Characteristics of severely malnourished under‐five children hospitalized with diarrhoea, and their policy implications

Chisti, Mohammod Jobayer; Hossain, Mohammad Ismail; Malek, Mohammad Abdul; Faruque, A. S. G.; Ahmed, Tahmeed; Salam, Mohammed Abdus

doi:10.1111/j.1651-2227.2007.00192.x

Cited by 37 publications

(49 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The severely-underweight children in our study were also more likely to have illiterate or less-educated mothers (<5 years of schooling) as has been observed in previous studies in Bangladesh (9,12,(18)(19)(20)(21)(22), and the underweight children were three times more likely to have teen-aged mothers than the better-nourished children. A previous report from Kenya also showed young maternal age to be a risk factor for severe PEM (OR=3.95, p<0.001) (23).…”

Section: Discussionsupporting

confidence: 70%

Risk Factors Associated with Severe Underweight among Young Children Reporting to a Diarrhoea Treatment Facility in Bangladesh

Nahar

Ahmed

Brown

et al. 2010

J Health Popul Nutr

Self Cite

View full text Add to dashboard Cite

Protein-energy malnutrition (PEM) is a serious health problem among young children in Bangladesh. PEM increases childhood morbidity and mortality. Information is needed on the major risk factors for PEM to assist with the design and targeting of appropriate prevention programmes. To compare the underlying characteristics of children, aged 6-24 months, with or without severe underweight, reporting to the Dhaka Hospital of ICDDR,B in Bangladesh, a case-control study was conducted among 507 children with weightfor-age z-score (WAZ) <-3 and 500 comparison children from the same communities with WAZ >-2.5. There were no significant differences between the groups in age [overall mean±standard deviation (SD) 12.6±4.1 months] or sex ratio (44% girls), area of residence, or year of enrollment. Results of logistic regression analysis revealed that severely-underweight children were more likely to have: undernourished mothers [body mass index (BMI) <18.5, adjusted odds ratio (AOR)=3.8, 95% confidence interval (CI) 2.6-5.4] who were aged <19 years (AOR=3.0, 95% CI 1.9-4.8) and completed <5 years of education (AOR=2.7, 95% CI 1.9-3.8), had a history of shorter duration of predominant breastfeeding (<4 months, AOR=2.3, 95% CI 1.6-3.3), discontinued breastfeeding (AOR=2.0, 95% CI 1.1-3.5), and had higher birth-order (>3 AOR=1.8, 95% CI 1.2-2.7); and fathers who were rickshaw-pullers or unskilled day-labourers (AOR=4.4; 95% CI 3.1-6.1) and completed <5 years of education (AOR=1.5; 95% CI 1.1-2.2), came from poorer families (monthly income of Tk <5,000, AOR=2.7, 95% CI 1.9-3.8). Parental education, economic and nutritional characteristics, child-feeding practices, and birth-order were important risk factors for severe underweight in this population, and these characteristics can be used for designing and targeting preventive intervention programmes.

show abstract

Section: Discussionsupporting

confidence: 70%

Risk Factors Associated with Severe Underweight among Young Children Reporting to a Diarrhoea Treatment Facility in Bangladesh

Nahar

Ahmed

Brown

et al. 2010

J Health Popul Nutr

Self Cite

View full text Add to dashboard Cite

show abstract

“…The prevalence of stunting and underweight in the present study was higher than in Pakistani children (35% stunting and 29.5% underweight) (Mian et al 2002) and Malaysian children (29.2% stunting and 26.1% underweight) (Marjan et al 1998) but stunting was lower than in Indonesian children (55% stunting) (Hadju et al 1995). Severe stunting and underweight (below (3 Z-score) of the present study was comparable to Bangladeshi children (11% stunting and 16% underweight) (Chisti et al 2007). Frongillo et al (1997) analysed the socio-economic factors that were responsible for undernutrition (100) in different countries, and also indicated that greater prevalence of undernutrition in Asians nations was due to environmental factors and ethnic differences.…”

Section: Discussionmentioning

confidence: 54%

Prevalence of undernutrition in Nepalese children

Ghosh

Adhikari

Chowdhury

et al. 2008

Annals of Human Biology

View full text Add to dashboard Cite

show abstract

“…Simultaneous changes have also been observed in the risk factors for malnutrition (2,15,16) . We found a high baseline prevalence for stunting and underweight in Dhaka, which might be due to the longer period of observation in Dhaka (20 years, 1993-2012) as compared with Matlab (13 years, 2000-2012).…”

Section: Discussionmentioning

confidence: 94%

Changing childhood malnutrition in Bangladesh: trends over the last two decades in urban–rural differentials (1993–2012)

Das

Chisti

Malek

et al. 2015

Public Health Nutr.

Self Cite

View full text Add to dashboard Cite

Objective: The present study determined trends in malnutrition among under-5 children in urban and rural areas of Bangladesh. Design: Surveillance. Setting: The 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. Subjects: A total of 28 816 under-5 children were enrolled at Dhaka from 1993 to 2012 and 11 533 at Matlab between 2000 and 2012. Results: In 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 BMIfor-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 %). Conclusions: The 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. Keywords Bangladesh Malnutrition Overweight and obesityRural and urban Under-5 childrenEconomic improvement and reduction in poverty, both in developed and developing countries, have been observed within the last couple of decades; however, the pace is not sufficient to meet Millennium Development Goal 1 ('eradicate extreme poverty and hunger') (1) . Improvement has also occurred in meeting basic health needs such as the prevention and treatment of infectious and communicable diseases (2) , and efforts have been made to ensure provision of safe drinking-water and improved sanitation practices to reduce diarrhoeal episodes (2,3) . According to WHO, globally about 27 % of children are stunted (4) and 17 % are underweight (5) . The scenario is even worse in the Asian subcontinent and sub-Saharan Africa (2) . Despite efforts to reduce childhood malnutrition through various interventions, it remains a great public health challenge (2) . The other components of malnutrition, such as overweight and obesity, are emerging public health concerns (6,7) . In 2011, WHO reported that over 40 million children under the age of 5 years (under-5s) were ove...

show abstract

Characteristics of severely malnourished under‐five children hospitalized with diarrhoea, and their policy implications

Abstract: There thus is a need to incorporate appropriate, cost-effective and sustainable preventive strategies and improved management policies in the health systems as well as in social support systems in Bangladesh.

Cited by 37 publications

References 15 publications

Risk Factors Associated with Severe Underweight among Young Children Reporting to a Diarrhoea Treatment Facility in Bangladesh

Risk Factors Associated with Severe Underweight among Young Children Reporting to a Diarrhoea Treatment Facility in Bangladesh

Prevalence of undernutrition in Nepalese children

Changing childhood malnutrition in Bangladesh: trends over the last two decades in urban–rural differentials (1993–2012)

Contact Info

Product

Resources

About