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Choudhary P, Padhi BK, Mital AK, Gandhi AP, Mishra SK, Suri N, Baral SS, Satapathy P, Shamim MA, Thangavelu L, Rustagi S, Sah R, Khatib MN, Gaidhane S, Zahiruddin QS, Abd-Alrazaq A, Abu Serhan H. Prevalence of stunting among under-five children in refugee and internally displaced communities: a systematic review and meta-analysis. Front Public Health 2023; 11:1278343. [PMID: 38094233 PMCID: PMC10716242 DOI: 10.3389/fpubh.2023.1278343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 10/25/2023] [Indexed: 12/18/2023] Open
Abstract
Background A pooled estimate of stunting prevalence in refugee and internally displaced under-five children can help quantify the problem and focus on the nutritional needs of these marginalized groups. We aimed to assess the pooled prevalence of stunting in refugees and internally displaced under-five children from different parts of the globe. Methods In this systematic review and meta-analysis, seven databases (Cochrane, EBSCOHost, EMBASE, ProQuest, PubMed, Scopus, and Web of Science) along with "preprint servers" were searched systematically from the earliest available date to 14 February 2023. Refugee and internally displaced (IDP) under-five children were included, and study quality was assessed using "National Heart, Lung, and Blood Institute (NHLBI)" tools. Results A total of 776 abstracts (PubMed = 208, Scopus = 192, Cochrane = 1, Web of Science = 27, Embase = 8, EBSCOHost = 123, ProQuest = 5, Google Scholar = 209, and Preprints = 3) were retrieved, duplicates removed, and screened, among which 30 studies were found eligible for qualitative and quantitative synthesis. The pooled prevalence of stunting was 26% [95% confidence interval (CI): 21-31]. Heterogeneity was high (I2 = 99%, p < 0.01). A subgroup analysis of the type of study subjects revealed a pooled stunting prevalence of 37% (95% CI: 23-53) in internally displaced populations and 22% (95% CI: 18-28) among refugee children. Based on geographical distribution, the stunting was 32% (95% CI: 24-40) in the African region, 34% (95% CI: 24-46) in the South-East Asian region, and 14% (95% CI: 11-19) in Eastern Mediterranean region. Conclusion The stunting rate is more in the internally displaced population than the refugee population and more in the South-East Asian and African regions. Our recommendation is to conduct further research to evaluate the determinants of undernutrition among under-five children of refugees and internally displaced populations from different regions so that international organizations and responsible stakeholders of that region can take effective remedial actions. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=387156, PROSPERO [CRD42023387156].
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Affiliation(s)
- Priyanka Choudhary
- Department of Community Medicine, Shri Atal Bihari Vajpayee Government Medical College, Faridabad, India
| | - Bijaya K. Padhi
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Amit Kumar Mital
- Department of Paediatrics, Shri Atal Bihari Vajpayee Government Medical College, Faridabad, India
| | - Aravind P. Gandhi
- Department of Community Medicine, All India Institute of Medical Sciences, Nagpur, India
| | - Sanjeeb Kumar Mishra
- Department of Community Medicine, Veer Surendra Sai Institute of Medical Science and Research (VIMSAR), Sambalpur, Odisha, India
| | - Neha Suri
- Department of Physical Medicine and Rehabilitation, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sudhansu Sekhar Baral
- Department of Physical Medicine and Rehabilitation, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Prakasini Satapathy
- School of Pharmacy, Graphic Era Hill University, Dehradun, India
- Evidence Synthesis Lab, Kolkata, India
| | | | - Lakshmi Thangavelu
- Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | - Sarvesh Rustagi
- School of Applied and Life Sciences, Uttaranchal University, Dehradun, Uttarakhand, India
| | - Ranjit Sah
- Tribhuvan University Teaching Hospital, Kathmandu, Nepal
- Department of Clinical Microbiology, DY Patil Medical College, Hospital and Research Centre, DY Patil Vidyapeeth, Pune, Maharashtra, India
| | - Mahalaqua Nazli Khatib
- Division of Evidence Synthesis, Global Consortium of Public Health and Research, Datta Meghe Institute of Higher Education, Wardha, India
| | - Shilpa Gaidhane
- One Health Centre (COHERD), Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education, Wardha, India
| | - Quazi Syed Zahiruddin
- Global Health Academy, Division of Evidence Synthesis, School of Epidemiology and Public Health and Research, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, India
| | - Alaa Abd-Alrazaq
- AI Center for Precision Health, Weill Cornell Medicine, Doha, Qatar
