A Cross-Sectional Study on Nutritional and Morbidity Status of Children Attending Anganwadi Centers in Andhra Pradesh, India

Background

The health status of children is considered a very important and vital factor for building the future of a growing nation. So providing proper nutrition to the child is very important to enhance the growth of the child.

Objectives

The present study is intended to assess the nutritional status and morbidity pattern of children attending Anganwadi centers.

Materials and methods

This community-based cross-sectional study was conducted in children in the age group of 3-6 years attending the Anganwadi centers. By using the simple random sampling technique 13 Anganwadi centers were selected and a sample of 381 children was selected as the study population. Data was entered and analyzed using SPSS version 17 (Chicago: SPSS Inc). Ethical clearance was obtained from the institutional ethical committee (ECR/460/Inst/AP/2013/RR_19).

Results

The overall prevalence of underweight, stunting, and wasting was 172 (45.2%), 243 (63.8%), and 79 (20.7%), respectively, according to the WHO-recommended classification. It was observed that a high prevalence of morbidity was of anemia, 125 (32.08%), followed by upper respiratory tract infection, 78 (20.48%).

Conclusion

The present study shows that there are still many children who are malnourished and suffering from anemia in our country, even after 46 years of Integrated Child Development Services (ICDS). As malnutrition is a complex and multi-dimensional issue, comprehensive studies regarding causative, aggravating, and associated factors leading to malnutrition are required to be studied, to know the problem in-depth, and formulate better health policies.

Morbidity profile of under-5 slum dwellers of Amritsar city: A descriptive cross-sectional study

Context:

Children living in slums are deprived from basic necessities. Unhygienic environment and deficient nutrition hinder their growth and make them more prone to infectious diseases.

Aims:

To study morbidity profile of under-5 children and determine social epidemiological factors associated with it.

Settings and Design:

A descriptive cross-sectional study in urban slums of district Amritsar.

Methods and Material:

In total, 400 households each from four slums (1600 in total) were randomly selected. One to one interview with mother of each under 5 was conducted and information was recorded on pretested performa. Height and weight with haemoglobin estimation was done for each child.

Statistical Analysis Used:

Descriptive statistics (frequencies and proportions) and univariate logistic regression was applied to determine factors associated with under nutrition.

Results:

Out of 1136 under-5, 50, 45 and 8% were stunted, underweight and wasted. Severe malnutrition was seen among 23%. In total, 79% had anaemia. About 69% suffered from one or more infectious disease in last 3 months. Anaemia, birth order >2, lower socio-economic status and suffering from any infectious disease in last 3 months were associated with malnutrition.

Conclusions:

Severe malnutrition and anaemia was high among under-5 of urban slums and 69% suffered from infectious disease in last 3 months emphasizing on addressal of health needs of under-5 residing in urban slums.

Determinants of stunting among children under 2 years in urban informal settlements in Mumbai, India: evidence from a household census

BACKGROUND

There is limited evidence on the determinants of childhood stunting across urban India or specifically in slum settlements. This study aims to assess the extent of stunting among children under 2 years of age and examine its determinants in informal settlements of Mumbai.

METHODS

Data were collected in 2014-2015 in a post intervention census of a cluster randomized controlled trial to improve the health of women and children. Census covered 40 slum settlements of around 600 households each. A total of 3578 children were included in the study. Mixed effects logistic regression models were used to identify factors associated with stunting.

RESULTS

The prevalence of stunting among children aged 0-23 months was 38%. In the adjusted model, higher maternal education (AOR 0.59; 95% CI 0.42, 0.82), birth interval of at least 2 years (AOR 0.71; 95% CI 0.58, 0.87) and intended conception of the child (AOR 0.80; 95% CI 0.64, 0.99) were associated with lower odds of stunting. Maternal exposure to physical violence (AOR 1.83; 95% CI 1.21, 2.77) was associated with higher odds of being stunted. A child aged 18-23 months had 5.04 times greater odds (95% CI 3.91, 6.5) of being stunted than a child less than 6 months of age. Male child had higher odds of being stunted (AOR 1.33; 95% CI 1.14, 1.54).

CONCLUSIONS

Our findings support a multidimensional aetiology for stunting. The results of the study emphasize the importance of women's status and decision-making power in urban India, along with access to and uptake of family planning and services to provide support for survivors of domestic violence. Ultimately, a multilateral effort is needed to ensure the success of nutrition-specific interventions by focusing on the underlying health and social status of women living in urban slums.

TRIAL REGISTRATION

ISRCTN Register: ISRCTN56183183 , and Clinical Trials Registry of India: CTRI/2012/09/003004.

