期刊论文详细信息
BMC Pediatrics
Factors affecting malnutrition in children and the uptake of interventions to prevent the condition
Edmund T. Nartey2  Eric K. Sifah1  Edem M. A. Tette1 
[1]Princess Marie Louis Children’s Hospital (PML), Accra, Ghana
[2]World Health Organisation Collaborating Centre for Advocacy and Training in Pharmacovigilance, Centre for Tropical Clinical Pharmacology & Therapeutics, School of Medicine and Dentistry, University of Ghana, Accra, Ghana
关键词: Interventions;    Risk factors;    Diarrhoea;    Prevention;    Children;    Malnutrition;   
Others  :  1234518
DOI  :  10.1186/s12887-015-0496-3
 received in 2015-04-30, accepted in 2015-10-23,  发布年份 2015
PDF
【 摘 要 】

Background

Malnutrition is a major cause of child morbidity and mortality. There are several interventions to prevent the condition but it is unclear how well they are taken up by both malnourished and well nourished children and their mothers and the extent to which this is influenced by socio-economic factors. We examined socio-economic factors, health outcomes and the uptake of interventions to prevent malnutrition by mothers of malnourished and well-nourished in under-fives attending Princess Marie Louise Children's Hospital (PML).

Methods

An unmatched case control study of malnourished and well-nourished children and their mothers was conducted at PML, the largest facility for managing malnutrition in Ghanaian children. Malnourished children with moderate and severe acute malnutrition were recruited and compared with a group of well-nourished children attending the hospital. Weight-for-height was used to classify nutritional status. Record forms and a semi-structured questionnaire were used for data collection, which was analysed with Stata 11.0 software.

Results

In all, 182 malnourished and 189 well-nourished children and their mothers/carers participated in the study. Children aged 6–12 months old formed more than half of the malnourished children. The socio-demographic factors associated with malnutrition in the multivariate analysis were age ≤24 months and a monthly family income of ≤200 GH Cedis. Whereas among the health outcomes, low birth weight, an episode of diarrhoea and the presence of developmental delay were associated with malnutrition. Among the interventions, inadequate antenatal visits, faltering growth and not de-worming one's child were associated with malnutrition in the multivariate analysis. Immunisation and Vitamin A supplementation were not associated with malnutrition. Missed opportunities for intervention were encountered.

Conclusion

Poverty remains an important underlying cause of malnutrition in children attending Princess Marie Louise Children’s Hospital. Specific and targeted interventions are needed to address this and must include efforts to prevent low birthweight and diarrhoea, and reduce health inequalities. Regular antenatal clinic attendance, de-worming of children and growth monitoring should also be encouraged. However, further studies are needed on the timing and use of information on growth faltering to prevent severe forms of malnutrition.

