BACKGROUND

Child malnutrition is a prevailing global public health concern especially in low- and middle-income countries. Conditional cash transfer (CCT) programs were implemented to help address this problem.

To determine the relationship between the nutritional status among 0-59 months old children and household enrollment in a Philippine CCT program, Pantawid Pamilyang Pilipino Program (4Ps).

A cross-sectional study was employed to 392 children and mothers/primary caregivers in a rural municipality in Leyte. Stratified random sampling technique was used in selecting the participants. Anthropometric characteristics were measured for these 392 children and were classified as 4Ps and non-4Ps members. Chi-square test was used to determine the relationship between the variables of interest.

4Ps household beneficiaries had mothers/primary caregivers who were older and had fewer years of education. The 4Ps beneficiary households had more household members and had lower average monthly income compared to the non-beneficiaries. No significant differences were found between the 4Ps beneficiary and non-beneficiary households in terms of the household hunger scale, the mean age of the children, and the sex distribution of the children included in the study. Specific profile components were found to be correlated to the children’s nutritional status. The age of the children was significantly associated to their length/height-for-age (L/HFA) wherein stunting was noted to occur among children older than 12 months of age. Maternal education was significantly associated to the weight-for-age (WFA) of the children. Children who were underweight had mothers/primary caregivers with fewer years of education. No significant correlation was found between the child’s sex, age of the mother/primary caregiver, household size, average monthly household income, and household hunger scale and the children’s nutritional status Lastly, there was no significant correlation between 4Ps household enrollment and the WFA and L/HFA status of the children. 4Ps household enrollment was, however, significantly correlated to the weight-for-length/height (WFL/H) or wasting status of the children.

The 4Ps program has the potential to enhance the nutritional outcomes of children hence the need to maximize its gains. In addition, the relationship of different sociodemographic variables with the children’s nutritional status reflects the complexity and multidimensionality of childhood malnutrition, implying the need for a holistic and multistakeholder approach in addressing the problem.

OBJECTIVE

This study aimed to investigate the determinants linked to stunting among infants and young children aged 0-23 months in the Fourth District of Camarines Sur.

An analytical cross-sectional study was conducted among 628 primary caregivers with infants and young children aged 0-23 months in four municipalities of the Fourth District of Camarines Sur, Philippines, using a two stage stratified random sampling design. Data on sociodemographic and economic factors were collected through face-to-face interviews. Infant and young child feeding (IYCF) indicators were assessed using a list-based approach, while weight and length were evaluated using the World Health Organization Anthro Plus software. Descriptive statistics and multiple logistic regression were done using R statistical software version 4.3.1.

The study revealed that the prevalence of stunting was of significant public health concern, reaching 42.8%. Holding other variables constant, age of the child (OR=0.77; 95% CI: 0.63-0.94), having college undergraduate mothers (OR=0.26; 95% CI: 0.05-1.28), and belonging to a poor income household (OR=0.40; 95% CI: 0.14-0.88) were associated with stunting among infants aged 0.01-6.00 months. Moreover, after controlling for the confounding effects of other variables, age (OR=1.09; 95% CI: 1.05-1.14) and sex of the child (OR=1.55; 95% CI: 1.05-2.28) were associated with stunting among older children aged 6.00-23.99 months.

This study emphasizes the challenge of stunting in the Fourth District of Camarines Sur. None of the IYCF indicators were associated with stunting; however, maternal education, the child’s age, sex, and socioeconomic status were identified as significant factors influencing stunting. Addressing these determinants through targeted interventions focusing on improving maternal education and enhancing socio-economic conditions were crucial to reducing stunting in the study areas.