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Abimibayo Adeoya A, Sasaki H, Fuda M, Okamoto T, Egawa S. Child Nutrition in Disaster: A Scoping Review. TOHOKU J EXP MED 2022; 256:103-118. [DOI: 10.1620/tjem.256.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Akindele Abimibayo Adeoya
- International Cooperation for Disaster Medicine Laboratory, International Research Institute of Disaster Science (IRIDeS), Tohoku University
| | - Hiroyuki Sasaki
- International Cooperation for Disaster Medicine Laboratory, International Research Institute of Disaster Science (IRIDeS), Tohoku University
| | - Mikiko Fuda
- Nutrition Support Center, Tohoku University Hospital
| | - Tomoko Okamoto
- Department of Nutrition, Sapporo University of Health Sciences
| | - Shinichi Egawa
- International Cooperation for Disaster Medicine Laboratory, International Research Institute of Disaster Science (IRIDeS), Tohoku University
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Dhoubhadel BG, Raya GB, Shrestha D, Shrestha RK, Dhungel Y, Suzuki M, Yasunami M, Smith C, Ariyoshi K, Parry CM. Changes in nutritional status of children who lived in temporary shelters in Bhaktapur municipality after the 2015 Nepal earthquake. Trop Med Health 2020; 48:53. [PMID: 32607058 PMCID: PMC7321544 DOI: 10.1186/s41182-020-00225-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 05/15/2020] [Indexed: 01/02/2023] Open
Abstract
Abstract
Background
The nutritional status of children may deteriorate after natural disasters such as earthquakes. A 7.8 Richter scale earthquake struck Nepal in 2015 that affected 1.1 million children. Children whose homes were destroyed and had to live in temporary shelters were at risk of malnutrition. With the support of Nagasaki University School of Tropical Medicine and Global Health (TMGH) and Siddhi Memorial Hospital (SMH), we conducted a nutritional survey of under-5 children living in temporary shelters in Bhaktapur Municipality in 2015 immediately after the earthquake and a follow-up survey in 2017.
Results
We found 591 under-5 children living in 22 temporary shelters in 2015. A total of 285 children were followed up and re-assessed in 2017. In a paired analysis (n = 285), the prevalence of underweight children increased from 10.9% in 2015 to 14.0% in 2017 (P < 0.001), stunting increased from 26.7 to 31.9% (P = 0.07), and wasting decreased from 4.2 to 2.5% (P = 0.19).
Conclusions
Children who lived in temporary shelters after the 2015 Nepal earthquake might be at increased risk of a deterioration in nutritional status.
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Idowu OS, Akindolire AE, Adebayo BE, Adebayo AM, Ariyo O. Determinants of anthropometric characteristics of under-five children in internally displaced persons´ camps in Abuja municipal area council, Abuja, Nigeria. Pan Afr Med J 2020; 36:313. [PMID: 33193967 PMCID: PMC7603821 DOI: 10.11604/pamj.2020.36.313.21221] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Accepted: 02/19/2020] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION displacement predisposes to deprivation and hunger and consequently malnutrition. In Nigeria, information on anthropometric characteristics and associated factors among displaced under-five children is important to strengthen strategies to ameliorate malnutrition and promote child health. This study was conducted to identify the determinants on anthropometric indices among under-five children in internally displaced persons' camps in Abuja, Nigeria. METHODS this cross-sectional study involved 317 mother-child (0-59 months) pairs selected using two-stage simple random sampling technique. Information on socio-demographic, care practices (infant feeding, immunization, deworming) and anthropometric characteristics of index children was obtained using semi-structured, interviewer-administered questionnaire. Weight and length/height were assessed using standard procedure and analysed using World Health Organization (WHO) Anthro software. Data were analysed using descriptive statistics and logistic regression at p<0.05. RESULTS median age was 24 months, 50.8% were male and 42.3% were delivered at health facility. Only 45.4% were exclusively breastfed, 28.8% were fed complementary foods too early, 45.4% were dewormed in the preceding six months and 43.9% had complete/up-to-date immunisation. Prevalence of underweight, stunting and wasting was 42%, 41% and 29.3%, respectively. Poor anthropometric indices were higher among male than female children, except wasting. Having good anthropometric index was 2.5 times higher among children <12 months than children ≥37 months (CI: 1.08-5.8), 2.4 times higher among 1st birth order than 5th orders (CI: 0.19-0.93), 1.7 times higher among female than male children (CI: 1.08-2.82). CONCLUSION malnutrition is a major health problem among under-five children in internally displaced camps and major determinants include age, birth order, gender and deworming status.
