Epidemiology of Malnutrition among Children with Cerebral Palsy in Low- and Middle-Income Countries: Findings from the Global LMIC CP Register

Jahan, Israt; Muhit, Mohammad; Hardianto, Denny; Laryea, Francis; Amponsah, Samuel Kofi; Chhetri, Amir Banjara; Smithers‐Sheedy, Hayley; McIntyre, Sarah; Badawi, Nadia; Khandaker, Gulam

doi:10.3390/nu13113676

Cited by 26 publications

(46 citation statements)

References 31 publications

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“…Such an evidence gap from LMICs where the majority of children with CP reside is concerning [ 11 ]. Considering the high burden of malnourished children with CP in LMICs [ 1 , 2 , 3 , 4 , 5 , 8 , 9 ], there is a dire need to reduce this evidence gap, and integration of nutrition interventions in the existing service plan for children with CP is essential.…”

Section: Discussionmentioning

confidence: 99%

“…Undernutrition is a major global public health challenge, and children with disability, such as cerebral palsy (CP), often suffer from undernutrition, especially in low- and middle-income countries (LMICs). The proportion of malnutrition is substantially higher among children with CP in LMICs compared to the general population [ 1 , 2 , 3 , 4 , 5 ]. Ensuring availability and accessibility to evidence-based nutrition interventions is essential to avert adverse outcomes of malnutrition among those vulnerable children [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…Nutritional management of children with CP is complex as several interlinked factors interfere with their growth directly and indirectly [ 7 ]. While a few factors have been identified as common predictors of malnutrition (e.g., gross motor and oromotor function limitations) [ 1 , 8 , 9 ], the conceptual framework of malnutrition in children with CP is not yet clearly understood, especially in LMICs. To date, several clinical nutrition guidelines based on current evidence on surgical and non-surgical intervention outcomes have been published [ 6 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

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Nutrition Interventions for Children with Cerebral Palsy in Low- and Middle-Income Countries: A Scoping Review

et al. 2022

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Background: Malnutrition is substantially higher among children with cerebral palsy (CP) in low- and middle-income countries (LMICs) when compared with the general population. Access to appropriate interventions is crucial for better management of malnutrition and nutritional outcomes of those children. We aimed to review the existing evidence on nutrition interventions for children with CP in LMICs. Methods: Online databases, i.e., PubMed and Scopus, and Google Scholar were searched up to 10 January 2022, to identify peer-reviewed publications/evidence on LMIC focused nutritional management guidelines/interventions. Following title screening and abstract review, full articles that met the inclusion/exclusion criteria were retained for data charting. Information about the study characteristics, nutrition interventions, and their effectiveness were extracted. Descriptive data were reported. Results: Eight articles published between 2008 and 2019 were included with data from a total of n = 252 children with CP (age range: 1 y 0 m–18 y 7 m, 42% female). Five studies followed experimental design; n = 6 were conducted in hospital/clinic/center-based settings. Four studies focused on parental/caregiver training; n = 2 studies had surgical interventions (i.e., gastrostomy) and n = 1 provided neurodevelopmental therapy feeding intervention. Dietary modification as an intervention (or component) was reported in n = 5 studies and had better effect on the nutritional outcomes of children with CP compared to interventions focused on feeding skills or other behavioral modifications. Surgical interventions improved nutritional outcomes in both studies; however, none documented any adverse consequences of the surgical interventions. Conclusion: There is a substantial knowledge gap on nutrition interventions for children with CP in LMICs. This hinders the development of best practice guidelines for the nutritional management of children with CP in those settings. Findings suggest interventions directly related to growth/feeding of children had a better outcome than behavioral interventions. This should be considered in planning of nutrition-focused intervention or comprehensive services for children with CP in LMICs.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Nutrition Interventions for Children with Cerebral Palsy in Low- and Middle-Income Countries: A Scoping Review

et al. 2022

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“…Further, approximately one-half of all childhood deaths globally are caused directly or indirectly by malnutrition [6]. Various malnutrition diseases, including undernutritionand overnutrition-related disorders, are highly prevalent among children and adolescents in many countries [7,8]. For example, vitamin A deficiency (VAD) remains a public health problem in China, where the prevalence of VAD in children was 5.16% in 2015 [9].…”

