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Ngwalangwa F, Chirambo CM, Lindsjö C, Dube Q, Langton J, Baker T, Hildenwall H. Feeding practices and association of fasting and low or hypo glycaemia in severe paediatric illnesses in Malawi - a mixed method study. BMC Pediatr 2020; 20:423. [PMID: 32887575 PMCID: PMC7472578 DOI: 10.1186/s12887-020-02305-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 08/20/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The presence of low or hypo glycaemia in children upon admission to hospital in low income countries is a marker for poor outcome. Fasting during illness may contribute to low blood glucose and caretakers' feeding practices during childhood illnesses may thus play a role in the development of low or hypo glycaemia. This study aims to describe the caretaker's feeding practices and association of fasting with low or hypo glycaemia in sick children in Malawi. METHODS A mixed method approach was used combining quantitative cross-sectional data for children aged 0-17 years admitted to Queen Elizabeth Central Hospital (QECH), a tertiary hospital in Malawi, with qualitative focus group discussions conducted with caretakers of young children who were previously referred to QECH from the five health centres around QECH. Logistic regression was used to analyse the quantitative data and thematic content analysis was conducted for qualitative data analysis. RESULTS Data for 5131 children who were admitted through the hospital's Paediatric Accident and Emergency Department (A&E) were analysed whereof 2.1% presented with hypoglycaemia (< 2.5 mmol/l) and 6.6% with low glycaemia (≥2.5mmoll/l - < 5 mmol/l). Fasting for more than eight hours was associated with low glycaemia as well as hypoglycaemia with Adjusted Odds Ratios (AOR) of 2.9 (95% Confidence Interval (CI) of 2.3-3.7) and 4.6, (95% CI 3.0-7.0), respectively. Caretakers demonstrated awareness of the importance of feeding during childhood illness and reported intensified feeding attention to sick children but face feeding challenges when illness becomes severe causing them to seek care at a health facility. CONCLUSION Results suggests that caretakers understand the importance of feeding during illness and make efforts to intensify feeding a sick child but challenges occur when illness is severe leading to fasting. Fasting among children admitted to hospitals may serve as a marker of severe illness and determine those at risk of low and hypoglycaemia.
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Affiliation(s)
- Fatsani Ngwalangwa
- Department of Paediatrics, College of Medicine, University of Malawi, P/Bag 360, Blantyre, Malawi.
| | | | - Cecilia Lindsjö
- Department of Care Science, Malmö University, 205 06, Malmö, Sweden
| | - Queen Dube
- Department of Paediatrics, Queen Elizabeth Central Hospital, P.O Box 95, Blantyre, Malawi
| | - Josephine Langton
- Department of Paediatrics, College of Medicine, University of Malawi, P/Bag 360, Blantyre, Malawi
| | - Tim Baker
- Department of Paediatrics, College of Medicine, University of Malawi, P/Bag 360, Blantyre, Malawi.,Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Helena Hildenwall
- Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden.,Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Department of Clinical Science, Intervention and Technology, Karolinska Institutet, 141 52, Huddinge, Sweden
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Degefa N, Tadesse H, Aga F, Yeheyis T. Sick Child Feeding Practice and Associated Factors among Mothers of Children Less Than 24 Months Old, in Burayu Town, Ethiopia. Int J Pediatr 2019; 2019:3293516. [PMID: 31929806 PMCID: PMC6942812 DOI: 10.1155/2019/3293516] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 07/15/2019] [Accepted: 09/01/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Growing evidence suggests that inadequate intake, poor caring practices, and disease process were some of the immediate and major causes of undernutrition in children. This points out that infant and young child feeding were the basic grounds to improve child survival and promote healthy growth and development. The first two years of a child's life are particularly important, as optimal nutrition during this period lowers morbidity and mortality, reduces the risk of chronic disease, and enhances the chances of better development. The study was aimed to assess sick infant and young child feeding practice and associated factors among mothers of children aged less than 24 months old in the Burayu town Oromia, Ethiopia. METHODS Institutional based cross-sectional study design was utilized. The study was conducted from April-May, 2015 among 362 mother-child pair attending the maternal and childcare (MCH) units of the two public health facilities in the Burayu town. Bivariate and multivariable analysis was done to test the relationship between the explanatory and outcome variables and the odds ratio with 95% confidence interval and the p-value was used to ascertain statistical significance. RESULT More than half (53.6%) of all mothers fed their child more frequently at the time of illness than at a time of health. The mean age of respondents was 25.41 ± 3.56 and ranged from 15-30 years. Nearly three out of five (60.8%) of the respondents attended no formal education. A mother who had got counseling on sick child feeding were nearly three times more likely to feed their child appropriately than their counterparts (AOR: 2.95; 95% CI; 1.78, 4.91). Mothers who were housewives were 55% times less likely to feed their sick child appropriately than those who were working (AOR: 0.45; 95% CI; 0.26, 0.79). Those mothers who have a child aged less than 6 months were 88% less likely to practice appropriate sick child feeding than those who have a child aged more than 6 months (AOR: 0.22; 95% CI; 0.12,0.40). CONCLUSION Respondents who do not receive counseling on infant and young child feeding have poor sick child feeding practice. Working mother had owned better practices of feeding child particularly at the time of illness. Infants below the age of 6 months deserve more concern in providing frequent breastfeeds at the time of illness.