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Affiliation(s)
| | | | | | - Ayodeji Matthew Adebayo
- Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Oluwaseun Ariyo
- Department of Human Nutrition, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Feeding Practices and Undernutrition in 6⁻23-Month-Old Children of Orthodox Christian Mothers in Rural Tigray, Ethiopia: Longitudinal Study. Nutrients 2019; 11:nu11010138. [PMID: 30634659 PMCID: PMC6356195 DOI: 10.3390/nu11010138] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 12/31/2018] [Accepted: 01/02/2019] [Indexed: 11/17/2022] Open
Abstract
Fasting period and fasting status affect the feeding practices and nutritional status of Ethiopian Orthodox mothers. Even if children are exempted from fasting, some mothers do not prepare their food from animal sources as it could contaminate utensils for cooking family foods. Therefore, the objective of this study was to assess feeding practices and undernutrition in 6⁻23-months old children whose mothers are Ethiopian Orthodox religion followers during lent fasting and non-fasting periods in rural Tigray, Northern Ethiopia, and to identify associated factors. A community-based longitudinal study was carried out in Ethiopian Orthodox lent fasting and non-fasting periods. Using a multi-stage systematic random sampling technique, 567 and 522 children aged 6⁻23 months old participated in the fasting and non-fasting assessments, respectively. Statistical analyses were done using logistic regression, an independent sample t-test, Wilcoxon signed-rank (WSRT) and McNemar's tests. The prevalences of stunting, underweight and wasting were 31.6⁻33.7%, 11.7⁻15.7% and 4.4⁻4.8%, respectively. The weight-for-height (WHZ) and height-for-age (HAZ) values for children of fasting mothers were significantly lower (p < 0.05) compared to those of non-fasting mothers. Likewise, the median weight-for-age (WAZ) and diet diversity score (DDS) of children of fasting mothers were also significantly higher in non-fasting than in fasting periods. A small proportion of children (2.3⁻6.7%) met the minimum acceptable diet (MAD) in the study population, but these measures were significantly increased (p < 0.001) in the children of non-fasting mothers. Mother's fasting during lactation period of the indexed child was amongst the independent factors common in child stunting, underweight and wasting. Nutritional status and feeding practices of 6⁻23-month-old children are affected by maternal fasting during the fasting period. Therefore, without involvement of religious institutions in the existing nutritional activities, reduction of undernutrition would not be successful and sustainable.
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Balachanthar S, Zakaria NA, Lee LK. Development of emergency food assistance design: a nutritionally balanced, culturally tailored and cost-effective strategy for flood mitigation. Ecol Food Nutr 2018; 57:314-329. [PMID: 29989434 DOI: 10.1080/03670244.2018.1492380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Emergency food assistance forms an integral component of flood mitigation in Malaysia. A cross-sectional survey investigating emergency food assistance among 202 flood victims was conducted and alternative food assistance plan was developed using linear programming targeting post-disaster food requirement scenarios. From the study, the receipt of food aid was significantly associated with ethnicity, household income, residential area and evacuation into temporary shelters. Linear programming analysis identified nutritionally appropriate food assistance targeting mass feeding, emergency food basket, and immediate food requirement for as low as MYR 6.07 (1.55 USD), MYR 7.14 (1.82 USD), and MYR 8.00 (2.04 USD), respectively. This study provides nutritional guidelines for disaster food assistance policy.
