Determinants of infant growth in the slums of Dhaka: size and maturity at birth, breastfeeding and morbidity

Arifeen, Shams El; Re, Black; Caulfield, Laura E.; Antelman, Gretchen; Ah, Baqui

doi:10.1038/sj.ejcn.1601141

Cited by 36 publications

(30 citation statements)

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“…Households with low economic status are less likely to access adequate food, health care, and quality education, and are also prone to preventable illnesses like diarrhea which result from an unhygienic environment; all of these factors serve to increase the risk of undernutrition. This study found a lower risk of underweight and wasting among children of middle compared to lower economic status households, as also supported by other studies [23,45]. …”

Section: Discussionsupporting

confidence: 90%

Undernutrition among HIV-positive children in Dar es Salaam, Tanzania: antiretroviral therapy alone is not enough

et al. 2011

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BackgroundThe prevalence of HIV/AIDS has exacerbated the impact of childhood undernutrition in many developing countries, including Tanzania. Even with the provision of antiretroviral therapy, undernutrition among HIV-positive children remains a serious problem. Most studies to examine risk factors for undernutrition have been limited to the general population and ART-naive HIV-positive children, making it difficult to generalize findings to ART-treated HIV-positive children. The objectives of this study were thus to compare the proportions of undernutrition among ART-treated HIV-positive and HIV-negative children and to examine factors associated with undernutrition among ART-treated HIV-positive children in Dar es Salaam, Tanzania.MethodsFrom September to October 2010, we conducted a cross-sectional survey among 213 ART-treated HIV-positive and 202 HIV-negative children in Dar es Salaam, Tanzania. We measured the children's anthropometrics, socio-demographic factors, food security, dietary habits, diarrhea episodes, economic status, and HIV clinical stage. Data were analyzed using both univariate and multivariate methods.ResultsART-treated HIV-positive children had higher rates of undernutrition than their HIV-negative counterparts. Among the ART-treated HIV-positive children, 78 (36.6%) were stunted, 47 (22.1%) were underweight, and 29 (13.6%) were wasted. Households of ART-treated HIV-positive children exhibited lower economic status, lower levels of education, and higher percentages of unmarried caregivers with higher unemployment rates. Food insecurity was prevalent in over half of ART-treated HIV-positive children's households. Furthermore, ART-treated HIV-positive children were more likely to be orphaned, to be fed less frequently, and to have lower body weight at birth compared to HIV-negative children.In the multivariate analysis, child's HIV-positive status was associated with being underweight (AOR = 4.61, 95% CI 1.38-15.36 P = 0.013) and wasting (AOR = 9.62, 95% CI 1.72-54.02, P = 0.010) but not with stunting (AOR = 0.68, 95% CI 0.26-1.77, P = 0.428). Important factors associated with underweight status among ART-treated HIV-positive children included hunger (AOR = 9.90, P = 0.022), feeding frequency (AOR = 0.02, p < 0.001), and low birth weight (AOR = 5.13, P = 0.039). Factors associated with wasting among ART-treated HIV-positive children were diarrhea (AOR = 22.49, P = 0.001) and feeding frequency (AOR = 0.03, p < 0.001).ConclusionHIV/AIDS is associated with an increased burden of child underweight status and wasting, even among ART-treated children, in Dar es Salaam, Tanzania. In addition to increasing coverage of ART among HIV-positive children, interventions to ameliorate poor nutrition status may be necessary in this and similar settings. Such interventions should aim at promoting adequate feeding patterns, as well as preventing and treating diarrhea.

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Section: Discussionsupporting

confidence: 90%

Undernutrition among HIV-positive children in Dar es Salaam, Tanzania: antiretroviral therapy alone is not enough

et al. 2011

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“…Os resultados deste estudo indicam que as crianças cujas mães tinham estatura < 150 cm apresentaram estimativas negativas na média do índice comprimento/idade em escore Z, quando comparadas com aquelas crianças cujas mães tinham maior altura, corroborando achados de outros autores 20 . A altura materna tem se mostrado fortemente associada com o crescimento da criança, indicando possivelmente a influência da herança genética.…”

Section: Discussionunclassified

Predictors of linear growth in the first year of life of a prospective cohort of full term children with normal birth weight

Queiroz¹,

Assis²,

Pinheiro³

et al. 2012

J Pediatr (Rio J)

