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Risk factors for malnutrition among preschool children in rural Karnataka: a case-control study.

ABSTRACT: The prevalence of malnutrition among children in developing countries is very high. As a step towards reducing the prevalence of malnutrition, there is a need to identify the important determinants of malnutrition in the specific population so that preventive and control measures can be implemented. The objective of the study is to determine the risk factors for malnutrition among preschool children in Rural Karnataka, South India.A case-control study was carried out among preschool children, aged between three to six years, attending the Anganwadi centers and their mothers' in Udupi district of Karnataka, India. A total of 570 children (190 cases and 380 controls) were selected by multistage cluster sampling technique. A semi-structured risk factors questionnaire was used to identify the risk factors for malnutrition among children.The majority (45.8 and 45.5%) of the children in the study were in the age group of 3.0 to 4.0 years in case and control groups respectively. There was a slight preponderance of illiterate parents among cases in comparison to the controls. Largely, 87.4% of the children belonged to poor socio-economic status in the case groups compared to 82.4% in the control group. After adjusting for the confounders, underweight was significantly associated with socio-economic status of the parents (aOR: 2.05, 95% CI: 1.06, 3.96), birth weight?

SUBMITTER: Ansuya

PROVIDER: S-EPMC5828120 | biostudies-literature | 2018 Feb

REPOSITORIES: biostudies-literature

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Risk factors for malnutrition among preschool children in rural Karnataka: a case-control study.

Ansuya Nayak Baby S BS Unnikrishnan B B George Anice A N Shashidhara Y SY Mundkur Suneel C SC Guddattu Vasudev V

BMC public health 20180226 1

<h4>Background</h4>The prevalence of malnutrition among children in developing countries is very high. As a step towards reducing the prevalence of malnutrition, there is a need to identify the important determinants of malnutrition in the specific population so that preventive and control measures can be implemented. The objective of the study is to determine the risk factors for malnutrition among preschool children in Rural Karnataka, South India.<h4>Methods</h4>A case-control study was carri ...[more]

PMID: 29482540

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Project description:BackgroundFor over 20?years, Madagascar has been challenged by continued high prevalence of stunting, underweight and wasting among children under 5 years of age. Yet, nutritional status of post-under-five age group has never been assessed in the country, despite its importance in relation not only to physical health but also to cognitive capacity and educational achievements of children. This study aims to estimate prevalence of malnutrition among schoolchildren aged 5-14?years in Madagascar. It further attempts to identify the possible risk factors for their malnutrition. This is the first study that estimates prevalence of malnutrition among school-aged children in Madagascar.MethodsA cross-sectional household survey was conducted in Antananarivo-Avaradrano district, Analamanga region, Madagascar. The study targeted 393 first and second graders 5-14?years of age enrolled at 10 primary schools, where school-feeding was implemented. Data were collected from anthropometric measurements, their subsequent household structured interviews and observations. Bivariate (Chi-square test or Mann-Whitney's U test) and multivariable (logistic regression) analyses were performed, to identify the possible risk factors associated with malnutrition.ResultsThe overall prevalence rates of stunting, underweight and thinness were 34.9%, 36.9% and 11.2%, respectively. Nineteen children (4.8%) suffered from all the three forms of undernutrition. Older schoolchildren had a significantly greater likelihood of being stunted, underweight and thin. The greater number of members a household had, the higher likelihood of being stunted and thin its schoolchild had. Children having lower Household Dietary Diversity Score were more likely to be underweight. Yet, 'Had lunch at school yesterday' was associated neither with being stunted nor with being underweight and thin. This implies room for improvement of the current school feeding program.ConclusionsPrevalence rates of stunting and underweight among 393 children examined were as high as the national averages among children under 5 years of age. Adequate food availability and dietary diversity over a sufficient period (incl. 5-14?years of age) are necessary for increasing likelihood of catch-up in height-for-age and weight-for-age, which are expectable during adolescence. To supplement inadequate household dietary diversity practices, school-feeding program may need to use more animal-protein ingredients.

Project description:Abstract Objectives Children hospitalized with complicated severe malnutrition (CSM) have unacceptably high mortality rates despite receiving standard nutritional and medical treatment. The underlying pathology of the poor prognosis is not well understood. Growing evidence indicates presence of metabolic dysfunction in CSM. Yet, it is unclear whether and how metabolic dysfunction contributes the poor prognosis. This study aimed to identify metabolic signatures and pathways associated with CSM mortality. Methods A case-control study was performed on CSM patients enrolled to a multicenter (one Malawi and two Kenya hospitals) randomized control trial (NCT02246296). A total of 90 death cases and 90 discharged controls that were propensity score matched by age, HIV and mid-upper arm circumferences were included in the study. Targeted metabolomics was performed on their serum samples collected at admission and on day 3 of hospitalization. In particular, 206 metabolites, including amino acids, acylcarnitines, lipids and organic acids were quantified by LC-MS/MS. Results Discriminant analysis (PLS-DA) showed that metabolomic signatures at admission could differentiate cases from controls, with a cross-validated classification error rate of 21.8%. An increase of homovanillic, isobutyric and propionic acids, and decrease of lipids lysoPC a C18:2, lysoPC a C20:4, PC ae C42:2, SM C26:0, and SM C26:1 were the top 8 significant features characterizing the admission metabolomes of cases. Notably, cases with higher levels of isobutyrate, a microbial fermentation product, had significantly shorter survival time, implying a role of gut integrity in mortality. Pathway analysis revealed that metabolites of the tricarboxylic acid (TCA) cycle pathway differentiated cases from controls. Analysis of day 3 samples showed metabolic differences in response to treatment, especially in the recovery rate of lipids, between cases and controls. Conclusions CSM non-survivors have metabolomes distinct from survivors indicating perturbations in mitochondrial function and nutrition utilization. Perturbed metabolites identified shed light on biological mechanisms of mortality and may serve as targets of nutritional or therapeutic interventions to improve CSM survival. Funding Sources Bill and Melinda Gates Foundation, Thrasher Research Fund, and RESTRACOMP Graduate Scholarship.

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Risk factors for malnutrition among preschool children in rural Karnataka: a case-control study.

Publications

Risk factors for malnutrition among preschool children in rural Karnataka: a case-control study.

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