Methods: This study was conducted through the analysis of a secondary dataset based on the 2015-2016 Myanmar Demographic and Health Survey (MDHS 2015-2016), a program funded by the United States Agency for International Development (USAID). Among the 5239 under-five children who participated in the Myanmar DHS 2015-2016 survey, 4172 children with complete anthropometric measurements were included in this study. This was a cross-sectional study, and Chi-squared analysis was applied to determine the association of each risk factor with stunting. In addition, logistic regression was used for multivariate analysis of all risk factors combined. Results: Out of 4172 children who participated in the study, 1146 (27.5%) were stunted. Type of place of residence, household wealth index, and maternal education level have a significant effect on stunting of under-five children with (?2=52.79, df=1, p=0.000), (?2=82.03, df=2, p=0.000) and (?2=72.31, df=3, p=0.000) respectively. When applied to multivariate logistic regression analysis, all three factors remained significant predictors of stunting in under-five children. Conclusions: Individual- and community-level factors determining the stunting of under-five children in Myanmar were explored. Government support programs for the occupation and income of the household heads and household members, as well as education programs targeting women in both the short term and long term, may help improve the condition.

Prevalence of under nutrition among under-5 children in the urban field practice area of a medical college in Muzaffarnagar, Uttar Pradesh

Background: In India, undernutrition in children mal the age of five is a serious public health issue. Despite India's expanding economy, both urban and rural areas still have significant rates of undernutrition-related child mortality. There are hardly many studies that concentrate on cities. In order to determine the prevalence of undernutrition in the urban field practice area of a medical college in Muzaffarnagar, Uttar Pradesh, the current study was conducted. Objective of the study was using World Health Organization (WHO) growth standards, to determine the prevalence of undernutrition among children under the age of five. Methods: A community-based cross-sectional study was conducted in the urban field practice region of the medical college Muzaffarnagar, India, from August 2022 to November 2022. From 1875 registered families, 400 under-five-year-old children were randomly chosen, and a house-to-house survey was used to collect the study's data. The study's goals were explained to the parents, and their written agreement was obtained. The children who were accessible during the study period had their anthropometric measurements taken in accordance with WHO criteria. For nutritional deficits and other morbidities, the kids were checked. Data analysis was performed using the statistical package for the social sciences (SPSS) 23 programme and the Chi square test. Results: A total of 400 under 5 were examined by going from house to house, and 257 (64.2%) of them were underweight. Boys had significantly (p=0.001) more undernutrition than girls. In the age range of 49 to 60 months, it peaked. Conclusions: Children's malnutrition continues to be a problem for public health, especially among underprivileged populations.

A community-based cross-sectional study to assess the prevalence of undernutrition in 0 to 6 years anganwadi children of Panvel block, Raigad district, Maharashtra

Background: An impaired nutritional status in preschool children significantly Impacts their overall childhood development. Early detection of undernutrition at an early age is crucial for early intervention. Objectives of the study were to conduct nutritional status assessments of preschool children, to detect the overall prevalence and various patterns of undernutrition in these children by applying a composite index of anthropometric failure (CIAF) indicator. Methods: A community-based, cross-sectional study was conducted in January 2019 to March 2020. The sample size of 8542 was computed by formula n=4pq/L2, by randomly selecting 132 Anganwadi. Nutritional status assessment of the children was done by anthropometrics and clinical examinations. Conventional indices (underweight, stunting, and wasting) and CIAF classification were used to assess. The prevalence of undernutrition. Statistical analysis was done by Microsoft Excel and SPSS version 27 and statistical tests were applied. Results: 50.6% of children were detected for “anthropometric failure” by the CIAF method. The conventional indices showed the prevalence of underweight at 32.9%, stunting at 35.7%, and wasting at 16.4%. The 13 to 25-month age group was more significantly affected (57%) than its counterparts for undernutrition. Statistically, no significant difference was found between genders across all age groups for undernutrition (?2=9.8, ?tab=11.08). Chronic undernutrition seemed highly prevalent than acute one in preschool children. Conclusions: A more comprehensive policy program is needed to identify and cover single as well as multiple anthropometrical failure children. Special attention is needed towards the 13 to 25 months old children.

A case study on undernutrition among children under five years of age in Barangay Calumpang, Nagcarlan, Laguna

Background@#In 2020, Barangay Calumpang, a 2nd class municipality in Nagcarlan, Laguna recorded the highest prevalence of undernutrition among children under five years of age out of the 52 barangays.@*Objectives@#This study was undertaken to describe the factors possibly causing undernutrition among children under five years of age in Barangay Calumpang and provide key recommendations to improve their nutritional status.@*Methods@#The study used a descriptive research design wherein secondary data from the 2020 Barangay Management Information System (BMIS) and Operation Timbang (OPT) 2021 was merged to extract the children's data. The Statistical Package for the Social Sciences (SPSS) was used for the principal component analysis (PCA) and creation of the wealth index. The children’s nutrition situation and profile were also cross-tabulated.@*Results@#We included 28 children. Undernutrition was more prevalent in boys than girls. Most of the children had improved water sources, sanitation facilities, and waste disposal methods. The wealth index showed that half of the subjects were in the lower quintiles, and all were partially immunized. The most prevalent forms of undernutrition were severe underweight (36%) and severe stunting (39%). Other forms of undernutrition were also present in the barangay, such as underweight (14%) and severe wasting (14%). There was also a prevalence of 11% for both stunting and wasting.@*Conclusion@#Undernutrition was more frequent in boys, lower quintile households (stunting), and partially immunized children. Conducting gender-targeted nutrition programs, developing nutrition-focused livelihood programs, increasing awareness on the advantages of immunization, and promoting proper infant and child feeding practices were some of the recommendations given to improve the nutritional status of children under five.