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Affiliation(s)
- Satesh Balachanthar
- a Food Technology Division , School of Industrial Technology, Universiti Sains Malaysia , Gelugor , Penang , Malaysia
| | - Nor Azazi Zakaria
- b River Engineering and Urban Drainage Research Centre , Universiti Sains Malaysia , Nibong Tebal , Penang , Malaysia
| | - Lai Kuan Lee
- a Food Technology Division , School of Industrial Technology, Universiti Sains Malaysia , Gelugor , Penang , Malaysia
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Abstract
Floods are the most common type of natural disaster in both developed and developing countries and have led to extensive morbidity and mortality throughout the world. Worldwide, over the past 30 years, flooding has claimed the lives of more than 200,000 people and affected more than 2.8 billion others. The impact of flooding on health varies among populations and depends primarily on vulnerability and the kind of event experienced. It severely disrupts livelihoods and has a significant impact on the health of pregnant women and children. In addition, it may exacerbate a range of negative psychological and physiological child and reproductive health outcomes. Awareness-raising, education, and the issuing of warnings appear to be key initiatives to mitigate or prevent flood morbidity and mortality, especially among people living in low- and middle-income countries. Agencies responding to emergencies also need to be more cognisant of the dangers, specifically those engaged in healthcare, nutrition, and water safety programmes.
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Affiliation(s)
- Lea H Mallett
- Research Scientist, Joseph J. Zilber School of Public Health and Children's Environmental Health Sciences Core Center, University of Wisconsin-Milwaukee, United States
| | - Ruth A Etzel
- Professor, Joseph J. Zilber School of Public Health and Children's Environmental Health Sciences Core Center, University of Wisconsin-Milwaukee, United States
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Güngör ES, Seval O, İlhan G, Verit FF. Do Syrian refugees have increased risk for worser pregnancy outcomes? Results of a tertiary center in İstanbul. Turk J Obstet Gynecol 2018; 15:23-27. [PMID: 29662712 PMCID: PMC5894532 DOI: 10.4274/tjod.64022] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 01/24/2018] [Indexed: 12/01/2022] Open
Abstract
Objective: To compare obstetric and perinatal outcomes of Syrian refugee pregnants and Turkish counterparts who gave birth at a tertiary center in İstanbul. Materials and Methods: A retrospective study including the birth records of 704 Syrian refugees and 744 Turkish pregnant women between January 2016 and May 2017 were analyzed. Demographic data, obstetric and neonatal outcomes were compared. The primary aims of this study were to evaluate the pregnancy outcomes and cesarean rates between the groups. The secondary outcomes were the use of antenatal vitamin supplementation, hemoglobin-hematocrit values, and maternal complications. Results: Our results showed that the use of folic acid and iron supplementation rates during pregnancy were similar between the groups (folic acid supplementation 8.1% vs 6.5%, p=0.264; iron supplementation 20.7% vs 19.6%, p=0.125; respectively for Turkish women and Syrian refugees). Cesarean rates were significantly higher for Turkish patients than in Syrian refugees (42.7% vs 32.7%; p<0.05). Gestational age at delivery was significantly higher among Turkish women when compared with Syrian refugees (37.7±2.3 vs 36.4±2.3 weeks, p<0.05), but there was no significant difference regarding the birtweights’ of the newborns (3134 g vs 3066 g for Turkish women and Syrian refugees, respectively, p=0.105). Although obstetric complications were seen more often in Syrian refugees, it did not reach statistical difference (9.7% vs 8.1%, respectively, p=0.285). Conclusion: Syrian refugees use antenatal vitamin supplementations at similar rates to Turkish citizens and obstetric and perinatal outcomes are similar between the groups.
