CLINICAL PREDICTORS OF GROWTH FALTERING AND NUTRITIONAL DEFICIENCIES IN CHILDREN UNDER FIVE YEARS. A CROSS-SECTIONAL CLINICAL STUDY
DOI:
https://doi.org/10.53350/Annalspakmed.1.8.23Keywords:
Growth, Malnutrition, Stunting, Infection, Nutrition, PediatricAbstract
Background: Growth faltering and nutritional deficiencies are still playing significant roles in childhood morbidity in developing countries. Timely detection of clinical predictors is important towards avoiding long-term physical and developmental disability in children below the age of five years.
Objectives: To identify clinical predictors of growth faltering and nutritional deficiency in children below the age of five years, who report to a tertiary care hospital.
Methods: 160 children of the age 659 months were reviewed in the cross-sectional clinical study. A structured questionnaire was used to record demographic features, feeding behaviors, socioeconomic status, frequent infections, immunization history, and medical conditions to collect data. Anthropometry was done according to the WHO standards encompassing weight, height/length, and MUAC. When necessary, laboratory tests comprised of hemoglobin and ferritin, vitamin D, and zinc concentrations. Chi-square tests and logistic regression were used as the statistical analysis with the level of significance of p < 0.05.
Results: 46.9 percent of the children had growth faltering with most of the abnormalities being stunting (27.5 percent). Nutritional deficiencies were revealed 58.1, iron deficiency anemia (36.2) and vitamin D deficiency (26.2) were the most common. Recurrent diarrhea (p = 0.001), recurrence respiratory infections (p = 0.002), poor dietary intake (p < 0.001), low birth weight (p = 0.004) and incomplete immunization (p = 0.001) were significant predictors of growth faltering.
Conclusion: Nutritional and infectious factors play a major role in the growth faltering of young children, which is complicated by socioeconomic issues. Preventive measures and remedial actions should be integrated through early detection, better feeding habits, better immunization coverage, and promotion of healthy growth during early childhood to reduce malnutrition.
References
1. Black RE, Victora CG, Walker SP, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet. 2016;387(10017):427-451. doi:10.1016/S0140-6736(15)01736-7
2. Akhtar S. Malnutrition in South Asia: magnitude, causes, and potential solutions. J Health Popul Nutr. 2016;35(1):113-120. doi:10.1186/s41043-016-0045-5
3. Khan GN, Turab A, Khan MI, et al. Feeding practices and nutritional status of children under 5 years in Pakistan. BMC Nutr. 2017;3:15. doi:10.1186/s40795-017-0137-4
4. Keats EC, Haider BA, Tam E, Bhutta ZA. Multiple micronutrient supplementation in children. Am J Clin Nutr. 2015;101(1):110-124. doi:10.3945/ajcn.114.090928
5. Islam MM, Sanin KI, Mahfuz M, et al. Risk factors of stunting among children. Public Health Nutr. 2018;21(14):2494-2503. doi:10.1017/S136898001800108X
6. Kumar P, Singh M. Vitamin D deficiency in children. Indian J Pediatr. 2017;84(6):444-453. doi:10.1007/s12098-017-2297-0
7. Baig-Ansari N, Rahbar MH, Bhutta ZA, Badruddin SH. Prevalence of anemia and micronutrient deficiency. Food Nutr Bull. 2017;38(2):179-185. doi:10.1177/0379572117701747
8. Ahmed T, Hossain M, Sanin KI. Global burden of malnutrition. Curr Opin Pediatr. 2019;31(5):725-733. doi:10.1097/MOP.0000000000000790
9. Prendergast AJ, Humphrey JH. The stunting syndrome in developing countries. Matern Child Nutr. 2014;10(4):515-526. doi:10.1111/mcn.12109
10. Chisti MJ, Salam MA, Ashraf H, et al. Predictors of severe malnutrition. J Health Popul Nutr. 2015;33(1):22-31. doi:10.1186/s41043-015-0022-6
11. Bhutta ZA, Das JK. Interventions to address maternal and childhood malnutrition. BMJ. 2015;351:h2603. doi:10.1136/bmj.h2603
12. Yakoob MY, Lo CW. Low birthweight and childhood outcomes. Glob Health Action. 2017;10(1):1323-1331. doi:10.1080/16549716.2017.1328892
13. Imdad A, Mayo-Wilson E, Herzer K, Bhutta ZA. Vitamin A supplementation. Cochrane Database Syst Rev. 2017;3:CD008524. doi:10.1002/14651858.CD008524.pub3
14. Dewey KG, Chaparro CM. Early child growth failure. Food Nutr Bull. 2015;36(1):S15-S23. doi:10.1177/15648265150361S103
15. Gebremedhin S. Prevalence and predictors of undernutrition. BMC Public Health. 2015;15:1012. doi:10.1186/s12889-015-2412-1
16. Kinyoki DK, Osgood-Zimmerman AE, Bhattacharjee NV, et al. Spatial distribution of child malnutrition in LMICs. Lancet Glob Health. 2020;8(4):e601-e616. doi:10.1016/S2214-109X(20)30022-0
17. UNICEF. State of the World’s Children: Nutrition. 2020.
18. WHO. Early childhood stunting and wasting. 2021.
19. Rahman S, Ali A, Sheikh N. Determinants of malnutrition in children in Pakistan. J Pak Med Assoc. 2018;68(6):864-869.
20. Tariq J, Sajjad A, Zakar R, Zakar MZ, Fischer F. Factors associated with undernutrition. PLoS One. 2018;13(10):e0205212. doi:10.1371/journal.pone.0205212
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