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Affiliation(s)
- Nega Degefa
- Department of Nursing, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Hiwot Tadesse
- Department of Nursing, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Fekadu Aga
- Department of Nursing, School of Nursing and Midwifery, College of Medicine and Allied Health Sciences Addis Ababa University, Addis Ababa, Ethiopia
| | - Tomas Yeheyis
- Department of Nursing, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
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Srivastava R, Gupta VG, Dhawan D, Geeta K, Bakhshi S. Poor nutritional knowledge and food restrictions among families of children with cancer and their impact: A cross-sectional study of 700 families. J Psychosoc Oncol 2019; 36:658-666. [DOI: 10.1080/07347332.2018.1484840] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Richa Srivastava
- Department of Medical Oncology, Dr BRA Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Vineet Govinda Gupta
- Department of Medical Oncology, Dr BRA Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Deepa Dhawan
- Department of Medical Oncology, Dr BRA Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Kumari Geeta
- Department of Food and Nutrition, Institute of Home Economics, New Delhi, India
| | - Sameer Bakhshi
- Department of Medical Oncology, Dr BRA Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
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Zhang D, Li Z, Zhang W, Guo P, Ma Z, Chen Q, Du S, Peng J, Deng Y, Hao Y. Hand-Washing: The Main Strategy for Avoiding Hand, Foot and Mouth Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:E610. [PMID: 27322307 PMCID: PMC4924067 DOI: 10.3390/ijerph13060610] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 06/02/2016] [Accepted: 06/13/2016] [Indexed: 12/16/2022]
Abstract
Epidemics of hand, foot and mouth disease (HFMD) among children have caused concern in China since 2007. We have conducted a retrospective study to investigate risk factors associated with HFMD. In this non-matching case-control study, 99 HFMD patients and 126 control from Guangdong Province were enlisted as participants. Data comprising demographic, socio-economic, clinical and behavior factors were collected from children's parents through face-to-face interviews by trained interviewers using a standardized questionnaire. Results of the primary logistic regression analyses revealed that age, history of cold food consumption, hand-washing routines, and airing out bedding were significantly associated with HFMD cases. Results of further multivariate analysis indicated that older age (OR = 0.44, 95% CI: 0.34-0.56) and hand-washing before meals (OR = 0.3, 95% CI: 0.13-0.70) are protective factors, whereas airing out bedding more than thrice a month (OR = 4.55, 95% CI: 1.19-17.37) was associated with increased risk for HFMD. Therefore, hand-washing should be recommended to prevent HFMD, and the potential threat of airing out bedding should be carefully considered. However, further studies are needed to examine other possible risk factors.