Section: Introductionmentioning

confidence: 99%

Multilevel Analysis of the Nutritional and Health Status among Children and Adolescents in Eastern China

et al. 2022

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We aimed to identify multiple nutritional health problems and the relevant factors among children and adolescents aged 7–17 years. This study was part of the China Nutrition and Health Surveillance of Children and Lactating Mothers in 2016–2017, conducted in Jiangsu Province in eastern China. After sampling, 3025 school-age children and adolescents were enrolled into this study. Demographic information collections and anthropometric measurements were conducted by trained local Center for Disease Control and Prevention (CDC) staff. Venous blood in the amount of 6 mL was drawn from each participant in the morning and used for testing biochemical and nutritional indicators. Multivariate logistic regression analysis and Poisson regression analysis were used for overnutrition- and undernutrition-related disorders to test relevant personal, parental, and household factors. The prevalence of wasting, overweight, and obesity was 5.5%, 14.8%, and 12.7%, respectively. Metabolic syndrome (MetS) was prevalent among 5.1% of participants. Among the study participants, 29.5% had hyperuricemia. The overall prevalence of high low-density lipoprotein (LDL) and high total cholesterol (TC) of all participants was 4.8% and 7.4%, respectively. 0.9% of the participants had vitamin A deficiency (VAD) and 14.6% had marginal vitamin A deficiency; 25.1% had vitamin D deficiency (VDD) and 54.5% had inadequate vitamin D levels. Anemia was present in 4.0% of all participants. The prevalence of zinc deficiency was 4.8%. Demographic characteristics, behavioral characteristics, parents’ characteristics, and family characteristics were associated with these multiple malnutrition disorders. The double burdens of malnutrition, which includes overnutrition- and undernutrition-related diseases, were prevalent among the school-age children and adolescents in Jiangsu Province in eastern China. There were various factors related to different nutritional problems. Thus, health education focusing on behavior intervention and nutrition education are necessary in containing nutritional problems among children.

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“…Stunting has a long-term effect, and there is little room for catch-up development [ 12 ]. When considered on a national basis, these inequalities produced by stunting can result in lower school outcomes, and years on average in school, and harm a country’s development and growth [ 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

The uptake of key Essential Nutrition Action (ENA) messages and its predictors among mothers of children aged 6–24 months in Southern Ethiopia, 2021: A community-based crossectional study

Habte¹,

Gizachew²,

Ejajo³

et al. 2022

PLoS ONE

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Background Essential nutrition action(ENA) is a framework for managing advocacy, establishing a foundation, and implementing a comprehensive package of preventive nutritional activities. Essential Nutrition Actions study studies provide current information on each nutrition action, allowing health systems to focus more on nutrition, which is critical in tackling the "double burden" of malnutrition: underweight and overweight. Hence, this study aimed at assessing the level of ENA practice and its predictors among mothers of children aged 6 to 24 months in southern Ethiopia. Methods A community-based cross-sectional study was conducted from May 1 to 30, 2021 among randomly selected 633 mothers of children aged 6–24 months. A multi-stage sampling technique was used to access study participants. Data were collected by using a pretested, structured interviewer-administered questionnaire. To identify predictors of ENA practice, bivariable and multivariable logistic regression were used. The strength of the association was measured using an adjusted odds ratio with 95 percent confidence intervals. The statistical significance was declared at a p-value less than 0.05. Results A total of 624 participants took part in the study, with a response rate of 98.6%. The uptake of key ENA messages among mothers was measured using 27 items, and it was found to be 47.4% (95% CI: 43.8, 51.4). Complementary feeding was the commonest ENA message practiced by 66.7% of respondents, while prevention of iodine deficiency disorder was practiced by only 33.7% of respondents. Variables namely, mother’s education level of college and above [AOR: 3.90, 95% CI: 1.79, 8.51], institutional delivery [AOR: 2.75, 95% CI: 1.17,6.49], having PNC service [AOR: 2.95, 95% CI: 1.91, 4.57], being knowledgeable on ENA message [AOR: 2.37, 95% CI: 1.81, 3.26] and being a model household [AOR: 3.83,95% CI: 2.58, 5.69] were positively associated with a good uptake of key ENA messages. On the other hand, primiparity [AOR: 0.32, 95% CI: 0.21,0.56] was identified as a negative predictor. Conclusion The overall practice of key Essential nutrition action messages in the study area was low as compared to studies. Stakeholders must step up their efforts to improve and hasten the utilization of maternal and child health services, especially institutional delivery and Postnatal care by focusing on uneducated women to promote compliance to key ENA messages. Furthermore, health workers need to focus on awareness-raising and model household creation.

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Epidemiology of Malnutrition among Children with Cerebral Palsy in Low- and Middle-Income Countries: Findings from the Global LMIC CP Register

Cited by 26 publications

References 31 publications

Nutrition Interventions for Children with Cerebral Palsy in Low- and Middle-Income Countries: A Scoping Review

Nutrition Interventions for Children with Cerebral Palsy in Low- and Middle-Income Countries: A Scoping Review

Multilevel Analysis of the Nutritional and Health Status among Children and Adolescents in Eastern China

The uptake of key Essential Nutrition Action (ENA) messages and its predictors among mothers of children aged 6–24 months in Southern Ethiopia, 2021: A community-based crossectional study

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