Effects of COVID-19 Pandemic on Nutritional Status, Feeding Practices, and Access to Food Among Infants and Children in Lower and Middle-Income Countries: a Narrative Review

Impact of inflammation on anemia in children: a cross-sectional study

INTRODUCTION

The association of inflammation and iron deficiency could be related to up to 40% of anemia in young children.

OBJECTIVE

To describe the anemia and iron deficiency in children and verify possible associations with dietary practices, nutritional status and inflammatory markers.

METHODS

This cross-sectional study was conducted with one hundred and twelve children aged between 6 months and 3 years in Early Childhood Education Centers in Minas Gerais, Brazil. Nutritional status regarding iron and inflammatory markers was assessed using the reference values proposed by the World Health Organization.

RESULTS

Anemia and iron deficiency were observed in 58 (51.8%) and 89 (79.5%), respectively, of children evaluated. Hemoglobin values were directly associated with the z-score of height for age after adjusting for high-sensitivity C-reactive protein values (β-adjusted = 0.375; 95% CI 0.088 to 0.662; p = 0.011). The values of high-sensitivity C-reactive protein correlated directly with RDW (r = 0.202; p = 0.033), ferritin (r = 0.425; p < 0.001) and soluble transferrin receptor (r = 0.446; p < 0.001), and inversely with hemoglobin (r = -0.287; p = 0.002), serum iron (r = -0.580; p < 0.001) and transferrin saturation index (r = -0.528; p < 0.001). The ROC curve shows that RDW (AUC = 0.708; CI 95% 0.612 to 0.803) and soluble transferrin receptor (AUC = 0.588; 95% CI 0.481 to 0.694) were the variables that showed the better level of discrimination of anemia.

CONCLUSIONS

The prevalence of anemia was higher than in national studies, and there was a correlation between inflammatory markers and biomarkers of iron nutritional status.

Evaluating the effectiveness of training on malnutrition for Anganwadi workers in Anekal Taluk, Bengaluru Urban District

Background

Post COVID-19 pandemic, due to lack of access to nutritional services, malnutrition prevalence has exacerbated. The role of Anganwadi workers in provision of nutrition services is important in prevention of malnutrition in the community.

Aim

We aimed to assess the effectiveness of training on malnutrition on the knowledge of malnutrition among Anganwadi workers in Anekal Taluk of Bengaluru Urban District, Karnataka.

Methods

We conducted a cross-sectional before and after study among 381 Anganwadi workers on the knowledge of malnutrition. After 6 months of training, 303 among the 381 Anganwadi workers were reassessed for knowledge retainment. The tool used for the assessment of knowledge of malnutrition was a 10-item multiple choice questionnaire. Qualitative information regarding challenges of managing malnutrition was also collected during the training.

Results

As compared to the pretest scores, 45.9% of the participants had an increase in knowledge of malnutrition immediately after the training and after 6 months. 19.81% of the participants had an increase in knowledge. During the discussion, participants shared issues of referral mechanism, anthropometry devices, complexity of the nature of malnutrition, Poshan tracker app use, and practical aspects of management of malnutrition.

Recommendations

A standardized curriculum for malnutrition, improved teaching-learning methods, and assessment methods for use among community health workers and calibration and functioning anthropometry tools are essential for malnutrition training. In the community, a strong link between the primary health care system and integrated child development scheme and services is crucial in community-based management of severe and moderate acute malnutrition.

Maternal media exposure and child anthropometric failures across 40 low- and middle-income countries

Objective

To examine the association between maternal exposure to various types of media and child anthropometric failures, and whether this association varies by mothers' socioeconomic status (SES) in low- and middle-income countries (LMICs).

Methods

This study analyzed Demographic and Health Survey data from 40 LMICs (2010-2024). The independent variable was defined as exposure to any mass media (i.e., newspapers/magazines, radio, television) at least once a week for the primary analysis, and mobile phone ownership and internet access were considered for secondary analyses. Three types of child anthropometric failures (i.e., stunting, underweight, wasting) were constructed based on the WHO child growth standards. Multivariable logistic regression models were conducted to examine the association between maternal media exposure and child anthropometric failures, as well as the moderating effects of mothers' socioeconomic status.

Results

Among 439,639 children aged under five, 13% were stunted, 23% were underweight, and 13% had wasting. Overall, 53% of mothers were exposed to any mass media, which was significantly associated with reduced odds of child stunting (OR = 0.90, 95% CI = 0.88-0.92), underweight (OR = 0.89, 95% CI = 0.87-0.91), and wasting (OR = 0.93, 95% CI = 0.90-0.96). The same was true for maternal mobile phone ownership and internet access. For specific types of media, the association was more pronounced among uneducated women and wealthier households.

Conclusions

This study underscores the potential importance of media-based interventions in improving child undernutrition in LMICs. Media exposure is an important channel for health information dissemination and empowerment especially for women with no education. At the same time, improvements in the overall living standards are necessary to induce and sustain healthy behaviors to ensure optimal growth among children.

Impact of COVID-19 on food security and diet quality in Chilanga District, Zambia

INTRODUCTION

Food security and nutrition have been severely impacted during the COVID-19 pandemic, particularly in low- and middle-income countries (LMICs). We aimed to quantify the impacts of the pandemic on food security and diet diversity within Chilanga District in Zambia and identify target areas for high-impact social protection and safety net programs.

METHODS

We conducted a cross-sectional study in Chilanga district immediately after the Omicron variant surge in February 2022. Diet quality and food security were assessed based on a household diet questionnaire and a Minimum Dietary Diversity-Women (MDD-W) score was calculated. A paired t-test was used to determine whether there was a statistically significant change in the MDD-W score and McNemar test was used to investigate the change in food security between the pre- and peri-COVID-19 period.

RESULTS

Compared to the pre-COVID-19 period, there were increases in food prices across the board in the peri-COVID-19 period and decreased consumption of key food categories including legumes, dairy and vitamin A rich foods. Despite high rates of food insecurity, only 6.6% of surveyed households received any cash or in-kind assistance from a government agency, non-profit, or other organization in the post-COVID-19 period.

CONCLUSION

The COVID-19 pandemic had significant impacts on food security and dietary diversity in Chilanga district. This is particularly relevant in the low-income communities that we surveyed, which had pre-existing challenges with food security. Additional resources must be invested in Chilanga District and similarly affected areas to address this gap in access to food and promote national equity. Trial Registration N/A.