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Affiliation(s)
- Emre Sinan Güngör
- Süleymaniye Maternity Research and Training Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - Olcay Seval
- Süleymaniye Maternity Research and Training Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - Gülşah İlhan
- Süleymaniye Maternity Research and Training Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - Fatma Ferda Verit
- Süleymaniye Maternity Research and Training Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
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Moriyama H, Fuchimukai T, Kondo N, Takayama JI. Obesity in elementary school children after the Great East Japan Earthquake. Pediatr Int 2018; 60:282-286. [PMID: 29205642 DOI: 10.1111/ped.13468] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 09/29/2017] [Accepted: 11/30/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Rikuzentakata was one of the cities most devastated by the Great East Japan Earthquake on 11 March 2011. Many buildings were swept away or destroyed and affected families were placed into temporary housing. The aim of this study was to determine the impact of long-term temporary housing on the body mass index (BMI) of elementary school children living in Rikuzentakata City. METHODS A retrospective cohort study was carried out of students attending 1st-3rd grade in 2010, and 4th-6th grade in 2013, in eight elementary schools in Rikuzentakata City. Height and weight were measured annually. We compared changes in BMI between children in temporary housing and those in permanent housing. Separately, parents of students attending one of the elementary schools were surveyed in 2013. RESULTS Of 526 children in the present study, 32% were living in temporary housing. The prevalence of obesity climbed from 5.3% in 2010 to 7.8% in 2013 in the temporary housing group, and from 7.6% to 7.8% in the permanent housing group. BMI z-score in the temporary housing group increased by 0.102 points between 2010 and 2013 (P < 0.02). Children in temporary housing spent more time reading comic books and their walking commute time had decreased by 2 min compared with before the disaster. CONCLUSION Obesity prevalence and BMI z-score increased in children in temporary housing compared with permanent housing. A more sedentary lifestyle may explain this trend. It is important for policy makers and health-care providers to recognize potential consequences of long-term residence in temporary housing.
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Affiliation(s)
- Hidenori Moriyama
- Department of Pediatrics, Iwate Prefectural Ofunato Hospital, Ofunato City, Iwate, Japan
| | - Toru Fuchimukai
- Department of Pediatrics, Iwate Prefectural Ofunato Hospital, Ofunato City, Iwate, Japan
| | - Naoki Kondo
- Department of Health Education and Health Sociology/Department of Health and Social Behavior, School of Public Health, University of Tokyo, Tokyo, Japan
| | - John I Takayama
- Department of Pediatrics, University of California San Francisco, San Francisco, California, USA
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Aydın R, Körükcü Ö, Kabukcuoğlu K. Bir Göçmen Olarak Anneliğe Geçiş: Riskler ve Engeller. PSIKIYATRIDE GUNCEL YAKLASIMLAR 2017. [DOI: 10.18863/pgy.285927] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Sitotaw IK, Hailesslasie K, Adama Y. Comparison of nutritional status and associated factors of lactating women between lowland and highland communities of District Raya, Alamata, Southern Tigiray, Ethiopia. BMC Nutr 2017; 3:61. [PMID: 32153841 PMCID: PMC7050921 DOI: 10.1186/s40795-017-0179-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 07/06/2017] [Indexed: 11/10/2022] Open
Abstract
Background The Ethiopian regions have a relatively higher prevalence of under-nutrition are found in the lowlands of the country, with the exception of the highlands of Tigiray, where under-nutrition is also prevalent.The intention of this study was to compare anthropometric nutritional status and associated factors of lactating women between lowland and highland communities of district Raya Alamata, Southern Tigiray, Ethiopia. Methods A community based comparative cross-sectional study design was conducted from January 27-March 7, 2014. Sample size was determined by two population estimation formula. The total calculated sample size was 456. A stratified sampling technique was used to stratify the study area to highland and lowland. Study participants were selected by simple random sampling technique. Data were collected using anthropometric measurements and structured questionnaire. The raw data were entered and analyzed using SPSS version 20.0. Bivariate and multivariable Logistic regression was done to determine the association between explanatory variable with chronic energy deficiency (CED) using body mass index (BMI), by computing odds ratio at 95% confidence level. A P - value <0.05 was considered as statistically significant. Result The prevalence of CED of lactating mothers from lowland and highland was 17.5% and 24.6% respectively. After multivariable logistic regression: age, husband occupation, taking vitamin A immediately after delivery or within the first 8 weeks after delivery and consumption of extra food during lactation time were factors associated with chronic energy deficiency for lowland lactating women whereas parity, number of meals per day and household consumption of iodized salt were factors associated with chronic energy deficiency for highland lactating women. Conclusion CED in both comparative studies were a serious public health problem. As it is known food security does not mean nutritionally secured, Therefore, the need to develop nutrition intervention such as nutrition security programs to address under-nutrition in the study area is significant, as it was found food secured participants were slightly vulnerable than food insecure. The dietary diversity score of the participants were very low so that encourage the community about nutrition diversification is substantial for adequate nutrient intake.