Nutritional profile of indigenous children under five years of age in the Upper Solimões River, Amazonas, Brazil (2013) / Perfil nutricional de crianças indígenas menores de cinco anos de idade no Alto Rio Solimões, Amazonas, Brasil (2013)

Abstract Objectives: to characterize the nutritional status of indigenous children underfive years of age living in rural communities in the Upper Solimões River region, inhabited by seven ethnic groups, based on data of december 2013. Methods: weight and height data extracted from SISVAN-I (Indigenous Food and Nutritional Surveillance System) forms filled in 2013 for 7,520 children (86.0% of the estimated children in this age group). The indices height-for-age (H/A), weight-for-age (W/A), weight-for-height(W/H), and body mass index-for-age (BMI/A) were calculated. Growth reference curves proposed by the World Health Organization were used to calculate z-scores. Results: the height-for-age (H/A) index presented the lowest mean z-score values, reaching -1.95 among children between 36 and 60 months. Mean z-score values for the weight-for-age (W/A) index also remained below zero. Mean z-score values for the indices weight-for-height (W/H) and body mass index-for-age (BMI/A) remained slightly above zero, reaching a maximum value of 0.5. Of all children, 45.7% presented low H/A, 9.6% presented low W/A, 4.5% presented low W/H, and 10.7% presented overweight based on BMI/A. Conclusion: our analysis show that in 2013 poor nutritional status persisted as an important health issue among these rural indigenous children.

Resumo Objetivos: caracterizar o estado nutricional de crianças indígenas menores de cinco anos, de comunidades rurais na região do Alto Solimões, habitada por sete etnias, com base em dados de dezembro de 2013. Métodos: foram extraídos dos formulários do SISVAN Indígena dados de peso e estatura, coletados em 2013, de 7.520 crianças (86,0% das crianças estimadas nesta faixa etária). Foram calculados os índices estatura-para-idade (E/I), peso-para-idade (P/I), peso-para-estatura (P/E) e índice de massa corporal para idade (IMC/I). Curvas de referência para crescimento propostas pela Organização Mundial da Saúde foram utilizadas para calcular escores z. Resultados: o índice estatura-para-idade (E/I) apresentou os menores valores médios de escore z, chegando a -1,95 nas crianças entre 36 e 60 meses. Os valores médios do escore z do índice peso-para-idade (P/I) também permaneceram abaixo de zero. Os valores médios do escore z para os índices P/E e índice de massa corporal para idade (IMC/I) mantiveram-se ligeiramente acima de zero, atingindo valor máximo de 0,5. Do total de crianças, 45,7% apresentaram baixa E/I, 9,6%, baixo P/I, 4,5% baixo P/E e 10,7% de excesso de peso de acordo com o IMC/I. Conclusão: em 2013 a desnutrição persistia como um importante agravo à saúde nessas crianças.

Child Undernutrition among the Bhoksa Tribe of Uttarakhand in India.

Aim: The study aimed to investigate the prevalence of undernutrition in terms of low birth weight, stunting, wasting, and underweight among children up to 3 years of age. Materials and Methods: We recruited 150 children of the Bhoksa Tribe aged between 2 to 36 months. Information related to nutritional indicators (length-for-age, weight-for-age, and weight-for-length) of the child and socio-demographic variables of the household were collected. Results: The prevalence of undernutrition in terms of low birth weight, stunting, wasting, and underweight was 15.4%, 32%, 29.98%, and 36.66%, respectively. The prevalence percentage of undernutrition was high among girls but the difference based on sex was not significant. A significant difference in mean birth weight was observed between low and high SES (2.45 kg v/s 2.93 kg). Conclusion: High prevalence of undernutrition concerning birth weight among the children of the Bhoksa Tribe was observed which may be due to socioeconomic inequality in the population.

INTRA-FAMILY DIFFERENCES IN NUTRITIONAL STATUS BETWEEN PRE-SCHOOL AND SCHOOL AGE CHILDREN

Currently under- and over-nutrition are public health problems in Indian children. A community-based study in 3249 children was undertaken to assess the magnitude of intra-family differences in nutritional status between pre-school and school age children from urban low middle income families. Length/height and weight were measured; nutritional status was computed using WHO Anthro and Anthro Plus software. One-fourth of children were stunted, 1/5th underweight, 1/10th wasted and less than 5% were overweight. Prevalence of stunting, underweight and wasting was higher in children whose elder siblings were stunted, underweight or wasted. However, majority of the younger siblings of under-nourished elder siblings were normally nourished; majority of the elder siblings of undernourished younger sibling were normally nourished. In view of this, it is essential to screen all children, identify those who are under- or overnourished using BMI-for-age and provide appropriate interventions.

