Association between maternal depression and the nutritional status of children under five-years-old in Peru: An analysis of the Demographic and Health Survey 2014-2017

Objective: To evaluate the association between maternal depression and nutritional status of children under 5 years old in Peru. Design: Cross-sectional study of the Demographic and Health Survey 2014-2017. Outcomes were mild (height Z-score for age <-2 SD) and moderate/severe (<-3DE) childhood chronic undernutrition and also mild (hemoglobin <11 g/dL) and moderate/severe (hemoglobin <10 g/dL) childhood anemia. Maternal depression was assessed by the questionnaire PHQ-9. Odds ratios and their confidence intervals (CIs) were estimated by multinomial logistic regression models, considering the complex sample design. Setting: Peru Participants: Peruvian women of childbearing age from 15 to 49 years who live with children from 6 to 59 months. Results: Maternal depression was significantly associated with a higher odds of moderate/severe chronic undernutrition in children aged 6-59 months (OR = 2.67; 95% CI 1.16-6.16). Conclusions: There was evidence that maternal depression was associated with an increased risk of moderate/severe chronic undernutrition Keywords: Mothers, depression, mental health, child undernutrition disorders, Peru.

Focus Group Discussion Dalam Peningkatan Pengetahuan Kader Untuk Melakukan Penyuluhan Kepada Masyarakat Tentang Pencegahan Stunting Sejak Dini

Stunting refers to a chronic undernutrition that make children look smaller than children in their age. In the program of community service, role of cadre (a health volunteer) is very important to disseminate the information about stunting to community. Increase cadre’s knowledge and encourage them to be more confidence when giving the information to community about stunting and local food that can meet childreen nutrition requirement to prevent stunting in community. This program is the second year program of community service to continue the evaluation from last year program. This program is specilally for cadre in Sumberkalong village. Each meeting was conducted through focus discussion group about prevention of stunting. Then, cadres disseminated the information to community including, pregnant women, newly marriage couple and toddler moms by visiting their home or door-to-door. There were 10 cadres who participate in the communitity service in the phase of year 1 until year 2 thouroughly. Three cadres were active and often asked some questions during meeting sessions. Some others were active if they were encouraged to ask or to give an opinion. Cadres explained that cadres' knowledge increase after joining several meeting session and focus group discussion. The cadres disseminated the information to the community with confidence. Program of community service which using a focus group discussion is considered effective to increased cadres’ knowledge. Focus group discussion can be employed in encouraging cadres in the community service program.Keywords: cadre’s knowledge; focus group discussion; stunting.Abstrak: Stunting merupakan kondisi gagal tumbuh pada tubuh dan otak yang diakibatkan keadaan kurang gizi dalam waktu yang lama. Sehingga, anak stunted memiliki tubuh yang lebih pendek dari anak normal seusianya. Peran kader kesehatan sangat penting dalam mendesiminasikan informasi kesehatan, termasuk informasi terkait pencegahan stunting anak balita di masyarakat, untuk meningkatkan pengetahuan kader kesehatan dan kemampuan kader kesehatan tentang stunting dan zat gizi lokal yang dapat membantu pemenuhan kebutuhan gizi untuk mencegah stunting di masyarakat. Kegiatan ini merupakan program pengabdian kepada masyarakan tahun ke-2 yang berfokus pada pemberdayaan kader kesehatan Desa Sumberkalong Kecamata Kalisat Kabupaten Jember. Setiap pertemuan kegiatan dilaksanakn Focus Group Discussion (FGD) bersama para kader kesehatan yang membahas pencegahan stunting. Kemudian, kader kesehatan mendesiminasikan informaasi yang telah diperoleh dari tim pelaksana program pengabdian kepada masyarakat, meliputi ibu-ibu yang memiliki anak usia balita, ibu hamil dan pasangan usia subur dengan melakukan kunjungan ke secara door-to-door ke rumah. Terdapat 10 kader kesehatan berpartisipasi dalam kegiatan pengabdian kepada masyarakat tahun ke-1 dan tahun ke-2. Sebanyak 3 kader yang aktif bertanya selama proses pertemuan dengan tim pelaksana pengabdian kepada masyarakat. Sebagain kader bertanya atau memberikan pendapatnya jika diminta. Seluruh kader menyampaikan bahwa pengetahuan kader meningkat selama mengikuti rangkaian pertemuan dan FGD.Kata kunci: Focus Group Discussion (FGD); pengetahuan kader; stunting.