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Affiliation(s)
- Ismael Kalayu Sitotaw
- Department of Public Health, College of Health Sciences, Arsi University, Assela, Ethiopia
| | - Kiday Hailesslasie
- Department of Public Health, College of Health Sciences, Mekele University, Mekele, Ethiopia
| | - Yohannes Adama
- Department of Public Health, College of Health Sciences, Mekele University, Mekele, Ethiopia
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Abstract
Malnutrition continues to be a major public health challenge especially in South Asian developing countries. The aim of the present review is to spotlight the magnitude of the prevalence of malnutrition and its dynamics in South Asian region and to suggest potential approaches for the prevention and control of this issue of public health significance. An extensive review of literature, covering malnutrition and its determinants, health and economic consequences and pragmatic preventive strategies was performed on computer based bibliographic databases (PubMed, Google Scholar, Scopus, Medline and Sciencedirect.com ) to retrieve abstracts and full texts for India, Pakistan, Bangladesh, Sri Lanka and Nepal. All relevant titles and abstracts were examined and evaluated for malnutrition and its prevalence in South Asia. The results revealed malnutrition to be a major public health problem and a potential cause of high disease burden and mortality in South Asia. Compelling evidence suggests malnutrition to be the leading cause of stunting, wasting and underweight with drastic economic consequences among vulnerable populations. Reduced cognitive performance and low productivity have also been associated with micronutrients malnutrition. Suboptimal breastfeeding, inadequate food supply, micronutrient deficiencies, low household income, poor health care system, increased healthcare costs, illiteracy, unhygienic and substandard living, inappropriate child's care and the caregiver, food insecurity and on top of that vicious cycle of poverty, have been recognized as principal indicators for growing malnutrition prevalence in South Asia. Global organizations, local governments, program managers, NGOs, academia, industry in particular and the society at large need to take up the challenge to completely confiscate malnutrition from the region for economic prosperity and a healthier future.
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Affiliation(s)
- Saeed Akhtar
- a Department of Food Science and Nutrition , Bahauddin Zakariya University , Multan , Pakistan
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Pyone T, Dickinson F, Kerr R, Boschi-Pinto C, Mathai M, van den Broek N. Data collection tools for maternal and child health in humanitarian emergencies: a systematic review. Bull World Health Organ 2015; 93:648-658A-M. [PMID: 26478629 PMCID: PMC4581640 DOI: 10.2471/blt.14.148429] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 05/01/2015] [Accepted: 05/07/2015] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To describe tools used for the assessment of maternal and child health issues in humanitarian emergency settings. METHODS We systematically searched MEDLINE, Web of Knowledge and POPLINE databases for studies published between January 2000 and June 2014. We also searched the websites of organizations active in humanitarian emergencies. We included studies reporting the development or use of data collection tools concerning the health of women and children in humanitarian emergencies. We used narrative synthesis to summarize the studies. FINDINGS We identified 100 studies: 80 reported on conflict situations and 20 followed natural disasters. Most studies (76/100) focused on the health status of the affected population while 24 focused on the availability and coverage of health services. Of 17 different data collection tools identified, 14 focused on sexual and reproductive health, nine concerned maternal, newborn and child health and four were used to collect information on sexual or gender-based violence. Sixty-nine studies were done for monitoring and evaluation purposes, 18 for advocacy, seven for operational research and six for needs assessment. CONCLUSION Practical and effective means of data collection are needed to inform life-saving actions in humanitarian emergencies. There are a wide variety of tools available, not all of which have been used in the field. A simplified, standardized tool should be developed for assessment of health issues in the early stages of humanitarian emergencies. A cluster approach is recommended, in partnership with operational researchers and humanitarian agencies, coordinated by the World Health Organization.
