Factors associated with underweight and stunting among children in rural Terai of eastern Nepal.

Malnutrition continues to affect a large proportion of children in the developing world. The authors undertook this study to identify biologic, socioeconomic, and health care factors associated with underweight and stunting in young children in an the eastern Tarai (plains) district of Nepal. Data were collected via questionnaires from mothers of 443 children aged 6 to 36 months in Sunsari district. Multistage cluster sampling was used to select villages and children. Anthropometric measurements were made on both children and their mothers. Logistic regression was used to measure the independent (adjusted) effect of risk and protective factors on the odds of underweight or stunting. More than half (53.3%) of the children were found to be underweight (<2 standard deviations weight for age below reference median) and more than one third (36.6%) had stunting (<2 standard deviations height for age below reference median). Low maternal body mass index, child's age, higher birth order, and lower standard of living score were strong predictors of underweight, whereas mother's education >5 years and participation in vitamin A and nutritional programs were protective. Infant age, low maternal body mass index, and low standard of living score were significant risk factors for stunting, whereas mother's education >5 years was strongly protective. These results suggest that underweight and stunting are the result of a nexus of biological, socioeconomic, and health care factors.

Children aged 6 to 60 months in Nepal may require a vitamin A supplement regardless of dietary intake from plant an animal food sources.

The purpose of this survey was to explore the relationship between the prevalence of the health indicators of malnutrition, diarrhea, and acute respiratory infection and the consumption of vitamin A-rich food and the supplementation status of three groups of children in Nepal (supplemented, supplemented only once, and never supplemented). A trained female community health worker interviewed mothers about vitamin A-rich food feeding practices to children aged 6 to 60 months using a standardized questionnaire and then estimated the nutritional status of the children using mid-upper-arm circumference measurements and recording the incidence of diarrhea and acute respiratory infection from mothers' interviews. Regardless of the amount of vitamin A-rich foods consumed, children who were regularly supplemented with high doses of vitamin A were protected against malnutrition, diarrhea, and acute respiratory infection at a higher rate than children who were supplemented only once or were never supplemented. Regularly providing a high-dose (200,000 IU) capsule of vitamin A to children aged 6 to 60 months, including those who eat vitamin A-rich foods, may be effective in decreasing the prevalence of morbidity from malnutrition, diarrhea, and acute respiratory infection.

Vitamin A supplementation and health outcomes for children in Nepal.

PURPOSE: To compare vitamin A supplementation status of children age 6-60 months to the prevalence of vitamin A deficiency disease, malnutrition, diarrhea, and acute respiratory infection. METHODS: The nutritional status of children was estimated using mid-upper-arm circumference measurements. A trained ophthalmology assistant assessed for clinical signs of vitamin A deficiency disease. A trained female community health worker interviewed mothers about child health status using a standardized questionnaire. RESULTS: Compared to children who did not receive supplements, children who received vitamin A supplements regularly had less malnutrition, diarrhea, and acute respiratory infection, regardless of the number of children per household, age, sex, or father's occupation. CONCLUSIONS: Supplementation with vitamin A is necessary twice a year. Children who received a vitamin A capsule only one time were not as protected as were those children who received vitamin A as a regular twice yearly scheduled dose.