Objective: This study aimed to investigate the determinants linked to stunting among infants and young children aged 0-23 months in the Fourth District of Camarines Sur. Methods: An analytical cross-sectional study was conducted among 628 primary caregivers with infants and young children aged 0-23 months in four municipalities of the Fourth District of Camarines Sur, Philippines, using a twostage stratified random sampling design. Data on sociodemographic and economic factors were collected through face-to-face interviews. Infant and young child feeding (IYCF) indicators were assessed using a list-based approach, while weight and length were evaluated using the World Health Organization Anthro Plus software. Descriptive statistics and multiple logistic regression were done using R statistical software version 4.3.1. Results: The study revealed that the prevalence of stunting was of significant public health concern, reaching 42.8%. Holding other variables constant, age of the child (OR=0.77; 95% CI: 0.63-0.94), having college undergraduate mothers (OR=0.26; 95% CI: 0.05-1.28), and belonging to a poor income household (OR=0.40; 95% CI: 0.14-0.88) were associated with stunting among infants aged 0.01-6.00 months. Moreover, after controlling for the confounding effects of other variables, age (OR=1.09; 95% CI: 1.05-1.14) and sex of the child (OR=1.55; 95% CI: 1.05-2.28) were associated with stunting among older children aged 6.00-23.99 months. Conclusion This study emphasizes the challenge of stunting in the Fourth District of Camarines Sur. None of the IYCF indicators were associated with stunting; however, maternal education, the child’s age, sex, and socioeconomic status were identified as significant factors influencing stunting. Addressing these determinants through targeted interventions focusing on improving maternal education and enhancing socio-economic conditions were crucial to reducing stunting in the study areas.
Human ; growth disorders ; risk factors ; nutritional status ; infant nutrition disorders

Objective: To explore the risk factors of malnutrition in infants with congenital heart disease within one year after surgery. Methods: This retrospective cohort study selected 502 infants with congenital heart disease who underwent surgical treatment in Guangzhou Women and Children's Medical Center from February 2018 to January 2019. Their basic information and clinical data were analyzed, and their nutrition status after the surgery was followed up by questionnaire survey. Weight-for-age Z score (WAZ)≤-2 one year after operation was defined as malnutrition group, and WAZ>-2 was non-malnutrition group. The perioperative indicators and complementary food advancement were compared between the two groups by chi-square test, t-test, and Kruskal-Wallis test. The risk factors of malnutrition were analyzed by Logistic regression. Results: A total of 502 infants were selected, including 301 males and 201 females, with the age of 4.1 (2.0, 6.8) months. There were 90 cases in malnutrition group and 412 cases in non-malnutrition group. The body length and weight at birth in the malnutrition group were lower than those in the non-malnutrition group ((47.8±3.8) vs. (49.3±2.5) cm, (2.7±0.6) vs.(3.0±0.5) kg, both P<0.001). The proportion of paternal high school education or above and the proportion of family per capita income of 5 000 yuan or above in the malnutrition group were lower than those in the non-malnutrition group ((18.9% (17/90) vs. 30.8% (127/412), 18.9% (17/90) vs. 33.7% (139/412), both P<0.05). Compared to the non-malnutrition group, the proportion of complex congenital heart disease in the malnutrition group was higher (62.2% (56/90) vs. 47.3% (195/412), P<0.05). The postoperative mechanical ventilation time, postoperative intensive care unit (ICU) stay time, postoperative hospital stay, total length of ICU stay and total hospital stay in the malnutrition group were significantly longer than those in non-malnutrition group (all P<0.05). The proportion of egg and fish supplementation over 2 times/week within one year after the surgery was also lower in the malnutrition group (both P<0.05). Logistic regression analysis showed that mother's weight at delivery (OR=0.95,95%CI 0.91-0.99), the pre-operative WAZ≤-2 (OR=6.04, 95%CI 3.13-11.65), the complexity of the cardiac disease (OR=2.23, 95%CI 1.22-4.06), the hospital stay after the surgery over 14 days (OR=2.61, 95%CI 1.30-5.26), the types of complementary food<4 (OR=2.57, 95%CI 1.39-4.76), and the frequency of meat and fish<2 times/week (OR=2.11, 95%CI 1.13-3.93) were the risk factors associated with malnutrition within one year after the surgery. Conclusion: Mother's weight at delivery pre-operative nutritional status, complexity of cardiac disease, postoperative hospital stay, types of daily supplements and frequency of fish are risk factors associated with malnutrition within one year after surgery in children with congenital heart disease.
Male ; Humans ; Female ; Cardiac Surgical Procedures ; Retrospective Studies ; Malnutrition/complications* ; Heart Defects, Congenital/surgery* ; Risk Factors ; Length of Stay ; Infant Nutrition Disorders/complications*