【 授权许可】

   
2015 Tette et al.

【 预 览 】
附件列表
Files Size Format View
20151202023334510.pdf 444KB PDF download
【 参考文献 】
  • [1]Muller O, Krawinkel M. Malnutrition and health in developing countries. CMAJ. 2005; 173(3):279-286.
  • [2]Black RE, Morris SS, Bryce J. Where and why are 10 million children dying every year? Lancet. 2003; 361(9376):2226-2234.
  • [3]Black RE, Allen LH, Bhutta ZA, Caulfield LE, de Onis M, Ezzati M et al.. Maternal and child undernutrition: global and regional exposures and health consequences. Lancet. 2008; 371(9608):243-260.
  • [4]Caulfield LE, de Onis M, Blossner M, Black RE. Undernutrition as an underlying cause of child deaths associated with diarrhea, pneumonia, malaria, and measles. Am J Clin Nutr. 2004; 80(1):193-198.
  • [5]Estimates TWBJCM: Levels & Trends in Child Malnutrition. WHO, Geneva; 2013.
  • [6]Rikimaru T, Yartey JE, Taniguchi K, Kennedy DO, Nkrumah FK. Risk factors for the prevalence of malnutrition among urban children in Ghana. J Nutr Sci Vitaminol (Tokyo). 1998; 44(3):391-407.
  • [7]Ighogboja SI. Some factors contributing to protein-energy malnutrition in the middle belt of Nigeria. East Afr Med J. 1992; 69(10):566-571.
  • [8]Tomkins A, Watson F: Malnutrition and Infection; A review. In: UN ACC/SCN. vol. Nutrition policy discussion paper. Geneva: Administrative committee on coordination-subcommittee on nutrition; 1989. http://www. unscn.org/layout/modules/resources/files/Policy_paper_No_5.pdf webcite
  • [9]Grantham-McGregor S, Cheung YB, Cueto S, Glewwe P, Richter L, Strupp B. Developmental potential in the first 5 years for children in developing countries. Lancet. 2007; 369(9555):60-70.
  • [10]Forero-Ramirez N, Gamboa LF, Bedi A, Sparrow R. Child malnutrition and prenatal care: evidence from three Latin American countries. Revista panamericana de salud publica =Pan American journal of public health. 2014; 35(3):163-171.
  • [11]Bhutta ZA, Das JK, Rizvi A, Gaffey MF, Walker N, Horton S et al.. Evidence-based interventions for improvement of maternal and child nutrition: what can be done and at what cost? Lancet. 2013; 382(9890):452-477.
  • [12]Annual Report of the Reproductive and Child Health and Family Health Division. Ghana Health Service, Accra; 2007.
  • [13]Lartey A. Maternal and child nutrition in Sub-Saharan Africa: challenges and interventions. Proc Nutr Soc. 2008; 67(1):105-108.
  • [14]Bhutta ZA, Ahmed T, Black RE, Cousens S, Dewey K, Giugliani E et al.. What works? Interventions for maternal and child undernutrition and survival. Lancet. 2008; 371(9610):417-440.
  • [15]Santosh Kumar A, Sunil Kumar D, Ashok NC, Ragavendraswamy Koppad R. Protein energy malnutrition and its association with immunization status and common morbidities among 1–5 year aged children in southern part of India, Mysore. Int J Curr Res Rev. 2013; 5(2):105-110.
  • [16]Brantuo MNA, Okwabi W, Adu-Afuawuah S, Agyepong E, Attafuah NT, Brew G et al.. Landscape analysis of readiness to accelerate the reduction of maternal and child undernutrition in Ghana. SCN News. 2009; 37(1564–3743):31-7.
  • [17]Ghana Health Service: Child Health Policy. MOH: Under Five’s Child Health Policy 2007-2015. In. Accra: Ghana Health Service; 2008.
  • [18]UNICEF: Underlying causes of undernutrition: Food insecurity. Food insecurity. In. Geneva: UNICEF.UNICEF: Underlying causes of undernutrition: Food insecurity. In. Geneva: UNICEF. http://www. unicef.org/nutrition/training/2.5/9.html webcite
  • [19]Interim National Guidelines for Community-Based Management of Severe Acute Malnutrition in Ghana. Ghana Health Service, Ghana; 2010.
  • [20]WHO child growth standards and the identification of severe acute malnutrition in infants and children; A Joint Statement. WHO, Geneva; 2009.
  • [21]Onis M, Blössner M. Global Database on Child Growth and Malnutrition. Programme of Nutrition. WHO, Geneva; 1997.
  • [22]UNHCR: MUAC and WFH z-score as indicators of severe acute malnutrition: a consultation of operational agencies and academic specialists to understand the evidence, identify knowledge gaps and to inform operational guidance. In. Geneva: ENN; 2012. http://www. cmamforum.org/Pool/Resources/MUACWFH-Report-ENN-2013.pdf webcite
  • [23]Ubesie AC, Ibeziako NS, Ndiokwelu CI, Uzoka CM, Nwafor CA. Under-five protein energy malnutrition admitted at the University of Nigeria Teaching Hospital, Enugu: a 10 year retrospective review. Nutr J. 2012; 11:43. BioMed Central Full Text
  • [24]Bryce J, Coitinho D, Darnton-Hill I, Pelletier D, Pinstrup-Andersen P. Maternal and child undernutrition: effective action at national level. Lancet. 2008; 371(9611):510-526.
  • [25]Scaling Up Nutrition: A Framework for Action. http://scalingupnutrition. org/wp-content/uploads/2013/05/SUN_Framework.pdf webcite
  • [26]Hong R. Effect of economic inequality on chronic childhood undernutrition in Ghana. Public Health Nutr. 2007; 10(4):371-378.
  • [27]Owoaje E, Onifade O, Desmennu A. Family and socioeconomic risk factors for undernutrition among children aged 6 to 23 Months in Ibadan, Nigeria. Pan Afr Med J. 2014; 17:161.
  • [28]Bain LE, Awah PK, Geraldine N, Kindong NP, Sigal Y, Bernard N et al.. Malnutrition in Sub-Saharan Africa: burden, causes and prospects. Pan Afr Med J. 2013; 15:120.
  • [29]von Braun J. Food insecurity, hunger and malnutrition: necessary policy and technology changes. N Biotechnol. 2010; 27(5):449-452.
  • [30]Ruel MT, Alderman H. Nutrition-sensitive interventions and programmes: how can they help to accelerate progress in improving maternal and child nutrition? Lancet. 2013; 382(9891):536-551.
  • [31]Mucha N. Preventing Moderate Acute Malnutrition (MAM) Through Nutrition-Sensitive Interventions. CMAM Forum Technical Brief. 2014.
  • [32]Langendorf C, Roederer T, de Pee S, Brown D, Doyon S, Mamaty AA et al.. Preventing acute malnutrition among young children in crises: a prospective intervention study in Niger. PLoS Med. 2014; 11(9): Article ID e1001714
  • [33]Maleta K, Virtanen SM, Espo M, Kulmala T, Ashorn P. Childhood malnutrition and its predictors in rural Malawi. Paediatr Perinat Epidemiol. 2003; 17(4):384-390.
  • [34]Dreyer BP. Early childhood stimulation in the developing and developed world: if not now, when? Pediatrics. 2011; 127(5):975.
  • [35]Engle PL, Black MM, Behrman JR, Cabral de Mello M, Gertler PJ, Kapiriri L et al.. Strategies to avoid the loss of developmental potential in more than 200 million children in the developing world. Lancet. 2007; 369(9557):229-242.
  • [36]Crenshaw JT. Healthy birth practice #6: keep mother and baby together- It's best for mother, baby, and breastfeeding. J Perinat Educ. 2014; 23(4):211-217.
  • [37]Aguayo VM, Roley JA, Malanzele J, Meershoek SP. Opportunities for improving the quality of nutritional services in the national health system in Mozambique: findings from Manica Province. J Trop Pediatr. 2004; 50(5):314-318.
  • [38]Hampshire RD, Aguayo VM, Harouna H, Roley JA, Tarini A, Baker SK. Delivery of nutrition services in health systems in sub-Saharan Africa: opportunities in Burkina Faso, Mozambique and Niger. Public Health Nutr. 2004; 7(8):1047-1053.
  • [39]Antwi S. Malnutrition: missed opportunities for diagnosis. Ghana Med J. 2008; 42(3):101-104.
  文献评价指标  
  下载次数:6次 浏览次数:13次