BACKGROUND/OBJECTIVES: The relationship between food intake and nutritional status has been clearly established. Yet, there are only limited studies on food intake among family members and their nutritional status. The study examined the relationship between intra-household food distribution and coexistence of dual forms of malnutrition (DFM) in the same household. SUBJECTS/METHODS: Households with a malnourished child and overweight mother were categorized as DFM. Intra-household food distribution among family members was reported using ratios, which are a measure of individual intakes as compared to all household member intakes adjusted to RDA. RESULTS: A 1,899 families were included in the study. The prevalence of DFM was 29.8% (95%CI 26.5-31.2). Children consumed lower amounts of energy (OR 1.34; 95%CI 1.06-1.69, P = 0.011), carbohydrates (OR 1.2; 95%CI1.03-1.61, P = 0.022), protein (OR 1.3; 95%CI 1.03-1.64, P = 0.026), and fat (OR 1.3; 95%CI 1.05-1.66, P = 0.016) than their mothers and other family members. In contrast, mothers consumed more carbohydrates than children and other family members (OR1.24; 95%CI 1.02-1.51, P = 0.03). CONCLUSIONS: This study is the first to report on the food distribution among family members and its relationship with occurrence of DFM in Indonesia. The results confirm the occurrence of an unequal food distribution between children and mothers, which increases risk of DFM in the household. The results also demonstrate that nutritional education at the household level is important to increase awareness of the impact of DFM.
Carbohydrates ; Child ; Eating ; Education ; Family Characteristics ; Humans ; Indonesia ; Malnutrition* ; Mothers ; Nutritional Status ; Overweight ; Prevalence

BACKGROUND/OBJECTIVES: The relationship between food intake and nutritional status has been clearly established. Yet, there are only limited studies on food intake among family members and their nutritional status. The study examined the relationship between intra-household food distribution and coexistence of dual forms of malnutrition (DFM) in the same household. SUBJECTS/METHODS: Households with a malnourished child and overweight mother were categorized as DFM. Intra-household food distribution among family members was reported using ratios, which are a measure of individual intakes as compared to all household member intakes adjusted to RDA. RESULTS: A 1,899 families were included in the study. The prevalence of DFM was 29.8% (95%CI 26.5-31.2). Children consumed lower amounts of energy (OR 1.34; 95%CI 1.06-1.69, P = 0.011), carbohydrates (OR 1.2; 95%CI1.03-1.61, P = 0.022), protein (OR 1.3; 95%CI 1.03-1.64, P = 0.026), and fat (OR 1.3; 95%CI 1.05-1.66, P = 0.016) than their mothers and other family members. In contrast, mothers consumed more carbohydrates than children and other family members (OR1.24; 95%CI 1.02-1.51, P = 0.03). CONCLUSIONS: This study is the first to report on the food distribution among family members and its relationship with occurrence of DFM in Indonesia. The results confirm the occurrence of an unequal food distribution between children and mothers, which increases risk of DFM in the household. The results also demonstrate that nutritional education at the household level is important to increase awareness of the impact of DFM.
Carbohydrates ; Child ; Eating ; Education ; Family Characteristics ; Humans ; Indonesia ; Malnutrition* ; Mothers ; Nutritional Status ; Overweight ; Prevalence

Dengue early warning system, based on many different factors including climatic factors, is likely to be a useful tool for predicting dengue cases. This study aims to assess the perceptions, attitudes, and responses to dengue early warning among a sample of residents in Kuala Lumpur, Malaysia as well as the factors associated with their willingness in participating dengue prevention public activity. A community-based cross-sectional study was conducted among residents of Titiwangsa District, Kuala Lumpur. A structured questionnaire was administered via face-to-face interview. About 75% of the respondents perceived dengue early warning as a useful tool for the community to take preventive measures. However, more than half did not know elevated temperature increases dengue cases. More than 80% wanted to know more how climate can be used to predict dengue outbreak. Willingness of participating in dengue control public activity was associated with age (p<0.001), educational level (p=0.005), perception (p<0.001), and attitude (p<0.001). Perception towards dengue early warning was positive among the urban residents. Majority of the participants reported good attitude with regard to dengue early warning while a minority demonstrated a poor response. Educational level, perception, and attitude are significantly associated with willingness to engage in dengue prevention public activity.