Publisher’s Note: Dietetics—A New Open Access Journal

Eighty-eight percent of countries face the serious burden of malnutrition of either two or three forms, such as acute and/or chronic undernutrition, micronutrient deficiencies, obesity, and diet-related diseases (including type II diabetes, cardiovascular diseases, and certain types of cancer) [...]

High-Prevalence Stunting in Preschool Children (1–5 Years) Attending Selected Health Centers in a Food Rich Area-Bushenyi District Southwestern Uganda

The prevalence of stunting among children in Uganda and Sub-Saharan Africa is still high, and if Uganda is to achieve the food-related Sustainable Development Goals (SDGs), it must urgently invest in improving nutrition and sanitation. In a food rich area like Bushenyi, chronic undernutrition could be due to several other factors than mere scarcity of food. The Objective(s). This study was carried out to determine the prevalence and socioclinical factors responsible for chronic undernutrition (stunting) among preschool children aged 1–5 years in selected Health facilities in Bushenyi district. Methodology. This was a cross-sectional study assessing the prevalence of stunting and its associated factors among children aged 1–5 years attending selected health centers in Bushenyi District. Data was collected using a pretested questionnaire, taking anthropometric measurements (height/length), and stool analysis for eggs of soil-transmitted helminthes. Prevalence of stunting was presented as percentages. Logistic regression with adjusted prevalence ratio was performed to test the association between the sociodemographic and clinical factors and stunting at bivariate levels of analysis. Results. Most of the children were female, with a median age of 2.1 years and resided in semiurban areas of Bushenyi with their parents. Prevalence of stunting was 89.3%. Only 10.7% of the children were infested with soil-transmitted helminthes. Children likely to be stunted were those who drank unboiled water and were exclusively breastfed. Conclusion. There is a high prevalence of chronic malnutrition in Bushenyi district associated with parents’/care takers’ low level of knowledge.

Neuroendocrine Basis for Disrupted Ovarian Cyclicity in Female Mice During Chronic Undernutrition

Chronic undernutrition is a type of metabolic stress that impairs reproduction in multiple species. Although energy balance and female reproductive capacity is recognized as tightly coupled, the neuroendocrine loci and molecular mechanisms that mediate ovarian cycle dysfunction during chronic undernutrition in adult females remain poorly understood. Here, we present a series of studies in which we tested the hypothesis that inhibition of kisspeptin (Kiss1) neurons, which are critical for controlling luteinizing hormone (LH) pulses and the preovulatory LH surge in females, underlies the impairment of the ovarian cycle by undernutrition. We first investigated the effect of chronic undernutrition (70% of unrestricted feed intake) on estrous cyclicity in intact female c57bl6 mice. Undernutrition caused a rapid cessation of ovarian cyclicity during the two-week treatment, suppressing ovarian steroidogenesis and inhibiting ovulation. Using two well-defined estradiol replacement paradigms, we directly tested the hypothesis that undernutrition inhibits Kiss1 neurons in the arcuate nucleus (ARC Kiss1) which are required for LH pulses and in the anteroventral periventricular nucleus (AVPV Kiss1) which are necessary for LH surge secretion. Undernutrition prevented LH pulses and impaired ARC Kiss1 neuronal activation, using c-Fos as a marker, in ovariectomized females subcutaneously implanted with a pellet containing a diestrus-like level of estradiol. In addition, undernutrition completely blocked the estradiol-induced LH surge and diminished Kiss1 mRNA abundance, without decreasing Erα, in micropunches of the AVPV. Collectively, these studies demonstrate that undernutrition disrupts ovarian cyclicity in females via impairment of both ARC Kiss1 control of LH pulses and AVPV Kiss1 induction of the LH surge.

Neuroendocrine Basis for Disrupted Ovarian Cyclicity in Females During Chronic Undernutrition: A Mouse Model