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Affiliation(s)
- Dingmei Zhang
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Zhiyuan Li
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Wangjian Zhang
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Pi Guo
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Zhanzhong Ma
- Department of Clinical Laboratory, Yuebei People's Hospital, Shaoguan 512026, China.
| | - Qian Chen
- Department of Prevention and Health Care, Shijie Hospital of Dongguan, Dongguan 523290, China.
| | - Shaokun Du
- Department of Prevention and Health Care, Shijie Hospital of Dongguan, Dongguan 523290, China.
| | - Jing Peng
- Baoan Center for Disease Control and Prevention of Shenzhen, Shenzhen 518101, China.
| | - Yu Deng
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Yuantao Hao
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
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Paintal K, Aguayo VM. Feeding practices for infants and young children during and after common illness. Evidence from South Asia. MATERNAL AND CHILD NUTRITION 2016; 12 Suppl 1:39-71. [PMID: 26840205 PMCID: PMC5067777 DOI: 10.1111/mcn.12222] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 08/20/2015] [Accepted: 08/20/2015] [Indexed: 01/21/2023]
Abstract
Global evidence shows that children's growth deteriorates rapidly during/after illness if foods and feeding practices do not meet the additional nutrient requirements associated with illness/convalescence. To inform policies and programmes, we conducted a review of the literature published from 1990 to 2014 to document how children 0–23 months old are fed during/after common childhood illnesses. The review indicates that infant and young child feeding (IYCF) during common childhood illnesses is far from optimal. When sick, most children continue to be breastfed, but few are breastfed more frequently, as recommended. Restriction/withdrawal of complementary foods during illness is frequent because of children's anorexia (perceived/real), poor awareness of caregivers' about the feeding needs of sick children, traditional beliefs/behaviours and/or suboptimal counselling and support by health workers. As a result, many children are fed lower quantities of complementary foods and/or are fed less frequently when they are sick. Mothers/caregivers often turn to family/community elders and traditional/non‐qualified practitioners to seek advice on how to feed their sick children. Thus, traditional beliefs and behaviours guide the use of ‘special’ feeding practices, foods and diets for sick children. A significant proportion of mothers/caregivers turn to the primary health care system for support but receive little or no advice. Building the knowledge, skills and capacity of community health workers and primary health care practitioners to provide mothers/caregivers with accurate and timely information, counselling and support on IYCF during and after common childhood illnesses, combined with large‐scale communication programmes to address traditional beliefs and norms that may be harmful, is an urgent priority to reduce the high burden of child stunting in South Asia.
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Affiliation(s)
- Kajali Paintal
- Regional Office for South Asia, United Nations Children's Fund (UNICEF), Kathmandu, Nepal
| | - Víctor M Aguayo
- Regional Office for South Asia, United Nations Children's Fund (UNICEF), Kathmandu, Nepal
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Francis MR, Nagarajan G, Sarkar R, Mohan VR, Kang G, Balraj V. Perception of drinking water safety and factors influencing acceptance and sustainability of a water quality intervention in rural southern India. BMC Public Health 2015; 15:731. [PMID: 26223687 PMCID: PMC4520261 DOI: 10.1186/s12889-015-1974-0] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 06/25/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Acceptance and long-term sustainability of water quality interventions are pivotal to realizing continued health benefits. However, there is limited research attempting to understand the factors that influence compliance to or adoption of such interventions. METHODS Eight focus group discussions with parents of young children--including compliant and not compliant households participating in an intervention study, and three key-informant interviews with village headmen were conducted between April and May 2014 to understand perceptions on the effects of unsafe water on health, household drinking water treatment practices, and the factors influencing acceptance and sustainability of an ongoing water quality intervention in a rural population of southern India. RESULTS The ability to recognize health benefits from the intervention, ease of access to water distribution centers and the willingness to pay for intervention maintenance were factors facilitating acceptance and sustainability of the water quality intervention. On the other hand, faulty perceptions on water treatment, lack of knowledge about health hazards associated with drinking unsafe water, false sense of protection from locally available water, resistance to change in taste or odor of water and a lack of support from male members of the household were important factors impeding acceptance and long term use of the intervention. CONCLUSION This study highlights the need to effectively involve communities at important stages of implementation for long term success of water quality interventions. Timely research on the factors influencing uptake of water quality interventions prior to implementation will ensure greater acceptance and sustainability of such interventions in low income settings.
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Affiliation(s)
- Mark Rohit Francis
- Division of Gastrointestinal Sciences, Christian Medical College, Vellore, TN, 632004, India.
| | - Guru Nagarajan
- Department of Physical Medicine and Rehabilitation, Christian Medical College, Vellore, TN, 632002, India.
| | - Rajiv Sarkar
- Division of Gastrointestinal Sciences, Christian Medical College, Vellore, TN, 632004, India.
| | - Venkata Raghava Mohan
- Department of Community Health, Christian Medical College, Vellore, TN, 632002, India.
| | - Gagandeep Kang
- Division of Gastrointestinal Sciences, Christian Medical College, Vellore, TN, 632004, India.
| | - Vinohar Balraj
- Society for Applied Studies, No 14, Natteri Krishnamachari Street, Krishna Nagar, Vellore, 632001, Tamilnadu, India.