Growth and Nutritional Status of Kandra (Fisherman) Adolescent Girls from Ganjam, Odisha, India.

Introduction: The National Family Health Survey-4 data from Odisha shows, adolescent growth spurt and nutritional level needs to be studied comprehensively for designing appropriate policies. Kandra community of Odisha is a Schedule Caste (SC) community with low socio-economic status. No study has been done on growth spurt of girls from this community. Hence, the paper examined growth and nutritional trend and test for significant difference on height, weight, and Body Mass Index (BMI). Methodology: Cross-sectional study with 78 sample were collected from one Gram Panchayat of Ganjam district, India. Somatometric measurements i.e., height, weight, chest, and calf circumference were collected from school-going adolescent, randomly. Mean difference between early and middle adolescent were seen through Levene's Test for equality of variances and independent sample-t-test. Result: Findings say, adolescent growth spurt was highest at age 13-14 years. The overall median height and weight were reported less than Indian and National Center for Health Statistics (NCHS) standards. The difference between 12-13 years and 14-16 years were significant at p<.001 for BMI. Conclusion: Findings were like the gaps reported in NFHS-4 nutritional indictors and is a concern as the girls are going to be future mother, and deficiency may pull their life into risk.

Regional Differences of Child Undernutrition in India: The Reflection of Composite Index of Anthropometric Failure (CIAF) from CNNS-2016-18 Data.

Background: The Composite Index of Anthropometric Failure (CIAF) has its multifaceted application in understanding child undernutrition. The nationwide data of Community National Nutrition Survey (CNNS) 2016-18 in India has unfolded this opportunity to re-examine the use of CIAF and its determinants. One recent study showed significant differences in child undernutrition between rich and poor wealth index households using this CNNS -16-18 data. But, the study did not consider regional as well as state-wise CIAF variation. However, it is a fact that regional understanding of child undernutrition is equally vital for national and regional health and nutritional planning, specifically in India. Therefore, the present study aims to understand the geographical region and state-wise distribution of CIAF and determine some selected determinants of CIAF. Methods: The study used secondary data set from the Community National Nutrition Survey (CNNS), India undertaken in 2016-18. The study sample comprised of 32941 children aged 0-59 months. The multivariate logistic regression models were used to explore the determinants of CIAF. Results: The results revealed that nearly half of the under-five children suffered from undernutrition (CIAF-46.71%). The final adjusted multivariate regression models showed that the higher CIAF prevalence was mainly confined in the central region states like Madhya Pradesh (56.0%) and Uttar Pradesh (52.0%). Besides, the Jharkhand state in the eastern region showed the highest percentage of CIAF (57.0%). The prevalence of child undernutrition was more elevated in poor economic households and Muslim households. Children in the age group ?12 months, boys, who did not consume milk other than breast milk and lived in rural areas, had a higher prevalence of undernutrition. In the case of mother characteristics, mother's age at birth < 20 years, mother never attended school and mother did not watch television had a higher number of undernourished children. Despite several significant determinants associated with child undernutrition, the considerable impact of the region was consistent throughout the statistical models. Conclusion: Therefore, the vulnerable geographical regions and states in terms of child undernutrition should prioritise nutrition-sensitive interventions in India and consider the involvement of other key risk factors.

Impact of Intervention on Nutritional Status of Under-Fives in Tribal Blocks of Palghar District in Maharashtra, India

Background: There is a need to improve their nutritional status of under?five children through specific targeted interventions. The present study discusses the impact of intervention on nutritional status among under?five children in Palghar district from Maharashtra. Objective: The objective is to improve the nutritional status of under?five children by implementing multi?component health and nutrition education intervention, focusing on dietary counseling and modification keeping in view the cultural and socio?economic status of population. Methods: A prospective pre? and post?intervention study was conducted in two tribal blocks. Total 480 under?five children were included in pre? and post?intervention survey each. Results: Exclusive breastfeeding rates improved from 48.9% to 50.5% and initiation of complementary feeding at 6 months improved from 48.3% to 72.5% in post intervention survey as compared to preintervention survey. Among other Infant and Young Child Feeding indicators, Minimum Meal Frequency increased significantly to 67.03% from 5.91% and minimum acceptable diet improved from 5.37% to 47.2% in post intervention survey. The prevalence of Severe Acute Malnutrition (SAM) reduced from 5.4% to nil whereas severe stunting and underweight significantly decreased by 17% and 8% respectively in post intervention survey. Severe anemia decreased from 16.24% to nil post intervention. Conclusion: The study reveals a substantial improvement in timely initiation of complementary feeds, nil cases of SAM, stunting, and underweight along with severe anemia in postintervention phase. This highlights the impact of multicomponent health and nutrition education interventions which may be adapted at a programmatic level to reduce child mortality and morbidity in India.