Chronic undernutrition is a type of metabolic stress that impairs reproduction across species and, in women, is implicated in the development of functional hypothalamic amenorrhea. Although the tight coupling of energy balance to reproductive capacity is recognized in principle, the neuroendocrine loci and molecular mechanisms that mediate ovarian cycle dysfunction during undernutrition remain poorly understood. Ovarian cyclicity is dependent on a population of kisspeptin (Kiss1) neurons in arcuate nucleus (ARCKiss1) for luteinizing hormone (LH) pulses and in the anteroventral periventricular nucleus (AVPVKiss1) for LH surge secretion. Here, we present a series of studies in which we tested the hypothesis that inhibition of both Kiss1 cell populations underlies the impairment of the cycle by undernutrition. During a baseline period, body weight, feed intake, and ovarian cycle stage (via vaginal cytology) were evaluated in female c57bl6 mice. Then, animals were randomly assigned into one of two groups (n=6-8/grp): 1) ad libitum fed controls or 2) feed restricted (70% of feed consumed during the baseline period). Control animals displayed clear and regular cycles throughout the 4-week treatment period. In contrast, feed restriction caused a significant and rapid cessation of ovarian cyclicity (4.8±0.3 vs. 1.5±0.5 estrus cycles/4 weeks; control vs. restricted, p&lt;0.05), causing all females to enter and remain mostly in diestrus. Based on these results, we conducted two experiments to directly test the hypothesis that undernutrition inhibits both modes of LH secretion (and both Kiss1 cell populations) using two well-defined estradiol (E) replacement paradigms. We first evaluated LH pulses in mice that were ovariectomized and implanted subcutaneously with a pellet containing a diestrus level of E (100 ng, OVX+LowE). Following 3 days of feed restriction or control diet (n=3/grp), serial blood samples were collected every 8 min for 88 min. Undernutrition prevented LH pulses and significantly reduced mean LH (5.2±0.6 vs. 0.6±0.2 ng/mL; control vs. restricted, p&lt;0.05). Fixed neural tissue was evaluated by immunohistochemistry to determine whether undernutrition impairs ARCKiss1 neuronal activation, using c-Fos as a marker. The percent of ARCKiss1 neurons expressing cFos was reduced by 90% (p&lt;0.05). We next evaluated the LH surge. After 3 days, control or feed restricted mice were OVX and implanted subcutaneously with a surge-inducing estradiol implant (OVX+HighE, 1 µg, n=3-4/grp). Undernutrition completely blocked the E-induced LH surge (1.9±0.3 vs. 0.2±0.02 ng/mL; control vs. restricted, p&lt;0.05) and diminished Kiss1 mRNA abundance in micropunches of the AVPV (42%, p&lt;0.05). Collectively, these studies clearly show that undernutrition impairs both ARCKiss1 control of LH pulses and AVPVKiss1 induction of the LH surge, via mechanisms that remain to be identified.

Pooled prevalence and associated factors of chronic undernutrition among under-five children in East Africa: A multilevel analysis

Background Childhood undernutrition is the leading cause of under-five mortality and morbidity in the world particularly in East African countries. Although there are studies on child undernutrition in different East African countries, our search of the literature revealed that there is limited evidence of a pooled analysis of these studies. Therefore, this study aimed to investigate the pooled prevalence and associated factors of chronic undernutrition (i.e. stunting) among under-five children in East Africa. Methods A pooled analysis of the Demographic and Health Surveys (DHSs) in 12 East African countries was conducted. A total weighted sample of 79744 under-five children was included in the study. Mixed-effect logistic regression analysis was used to identify significant factors associated with chronic undernutrition since the DHS data has a hierarchical structure. The intra-class correlation coefficient (ICC), Median Odds Ratio (MOR), Likelihood Ratio (LR)-test, and deviance was used for model comparison. Variables with p-value <0.2 in the bivariable mixed-effect logistic regression analysis were considered for the multivariable analysis. In the multivariable multilevel analysis model, the Adjusted Odds Ratio (AOR) with the 95% Confidence Interval (CI) were reported for significant factors. Results The pooled prevalence of chronic undernutrition among underfive children in East Africa was 33.3% (95% CI: 32.9%, 35.6%) ranging from 21.9% in Kenya to 53% in Burundi. Children whose mothers lived in rural area (AOR = 1.11, 95% CI: 1.06, 1.16), born to mother who had no formal education (AOR = 1.42, 95% CI: 1.34, 1.50) and primary education (AOR = 1.37, 95% CI: 1.31, 1.44), being in poor household (AOR = 1.66, 95% CI: 1.58, 1.74), and middle household (AOR = 1.42, 95% CI: 1.35, 1.49), child aged 36–48 months (AOR = 1.09, 95% CI: 1.04, 1.14), being male (AOR = 1.19, 95% CI: 1.15, 1.23), 2nd - 4th birth order (AOR = 1.08, 95% CI: 1.03, 1.13), and above 4th 1.27 (AOR = 1.27, 95% CI: 1.19, 1.35), home delivery 1.09 (AOR = 1.09, 95% CI: 1.05, 1.13), small size at birth (AOR = 1.35, 95% CI: 1.29, 1.40) and being multiple births (AOR = 1.98, 95% CI: 1.81, 2.17) were associated with increased odds of stunting. While, antenatal care visit (AOR = 0.89, 95% CI: 0.86, 0.93), mothers aged 25–34 (AOR = 0.83, 95% CI: 0.79, 0.86) and ≥ 35 years (AOR = 0.76, 95% CI: 0.72, 0.81), large size at birth (AOR = 0.85, 95% CI: 0.81, 0.88), and family size >8 (AOR = 0.92, 95% CI: 0.87, 0.98) were associated with decreased odds of stunting. Conclusion The study revealed that stunting among under-five children remains a major public health problem in East Africa. Therefore, to improve child nutrition status the governmental and non-governmental organizations should design public health interventions targeting rural residents, and the poorest households. Furthermore, enhancing health facility delivery, ANC visit, and maternal health education is vital for reducing child chronic undernutrition.