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Changing childhood malnutrition in Bangladesh: trends over the last two decades in urban–rural differentials (1993–2012). Public Health Nutr 2015; 18:1718-27. [DOI: 10.1017/s136898001500004x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjectiveThe present study determined trends in malnutrition among under-5 children in urban and rural areas of Bangladesh.DesignSurveillance.SettingThe study was conducted in the urban Dhaka and the rural Matlab hospitals of the International Centre for Diarrhoeal Disease Research, Bangladesh, where every fiftieth patient and all patients coming from the Health and Demographic Surveillance System were enrolled.SubjectsA total of 28 816 under-5 children were enrolled at Dhaka from 1993 to 2012 and 11 533 at Matlab between 2000 and 2012.ResultsIn Dhaka, 46 % of the children were underweight, 39 % were stunted and 28 % were wasted. In Matlab, the corresponding figures were 39 %, 31 % and 26 %, respectively. At Dhaka, 0·5 % of the children were overweight and obese when assessed by weight-for-age Z-score >+2·00, 1·4 % by BMI-for-age Z-score >+2·00 and 1·4 % by weight-for-height Z-score >+2·00; in Matlab the corresponding figures were 0·5 %, 1·4 % and 1·4 %, respectively. In Dhaka, the proportion of underweight, stunting and wasting decreased from 59 % to 28 % (a 53 % reduction), from 54 % to 22 % (59 % reduction) and from 33 % to 21 % (36 % reduction), respectively, between 1993 and 2012. In Matlab, these indicators decreased from 51 % to 27 % (a 47 % reduction), from 36 % to 25 % (31 % reduction) and from 34 % to 14 % (59 % reduction), respectively, from 2000 to 2012. On the other hand, the proportion of overweight (as assessed by BMI-for-age Z-score) increased significantly over the study period in both Dhaka (from 0·6 % to 2·6 %) and Matlab (from 0·8 % to 2·2 %).ConclusionsThe proportion of malnourished under-5 children has decreased gradually in both urban and rural Bangladesh; however, the reduction rates are not in line with meeting Millennium Development Goal 1. Trends for increasing childhood obesity have been noted during the study period as well.
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Masuku SKS, Lan SJJ. Nutritional knowledge, attitude, and practices among pregnant and lactating women living with HIV in the Manzini region of Swaziland. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2014; 32:261-269. [PMID: 25076663 PMCID: PMC4216962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The prevalence of HIV infection in Swaziland (26%) is among the highest in the world. We investigated nutritional knowledge, attitude, and practices (KAP) and the influence of sociodemographic factors on KAP among pregnant and lactating women living with HIV in the Manzini region of Swaziland. Interviews were conducted using a structured questionnaire to collect data from 324 subjects seeking healthcare from selected regional hospitals, health centres, and clinics in Manzini region. The results showed mean percentage scores of nutritional knowledge (67%), attitude (67%), and practices (51%) whereby educational level (p = 0.002), employment status (p = 0.009), income (p = 0.008), religion (p = 0.007), type of accommodation (p = 0.006), type of transport used when going for shopping (p = 0.001), and BMI (p = 0.015) were significantly associated with nutritional practices. Significant positive correlations between nutritional KAP were observed: nutritional K and A (r = 0.155, p = 0.005), nutritional K and P (r = 0.456, p = 0.001), and nutritional A and P (r = 0.230, p = 0.001). Multiple linear regression analysis indicated that type of transport used when going for shopping (p = 0.002), educational level (p = 0.001), income (p = 0.001), employment (p = 0.038), knowledge of food proportion in a plate (p = 0.000), a positive attitude towards high-fibre diet (p = 0.004), and eating a variety of foods (p = 0.006) were predictors of nutritional practices. Educational level was identified as a common predictor of nutritional knowledge, attitude, and practices, suggesting that both formal and informal education systems are potential factors influencing dietary practices among pregnant and lactating women living with HIV in Swaziland.
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