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Affiliation(s)
- Thidar Pyone
- Centre for Maternal and Newborn Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, E3 5QA, England
| | - Fiona Dickinson
- Centre for Maternal and Newborn Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, E3 5QA, England
| | - Robbie Kerr
- Centre for Maternal and Newborn Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, E3 5QA, England
| | - Cynthia Boschi-Pinto
- Department of Maternal, Newborn, Child & Adolescent Health, World Health Organization, Geneva, Switzerland
| | - Matthews Mathai
- Department of Maternal, Newborn, Child & Adolescent Health, World Health Organization, Geneva, Switzerland
| | - Nynke van den Broek
- Centre for Maternal and Newborn Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, E3 5QA, England
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Benage M, Greenough PG, Vinck P, Omeira N, Pham P. An assessment of antenatal care among Syrian refugees in Lebanon. Confl Health 2015; 9:8. [PMID: 25741381 PMCID: PMC4349304 DOI: 10.1186/s13031-015-0035-8] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 01/30/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND After more than three years of violence in Syria, Lebanon hosts over one million Syrian refugees creating significant public health concerns. Antenatal care delivery to tens of thousands of pregnant Syrian refugee women is critical to preventing maternal and fetal mortality but is not well characterized given the multiple factors obtaining health data in a displaced population. This study describes antenatal care access, the scope of existing antenatal care, and antenatal and family planning behaviors and practice among pregnant Syrian refugees in various living conditions and multiple geographic areas of Lebanon. METHODS A field-based survey was conducted between July and October 2013 in 14 main geographic sites of refugee concentration. The assessment evaluated antenatal services among a non-randomized sample of 420 self-identified pregnant Syrian refugee women that included demographics, gestational age, living accommodation, antenatal care coverage, antenatal care content, antenatal health behaviors, antenatal health literacy, and family planning perception and practices. RESULTS In total, 420 pregnant Syrian refugees living in Lebanon completed the survey. Of these, 82.9% (348) received some antenatal care. Of those with at least one antenatal visit, 222 (63.8%) received care attended by a skilled professional three or more times, 111 (31.9%) 1-2 times, and 15 (4.3%) had never received skilled antenatal care. We assessed antenatal care content defined by blood pressure measurement, and urine and blood sample analyses. Of those who had received any antenatal care, only 31.2% received all three interventions, 18.2% received two out of three, 32.1% received one out of three, and 18.5% received no interventions. Only (41.2%) had an adequate diet of vitamins, minerals, and folic acid. Access, content and health behaviors varied by gestational age, type of accommodation and location in Lebanon. CONCLUSIONS Standards of antenatal care are not being met for pregnant Syrian refugee women in Lebanon. This descriptive analysis of relative frequencies suggests reproductive health providers should focus attention on increasing antenatal care visits, particularly to third trimester and late gestational age patients and to those in less secure sheltering arrangements. With this approach they can improve care content by providing early testing and interventions per accepted guidelines designed to improve pregnancy outcomes.
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Affiliation(s)
- Matthew Benage
- />University of Missouri Medical School, Columbia, MO USA
| | - P Gregg Greenough
- />Brigham & Women’s Hospital, Harvard Medical School, Boston, MA USA
- />Harvard Humanitarian Initiative, Harvard University, Cambridge, MA USA
- />Harvard School of Public Health, Boston, MA USA
| | - Patrick Vinck
- />Brigham & Women’s Hospital, Harvard Medical School, Boston, MA USA
- />Harvard Humanitarian Initiative, Harvard University, Cambridge, MA USA
- />Harvard School of Public Health, Boston, MA USA
| | | | - Phuong Pham
- />Brigham & Women’s Hospital, Harvard Medical School, Boston, MA USA
- />Harvard Humanitarian Initiative, Harvard University, Cambridge, MA USA
- />Harvard School of Public Health, Boston, MA USA
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Which anthropometric indicators identify a pregnant woman as acutely malnourished and predict adverse birth outcomes in the humanitarian context? PLOS CURRENTS 2013; 5. [PMID: 23787989 PMCID: PMC3682760 DOI: 10.1371/currents.dis.54a8b618c1bc031ea140e3f2934599c8] [Citation(s) in RCA: 110] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Currently there is no consensus on how to identify pregnant women as acutely malnourished and when to enroll them in nutritional programmes. Médecins Sans Frontières Switzerland undertook a literature review with the purpose of determining values of anthropometric indicators for acute malnutrition that are associated with adverse birth outcomes (such as low birth weight (LBW)), pre-term birth and intra-uterine growth retardation (IUGR). A literature search in PUBMED was done covering 1 January 1995 to 12 September 2012 with the key terms maternal anthropometry and pregnancy. The review focused on the humanitarian context. Mid-upper-arm circumference (MUAC) was identified as the preferential indicator of choice because of its relatively strong association with LBW, narrow range of cut-off values, simplicity of measurement (important in humanitarian settings) and it does not require prior knowledge of gestational age. The MUAC values below which most adverse effects were identified were <22 and <23 cm. A conservative cut-off of <23 cm is recommended to include most pregnant women at risk of LBW for their infants in the African and Asian contexts.