Inequality, chronic undernutrition, maternity, and diabetes mellitus as the determinant of anemia among ever-married women in Bangladesh

Background Anemia is a public health concern at a global level. This study aims to delineate the association between household economic inequalities, and anemia among reproductive age group women in Bangladesh, along with other confounders. Methods A cross-sectional population sample from Bangladesh Demographic and health survey data comprising of 5920 reproductive age group women aged between 15 and 49 years was used in this study. The analyses were performed through the application of proportional odds into four models (viz., Model:1 socio-economic, Model:2 socio-demographic factors, Model 3: diabetics and maternity statis, Model 4: nutritional status.) Results The respondents from low and medium socioeconomic status (SES) households vs. richest households were 1.90 (95% CI, 1.65,2.17; p < .01) and 1.41 (95% CI, 1.12,1.78; p < .01) times more likely to suffer from anemia (Model 1). From the model 2 it appears that he likelihood of being anemic reduces for the low and medium SES groups vs. high SES group when sociodemographic variables are added (OR, 1.69, 95% CI, 1.43,1.99 and OR, 1.35, 95% CI, .07,1.70; p < 0.01, respectively). Model 3 evident that after adding the variables of diabetes and maternity status, the association between having anemia belonging to low and medium SES vs. high SES becomes weaker (OR1.36, 95% CI,0.85,2.15 and OR, 1.15, 95% CI, 0.6,2.19; p > .05, respectively). Moreover, the strength of the association between anemia and the subjects with pregnant vs. the subjects without these (OR: 1.7 (1.12, 4.02; p < 0.05) 1.47(0.11,3.399; p < 0.05) conditions was reduced after factoring body mass index (BMI, model 4). Besides, thin women (MBI < 18.50 Kg/m2) shows significantly become more likely to be anemic in comparison to women of normal BMI (OR:1.34, .92,1.96; p < 0.05) (model 4). Conclusions BMI, pregnancy, and diabetes mellitus were observed to be significantly associated with anemia, and the strength of the association was low with anemia and socioeconomic inequality.

TB in Indian adolescents: results from a nationally representative survey, 2015–2016

SETTING: Adolescents (age: 15–19 years) from the National Family Health Survey-4 (2015–2016), India.OBJECTIVE: To examine the sociodemographic and nutritional characteristics of adolescents with reported TB and those with a reported household TB exposure.METHODS: This was a cross-sectional study using secondary data. We assessed the factors associated with TB (reported in adolescents, or in a household member) using log binomial regression. We used height-for-age and body mass index for age Z-scores for stunting and thinness, respectively.RESULTS: Of the total 277 059 adolescents, 377 (136/100 000, 95%CI 123–151) were reported with TB and this was similar in both sexes. Another 4528 adolescents (1.6%, 95%CI 1.6–1.7) reported household TB exposure. Poverty and urban residence were associated with higher prevalence of TB and household TB exposure. The proportion of stunting was 40.7% (95%CI 33.5–48.0) in adolescents with reported TB and 38.2% (95%CI 36.2–40.2) (P = 0.248) in those with household TB exposure.CONCLUSION: Prevalence of reported adolescent TB was lower than adult TB. Poverty and urban residence were risk factors for both TB and household TB exposure. Chronic undernutrition was highly prevalent among those reported to have TB and in those at risk of TB by virtue of having household TB exposure.