Persistent Malnutrition and Associated Factors among Children under Five Years Attending Primary Health Care Facilities in Limpopo Province, South Africa

Despite years of interventions intended to reduce child malnutrition in South Africa, its negative effects, stunting in particular, persist mainly among children under five years old living in under-resourced regions. A cross-sectional study was conducted to determine the prevalence of malnutrition and associated factors among 404 children under age five attending childcare services with their mothers in selected healthcare facilities of Limpopo Province, South Africa. Anthropometry, socio-demographics and obstetric history were collected. Height-for-age, weight-for-age and body mass index-for-age Z-scores were used to determine stunting, underweight and thinness among children, respectively. Logistic regression analyses were performed to generate the factors associated with malnutrition. Stunting (45.3%) was the prevalent form of malnutrition among children under age five, affecting boys (51.7%) more than girls (38.8%) and children aged 12–23 months (62.4%) more than those <11 months old (40.1%), in addition to the overall prevalence of underweight (29.0%) and thinness (12.6%). Boys had increased odds of stunting (adjusted odds ratio, AOR = 2.07, 95% CI: 1.26–3.41, p = 0.004) and underweight (AOR = 2.17, 95% CI: 1.32–3.57, p = 0.002) than girls. Children aged 12–23 months were more likely to be stunted (AOR = 4.79, 95% CI: 2.36–9.75, p ≤ 0.0001) than children aged ≤11 months. Delayed introduction of solid foods increased the odds of stunting (AOR = 5.77, 95% CI: 2.63–12.64, p ≤ 0.0001) and underweight (AOR = 2.05, 95% CI: 1.08–3.89, p = 0.028). Children with normal birth weight were less likely to be thin (AOR = 0.42, 95% CI: 0.19–0.92, p = 0.029) and underweight (AOR = 0.34, 95% CI: 0.17–0.68, p = 0.003) than children who had low birth weight. Children whose mothers had obtained secondary school education (AOR = 0.39, 95% CI: 0.16–0.97, p = 0.044), and Grade 12 or post-Grade 12 education (AOR = 0.32, 95% CI: 0.12–0.83, p = 0.020) were less likely to be stunted than were children of mothers who had only primary school education. Suboptimal complementary feeding predisposed children to stunting and underweight. National nutrition programs should be context-specific to improve the introduction of complementary foods among children, especially in the remote and poor areas.

Prevalence of Malnutrition and Associated Factors among Under-Five Children in Pastoral Communities of Afar Regional State, Northeast Ethiopia: A Community-Based Cross-Sectional Study

BACKGROUND

Malnutrition among children remains one of the most important causes of morbidity and mortality in the world. In Ethiopia, malnutrition is one of the most serious public health problem and the biggest in the world. This study aimed to assess the prevalence of malnutrition and associated factors among under-five children in pastoral communities of Afar Regional state, Northeast Ethiopia.

METHODS

A community-based cross-sectional study was conducted on 840 children aged 6-59 months from March 01-25, 2017. A multistage cluster sampling method was used to select the study participants. A structured questionnaire was used and anthropometric measurements were taken to collect data. EPI Data 3.1 and SPSS version 20.0 were used for data entry and analysis, respectively. Bivariate and multivariable logistic regression analysis was used to identify the factors associated with malnutrition. The statistical significance was declared at p value < 0.05 with 95% confidence intervals in the final model.

RESULT

The study found the prevalence of wasting, stunting, and underweight was 16.2% (95% CI: 13.8-18.8%), 43.1% (95% CI: 39.8-46.5%), and 24.8% (95% CI: 21.9-27.8%), respectively. Family size (AOR = 2.72, 95% CI: 1.62-4.55), prelacteal feeding (AOR = 3.81, 95% CI: 1.79-5.42), and diarrhoea in the past two weeks (AOR = 4.57, 95% CI: 2.56-8.16) were associated with wasting. And sex of child (AOR = 1.98, 95% CI: 1.46-2.72), age of child ((12-23 months: AOR = 3.44, 95% CI: 2.24-5.29); (24-35 months: AOR = 3.58, 95% CI: 2.25-5.69); and (36-59 months: AOR = 4.42, 95% CI: 2.79-6.94)), and immunization status of child (AOR = 3.34, 95% CI: 1.31-4.81) were predictors for stunting. Moreover, mother's education (AOR = 4.06, 95% CI: 2.01-8.19), sex of child (AOR = 1.83, 95% CI: 1.29-2.94), prelacteal feeding (AOR = 2.81, 95% CI: 1.64-3.72), and immunization status of child (AOR = 3.17, 95% CI: 2.14-4.99) were significantly associated with underweight.

CONCLUSIONS

This study indicated that child malnutrition was high among under-five children. Family size of five and above, receiving prelacteal feeding, and diarrhoea in the past two weeks were positively associated with wasting. Male child, increasing age of child, and not fully immunized child were positive predictors for increasing stunting. Maternal illiteracy, male child, prelacteal feeding, and not fully immunized child were factors affecting underweight. Promoting use of family planning, preventing diarrhoeal diseases, and vaccinating children integrated with the access of nutrition education programs are vital interventions to improve nutritional status of the children.