OBJECTIVE: To study the application of ponderal index (PI), body mass index (BMI), mid-arm circumference/head circumference (MAC/HC), and Clinical Assessment of Nutritional Status (CANS) score in assessing the nutritional status of neonates at birth, and to find a simple and reliable scheme for the assessment of fetal nutritional status. METHODS: PI, BMI, MAC/HC, and CANS were used to assess the nutritional status of full-term infants and preterm infants shortly after birth. The assessment results of these methods were analyzed. RESULTS: Among the 678 full-term infants, 61, 102, 47, and 131 were diagnosed with malnutrition by PI, BMI, MAC/HC, and CANS respectively. Among the 140 preterm infants, 30, 87, 9, and 112 were diagnosed with malnutrition by PI, BMI, MAC/HC, and CANS respectively. The combination of BMI and CANS had a detection rate of 99.3% in full-term infants and 100% in preterm infants. Compared with the single method, the combination significantly improved the detection rate of malnutrition ( CONCLUSIONS The combination of BMI+CANS can reduce the rate of missed diagnosis of fetal malnutrition. It is therefore a simple and reliable method for the assessment of fetal malnutrition.
Body Mass Index ; Fetal Nutrition Disorders/diagnosis* ; Humans ; Infant, Newborn ; Infant, Premature ; Nutrition Assessment ; Nutritional Status

Patients with dysphagia often have difficulty in supplying adequate nutrition orally, and thus they often use gastrostomy for nutrition support. If the nutrition affects the deterioration of the disease, as in amyotrophic lateral sclerosis, the majority of patients will have a gastrostomy tube for proper nutrition. To prevent complications from gastrostomy tubes, it is important to educate the caregiver or patient about how to properly manage it. If these patients opt for home care because of financial or cultural reasons, it will be difficult for their healthcare team to observe them closely, leading to complications due to lax tube management. In this case, appropriate management education becomes more important. This paper reports an extremely rare case of duodenal intussusception caused by a migrated percutaneous radiologic gastrostomy (PRG) tube in a patient with amyotrophic lateral sclerosis (ALS) using simultaneous oral and enteral nutrition. The patient was treated successfully with urgent tube removal using the air reduction maneuver. This case highlights the importance of gastrostomy management.
Amyotrophic Lateral Sclerosis ; Caregivers ; Deglutition Disorders ; Education ; Enteral Nutrition ; Gastrostomy* ; Home Care Services ; Humans ; Intussusception* ; Motor Neuron Disease ; Patient Care Team

Tube feeding is used to provide nutritional support to patients who have difficulty taking food orally. A nasogastric tube is commonly used for these patients but there are some complications. Therefore, the oro-esophageal tube feeding method was developed to avoid these disadvantages. A 33-year-old male with a history of right basal ganglia intracranial hemorrhage was admitted to the rehabilitation department for the treatment of dysphagia caused by a new onset left basal ganglia intracranial hemorrhage. After the videofluoroscopic swallowing study, the nasogastric tube feeding was changed to intermittent feeding via an oro-esophageal tube. Unfortunately, the patient swallowed the tube during insertion. Hence, an emergent endoscopy was performed for tube removal. This article reports a rare case of a patient who underwent oro-esophageal tube removal with an esophagogastroduodenoscopy after tube swallowing during insertion. The insertion of an oro-esophageal tube requires a careful approach after considering the cognitive function, muscle strength, and family education.
Adult ; Basal Ganglia ; Cognition ; Deglutition ; Deglutition Disorders ; Education ; Endoscopy ; Endoscopy, Digestive System ; Enteral Nutrition ; Humans ; Intracranial Hemorrhages ; Male ; Methods ; Muscle Strength ; Nutritional Support ; Rehabilitation