Introduction: The high prevalence of chronic energy deficiency (CED) and anaemia among pregnant women in Indonesia is worrying. Nusa Tenggara Timur (NTT) is one of the provinces in Indonesia with the highest prevalence of CED. This study aimed to determine the effect of fortified milk supplementation on changes in mid-upper arm circumference (MUAC) and haemoglobin level among pregnant women. Methods: This quasi-experimental study was conducted in three locations of Community Health Centers in NTT from May to August 2019. Purposive sampling was used to recruit 69 pregnant women who were divided into two groups based on haemoglobin levels; the intervention group consisted of 31 pregnant women with haemoglobin levels below 11 g/dL, and control group consisted of 38 pregnant women with haemoglobin levels above 11 g/dL. Intervention group was provided with fortified milk supplementation, while control group received education about prevention of CED and anaemia. Data were analysed using regression discontinuity design with haemoglobin of 11 g/dL as cut-off. Results: Using regression discontinuity method, we were able to determine the effect of milk supplementation based on haemoglobin levels and confirm the result that milk supplementation significantly increased MUAC by 4.69 cm. Despite no discontinuity found, a positive increase of 0.98 g/dL in haemoglobin level was important to note. Conclusion: Milk supplementation of 300 kcal/day for three months significantly increased MUAC and to some extent, increased haemoglobin level. Thus, it should be considered when planning nutrition programmes to improve the nutritional status of pregnant women.

Introduction: Stunting is a major nutritional problem in Indonesia. The prevalence of stunting in DKI Jakarta province was relatively high at 27.5% in 2013 and 17.7% in 2018. This study aims to describe nutrient intakes of children aged 25-30 months and to determine the proportional differences in nutrient intakes between stunting and normal children in Central Jakarta, Indonesia. Methods: A case-control study with a total sample of 121 children aged 25-30 months was conducted in Gambir and Sawah Besar sub-districts, Central Jakarta, where the prevalence of stunting was high. All children were exclusively breastfed for at least four months and had similar socio-economic levels. Data collected included height measurement, questionnairebased interview, and 24-hour food recall. T-test and chi-square test were used to investigate the differences between two groups and logistic regression was used in multivariate analysis. Results: Factors associated with stunting were energy intake (AOR=6.0; 95% CI=1.0-35.0) and protein intake (AOR=4.0; 95% CI=1.1-15.5) after controlling for fat, carbohydrate, vitamin C, iron, and zinc intakes. The percentage of children with energy intake below the recommendation was much higher in stunted children (86.1%) compared to normal children (43.5%). Similarly, the percentage of children with protein intake below the recommendation was very much higher among stunted children (30.6%) compared to 8.2% in normal children. Conclusion: Children who lacked energy and protein intakes were at a higher risk of stunting than children who had sufficient intakes. Macronutrient intakes are important and should be consumed in sufficient quantities every day to prevent stunting.

OBJECTIVES: This study aimed to develop susceptible-exposed-infectious-recovered-vaccinated (SEIRV) models to examine the effects of vaccination on coronavirus disease 2019 (COVID-19) case trends in Malaysia during Phase 3 of the National COVID-19 Immunization Program amidst the Delta outbreak. METHODS: SEIRV models were developed and validated using COVID-19 case and vaccination data from the Ministry of Health, Malaysia, from June 21, 2021 to July 21, 2021 to generate forecasts of COVID-19 cases from July 22, 2021 to December 31, 2021. Three scenarios were examined to measure the effects of vaccination on COVID-19 case trends. Scenarios 1 and 2 represented the trends taking into account the earliest and latest possible times of achieving full vaccination for 80% of the adult population by October 31, 2021 and December 31, 2021, respectively. Scenario 3 described a scenario without vaccination for comparison. RESULTS: In scenario 1, forecasted cases peaked on August 28, 2021, which was close to the peak of observed cases on August 26, 2021. The observed peak was 20.27% higher than in scenario 1 and 10.37% lower than in scenario 2. The cumulative observed cases from July 22, 2021 to December 31, 2021 were 13.29% higher than in scenario 1 and 55.19% lower than in scenario 2. The daily COVID-19 case trends closely mirrored the forecast of COVID-19 cases in scenario 1 (best-case scenario). CONCLUSIONS Our study demonstrated that COVID-19 vaccination reduced COVID-19 case trends during the Delta outbreak. The compartmental models developed assisted in the management and control of the COVID-19 pandemic in Malaysia.

From late December 2019, an outbreak of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) occurred in Wuhan, China and has spread globally resulting in a pandemic. Brunei Darussalam reported its first case of COVID-19 on 9 March 2020. Several measures were implemented to prevent a national outbreak. We report our experience with surveillance of patients requiring admission in all government hospitals. We detected one positive case, and through contact tracing two further cases were detected. Therefore, without this screening programme, these cases would likely have been missed, leading to further nosocomial and community spread.