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16
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Kabakian-Khasholian T, Shayboub R, El-Kak F. Seeking maternal care at times of conflict: the case of Lebanon. Health Care Women Int 2013; 34:352-62. [PMID: 23550947 DOI: 10.1080/07399332.2012.736570] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Providing quality maternity care within the emergency care packages for internally displaced populations in war-affected areas is somewhat challenging, although very essential. In this retrospective study, we describe the experiences and health care seeking behaviors of 1,015 pregnant and postpartum women during the 2006 war in Lebanon. Women reported interruptions in regular maternity care and experienced more complications during this period. Availability of health services and experiences of complications were the most important determinants of health care seeking behaviors. Maternal health services should be a part of any comprehensive emergency responsiveness plan, catering to women's needs in war-affected areas.
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Affiliation(s)
- Tamar Kabakian-Khasholian
- Health Promotion and Community Health Department, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
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17
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Khan FA, Smith BM, Schwartzman K. Earthquake in Haiti: is the Latin American and Caribbean region's highest tuberculosis rate destined to become higher? Expert Rev Respir Med 2010; 4:417-9. [PMID: 20658900 DOI: 10.1586/ers.10.41] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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18
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Sekizuka N, Sakai A, Aoyama K, Kohama T, Nakahama Y, Fujita S, Hibino Y, Hitomi Y, Kambayashi Y, Nakamura H. Association between the incidence of premature rupture of membranes in pregnant women and seismic intensity of the Noto Peninsula earthquake. Environ Health Prev Med 2010; 15:292-8. [PMID: 21432558 DOI: 10.1007/s12199-010-0142-5] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2010] [Accepted: 03/19/2010] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES The Noto Peninsula earthquake struck the coast of the Noto Peninsula, Japan on March 25, 2007, resulting in the death of one woman and injury to 356 people. A total of 684 houses were totally destroyed by this earthquake, and more than 2,500 people were forced to live at shelters. In this study, we have evaluated the association between the incidence of peripartum abnormalities and seismic intensity of the Noto Peninsula earthquake. METHODS Demographic data, births, seismic intensity of the earthquake and the incidence of peripartum abnormalities between June 25, 2007 and January 31, 2008 were surveyed. The dataset included 126 pregnant women who lived in the disaster area. The seismic intensity of the earthquake was expressed on the scale (0-7, with 7 being the strongest measure) used by the Japan Meteorological Agency. The subjects of the analysis included 19.7% of the pregnant women affected by the disaster. RESULTS Of the pregnant women included in this study, 7.9% had a premature rupture of membranes (PROM), with the percentage being significantly higher in the group that experienced a seismic intensity of 6 than in that experienced a seismic intensity of 5. CONCLUSIONS Our epidemiologic study shows that the PROM among our study cohort was associated with seismic intensity, suggesting that the physical outcome was due to aftershocks of the earthquake at a seismic intensity ≥6. This outcome may result from the psychological stress caused by the earthquakes.
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Affiliation(s)
- Naomi Sekizuka
- Department of Health Sciences, Graduate School of Medical Science, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, 920-0942, Japan.
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