Pediatric malnutrition is an enormous health issue all around the world and its distribution is different in distinct areas of a country. This study has been designed to report the anthropometric status and some socio-economic factors among 2–5 years old children from Golestan province of Iran to show a better view of pediatric health status and better planning for future actions. This study was carried out by clustered-randomized sampling method on 1,382 of 2–5 years old children in urban and rural areas of Golestan province. Anthropometric measurements were performed and World Health Organization child growth standards were used for further analyses. The prevalence of stunting in boys and girls were 7.4% and 7.5% in urban and 4.1% and 5.4% in rural areas. The prevalence of underweight in boys and girls were 6.9% and 4.7% in urban and 5.7% and 4.4% in rural areas. The prevalence of subjects being at risk for overweight were 17.8% and 11.7% in boys and girls, respectively, in urban areas and were 11.1% and 9.2% in rural areas, respectively. There was a marginally significant difference between urban boys and girls in terms of weight status (p = 0.067). In this study remarkably high prevalence of malnutrition, especially a high dominance of overweight, was reported in Golestan province of Iran. Follow-up investigation to identify the cause of malnutrition and to establish public health policies are needed to revise these health issues in Golestan province of Iran.
Anthropometry ; Child Nutrition Disorders ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Growth Disorders ; Humans ; Iran ; Malnutrition ; Methods ; Obesity ; Overweight ; Prevalence ; Public Health ; Thinness ; World Health Organization

Malnutrition is one of the most important health issues in developing countries, which might have adverse effects on the physical and intellectual health of children. The search process was started to find Persian and English articles published until September 2017 regarding the prevalence of malnutrition in children under the age of six in Iran using national and international databases including SID, Magiran, Irandoc, IranMedex, PubMed, Medline, Scopus, and ISI Web of Science. The data were analyzed using meta-analysis methods and the random effects model. The heterogeneity of studies was analyzed using the I² index. The data were analyzed using R and STATA software (ver. 11.2). Twenty seven articles conducted from 2002 to 2016 were collected to be included in the meta-analysis process. The total sample size was 161,941 patients in an age range of 0-6 years. The final estimate of the prevalence of different forms of malnutrition through meta-analysis of data extracted from studies in Iran was as follows: severe underweight (1%; 95% confidence interval [CI], 1–1), moderate underweight (6%; 95% CI, 5–7), mild underweight (25%; 95% CI, 21–28), severe short stature (3%; 95% CI, 2–3), moderate short stature (8%; 95% CI, 6–9), mild short stature (21%; 95% CI, 17–24), severe slimness (1%; 95% CI, 1–1), moderate slimness (5%; 95% CI, 4–5) and mild slimness (20%; 95% CI, 17–24). Considering that the prevalence of malnutrition is relatively high in Iran, health authorities should plan to improve the nutritional status of children.
Child ; Child Nutrition Disorders ; Developing Countries ; Growth Disorders ; Humans ; Iran ; Malnutrition ; Nutritional Status ; Population Characteristics ; Prevalence ; Sample Size ; Sudden Infant Death ; Thinness ; Weight Loss

BACKGROUND: To investigate whether diabetes contributes to mortality for major types of diseases. METHODS: Six National Health and Nutrition Examination Survey data cycles (1999 to 2000, 2001 to 2002, 2003 to 2004, 2005 to 2006, 2007 to 2008, and 2009 to 2010) and their linked mortality files were used. A population of 15,513 participants was included according to the availability of diabetes and mortality status. RESULTS: Participants with diabetes tended to have higher all-cause mortality and mortality due to cardiovascular disease, cancer, chronic lower respiratory diseases, cerebrovascular disease, influenza and pneumonia, and kidney disease. Confounder-adjusted Cox proportional hazard models showed that both diagnosed diabetes category (yes or no) and diabetes status (diabetes, prediabetes, or no diabetes) were associated with all-cause mortality and with mortality due to cardiovascular disease, chronic lower respiratory diseases, influenza and pneumonia, and kidney disease. No associations were found for cancer-, accidents-, or Alzheimer's disease-related mortality. CONCLUSION: The current study's findings provide epidemiological evidence that diagnosed diabetes at the baseline is associated with increased mortality risk due to cardiovascular disease, chronic lower respiratory diseases, influenza and pneumonia, and kidney disease, but not with cancer or Alzheimer's disease.
Alzheimer Disease ; Cardiovascular Diseases ; Cerebrovascular Disorders ; Diabetes Complications ; Diabetes Mellitus ; Influenza, Human ; Kidney Diseases ; Mortality ; Nutrition Surveys ; Pneumonia ; Prediabetic State ; Proportional Hazards Models