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Objective: To investigate covariates that could affect the variation in mean length/age z scores in the first year of life of children born full term with normal birth weight. Methods:This was a prospective study of a cohort of mother-infant pairs recruited at public maternity units in two municipalities in the Brazilian state of Bahia, from March 2005 to October 2006. This paper reports the results for linear growth of 489 children who were followedup for the first 12 months of their lives. A mixed-effect regression model was used to investigate the influence of covariates of mean length/age z score during the first year of life. Results:The multivariate mixed effect analysis indicated that mothers not cohabiting with a partner (β = 0.2347; p = 0.004) and increased duration of exclusive breastfeeding (β = 0.0031; p < 0.001) had a positive impact, whereas mother's height less than 150 cm (β = -0.4393; p < 0.001), birth weight of 2,500-2,999 g (β = -0.8084; p < 0.001) and anemia in the child (β = -0.0875; p < 0.001) all had a negative impact on the variation in estimated length/age z score.Conclusions: Therefore, the results of this study indicate that short maternal stature, birth weight < 3,000 g and anemia in the infant had a negative effect on linear growth during the first year of life, whereas longer duration exclusive breastfeeding and mothers who did not cohabit with a partner had a positive effect.J Pediatr (Rio J). 2012;88(1):79-86: Infant growth, predictors, mixed effect models, cohort study. ResumoObjetivo: Investigar covariáveis que possam interferir na variação da média do índice comprimento/idade em escore Z no primeiro ano de vida de crianças nascidas a termo com peso adequado.Métodos: Trata-se de um estudo de coorte prospectivo, envolvendo pares de mães e crianças recrutadas nas maternidades públicas de dois municípios do estado da Bahia, entre março de 2005 e outubro de 2006. Neste estudo, apresentam-se os resultados para o crescimento linear de 489 crianças acompanhadas durante os primeiros 12 meses de vida. O modelo de efeitos mistos foi utilizado para explorar a influência de covariáveis na média do índice comprimento/idade em escore Z no primeiro ano de vida.Resultados: Na análise múltipla de efeito misto, observou-se que ausência de coabitação materna com companheiro (β = 0,2347; p = 0,004) e maior tempo de aleitamento materno exclusivo (β = 0,0031; p < 0,001) contribuíram positivamente, enquanto a altura materna menor do que 150 cm (β = -0,4393; p < 0,001), peso ao nascer entre 2.500-2.999 g (β = -0,8084; p < 0,001) e a anemia na criança (β = -0,0875; p < 0,001) contribuíram de forma negativa na variação das estimativas do índice comprimento/idade em escore Z.Conclusões: Assim, os resultados deste estudo indicam que a baixa estatura materna, o peso de nascimento < 3.000 g e a anemia influenciaram negativamente o crescimento linear no primeiro ano de vida, enquanto a maior duração do aleitamento materno exclusivo e a ausência de coabitação materna com companheiro exerceram influênci...

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“…Thus a deficient environment is associated with current and ongoing exposure to nutritional deficiencies, resulting in inadequate gains in stature and body weight. Parental height has been shown to be negatively associated with a stunting among children (22,(37)(38)(39) . Results on maternal education and household wealth and child nutrition are congruent with those of other studies (10,22,40) .…”

Section: Discussionmentioning

confidence: 99%

“…Parental height has been shown to be negatively associated with a stunting among children (22,(37)(38)(39) . Results on maternal education and household wealth and child nutrition are congruent with those of other studies (10,22,40) . Maternal education and household wealth are associated with multiple positive factors including increased access to food and health-care resources (41) .…”

Section: Discussionmentioning

confidence: 99%

“…Low-birth-weight (LBW) children experience smaller increments in height and weight and remain shorter and lighter with a higher percentage being stunted, underweight or wasted (22)(23)(24)(25) . This is especially true for LBW children born and raised in poor environments characterized by low socio-economic status, poor maternal nutritional status and high morbidity risk, and inhibits length and weight gains among LBW infants (26) .…”

Section: Discussionmentioning

confidence: 99%

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Undernutrition among Kenyan children: contribution of child, maternal and household factors

Gewa

Yandell

2011

Public Health Nutr.

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Objective: To examine the contribution of selected child-, maternal-and householdrelated factors to child undernutrition across two different age groups of Kenyan under-5s. Design: Demographic and Health Survey data, multistage stratified cluster sampling methodology. Setting: Rural and urban areas of Kenya. Subjects: A total of 1851 children between the ages of 0 and 24 months and 1942 children between the ages of 25 and 59 months in Kenya. Results: Thirty per cent of the younger children were stunted, 13 % were underweight and 8 % were wasted. Forty per cent of the older children were stunted, 17 % were underweight and 4 % were wasted. Longer breast-feeding duration, small birth size, childhood diarrhoea and/or cough, poor maternal nutritional status and urban residence were associated with higher odds of at least one form of undernutrition, while female gender, large birth size, up-to-date immunization, higher maternal age at first birth, BMI and education level at the time of the survey and higher household wealth were each associated with lower odds of at least one form of undernutrition among Kenyan children. The more proximal child factors had the strongest impact on the younger group of children while the intermediate and more distal maternal and household factors had the strongest impact on child undernutrition among the older group of children. Conclusions: The present analysis identifies determinants of undernutrition among two age groups of Kenyan pre-school children and demonstrates that the contribution of child, maternal and household factors on children's nutritional status varies with children's age.

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Determinants of infant growth in the slums of Dhaka: size and maturity at birth, breastfeeding and morbidity

Cited by 36 publications

References 45 publications

Undernutrition among HIV-positive children in Dar es Salaam, Tanzania: antiretroviral therapy alone is not enough

Undernutrition among HIV-positive children in Dar es Salaam, Tanzania: antiretroviral therapy alone is not enough

Predictors of linear growth in the first year of life of a prospective cohort of full term children with normal birth weight

Undernutrition among Kenyan children: contribution of child, maternal and household factors

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