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Modjadji, Perpetua, and Mpinane Pitso. "Maternal Tobacco and Alcohol Use in Relation to Child Malnutrition in Gauteng, South Africa: A Retrospective Analysis." Children 8, no. 2 (February 11, 2021): 133. http://dx.doi.org/10.3390/children8020133.
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Tobacco and alcohol use among mothers is associated with numerous adverse consequences for affected offspring, including poor growth and development. This study determined the association between maternal tobacco and alcohol use, and malnutrition, among infants aged ≤ 12 months (n = 300), in selected health facilities situated in Gauteng, South Africa. Data on alcohol and tobacco use were collected using a validated questionnaire, in addition to mothers’ socio-demographic characteristics and obstetric history. Stunting (low height/length-for-age), underweight (low weight-for-age) and thinness (low body mass index-for-age) were calculated using z-scores based on the World Health Organization child growth standards. The association of tobacco and alcohol use with stunting, underweight and thinness was analysed using logistic regression analysis. The results showed a mean age of 29 years (24.0; 35.0) for mothers and 7.6 ± 3 months for infants, and over half of the mothers were unemployed (63%). Approximately 18.7% of mothers had used tobacco and 3% had used alcohol during pregnancy. The prevalence of current tobacco and alcohol use among mothers were estimated at 14.3% and 49.7%, respectively, and almost three-quarters (67.3%) of them were still breastfeeding during the study period. Stunting (55%) was the most prevalent malnutrition indicator among infants, while underweight was 41.7%, and thinness was 22%. Current tobacco use was associated with increased odds of being thin [OR = 2.40, 95% CI: 1.09–5.45), and after adjusting for confounders, current alcohol use was associated with the likelihood of being underweight [AOR = 1.96, 95% CI: 1.06–3.63] among infants. Future prospective cohort studies that examine growth patterns among infants who are exposed to maternal tobacco and alcohol use from the intrauterine life to infancy are necessary to inform, partly, the public health programmes, to reduce malnutrition among children.
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Smuts, C. Marius, A. J. Spinnler Benadé, Jacques Berger, Le Thi Hop, Guillermo López de Romaña, Juliawati Untoro, Elvina Karyadi, Jürgen Erhardt, and Rainer Gross. "Iris I: A Foodlet-Based Multiple-Micronutrient Intervention in 6- to 12-Month-Old Infants at High Risk of Micronutrient Malnutrition in Four Contrasting Populations: Description of a Multicenter Field Trial." Food and Nutrition Bulletin 24, no. 3_suppl_1 (January 2003): S27—S33. http://dx.doi.org/10.1177/15648265030243s105.
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Infants in developing countries are at risk of concurrent micronutrient deficiencies, because the same causative factors may lead to deficiencies of different micronutrients. Inadequate dietary intake is considered one of the major causes of micronutrient deficiencies, especially among poor and underprivileged children in developing countries. Operational strategies and distribution systems are often duplicated when supplementation programs for single micronutrients are implemented at the same time. The International Research on Infant Supplementation (IRIS) trial was conducted in four distinct populations on three continents: Africa, Latin America, and Asia. The participating countries were South Africa, Peru, Vietnam, and Indonesia. The study had a randomized, doubleblind, placebo-controlled design. Each country aimed to enroll at least 70 infants per intervention group (65 + 5 anticipated dropouts). The micronutrient vehicle was in the form of a “foodlet” (food-like tablet) manufactured as chewable tablets, which were easy to break and dissolve, and which had the same taste, color, and flavor for all countries. Children were randomly assigned to one of four 6-month intervention groups: group 1 received a daily foodlet containing multiple micronutrients; group 2 received a daily placebo foodlet containing no micronutrients; group 3 received a weekly foodlet that contained multiple micronutrients (twice the dose of the daily foodlet) and placebo foodlets on the other days of the week; group 4 received a daily foodlet containing only 10 mg of elemental iron. The IRIS Trial aimed to examine the prevalence of multi-micronutrient deficiencies in 6- to 12-month-old infants from rural populations, and to examine the efficacy of multi-micronutrient supplementation in infants from the different countries included in the study. This paper describes the general methodology of the IRIS trial and the operational differences among the country sites.
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Maciel, Bruna L. L., Priscila N. Costa, José Q. Filho, Samilly A. Ribeiro, Francisco A. P. Rodrigues, Alberto M. Soares, Francisco S. Júnior, et al. "Higher Energy and Zinc Intakes from Complementary Feeding Are Associated with Decreased Risk of Undernutrition in Children from South America, Africa, and Asia." Journal of Nutrition 151, no. 1 (September 16, 2020): 170–78. http://dx.doi.org/10.1093/jn/nxaa271.
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ABSTRACT Background Few studies have focused on quantitatively analyzing nutrients from infant diets, compromising complementary feeding evaluation and health promotion worldwide. Objectives This study aimed to describe dietary intake in infants from 9 to 24 mo of age, determining nutrient intakes associated with the risk of underweight, wasting, and stunting. Methods Usual nutrient intakes from complementary feeding were determined by 24-h recalls collected when infants were 9–24 mo of age in communities from 7 low- and middle-income countries: Brazil (n = 169), Peru (n = 199), South Africa (n = 221), Tanzania (n = 210), Bangladesh (n = 208), India (n = 227), and Nepal (n = 229), totaling 1463 children and 22,282 food recalls. Intakes were corrected for within- and between-person variance and energy intake. Multivariable regression models were constructed to determine nutrient intakes associated with the development of underweight, wasting, and stunting at 12, 18, and 24 mo of age. Results Children with malnutrition presented significantly lower intakes of energy and zinc at 12, 18, and 24 mo of age, ranging from −16.4% to −25.9% for energy and −2.3% to −48.8% for zinc. Higher energy intakes decreased the risk of underweight at 12 [adjusted odds ratio (AOR): 0.90; 95% CI: 0.84, 0.96] and 24 mo (AOR: 0.91; 95% CI: 0.86, 0.96), and wasting at 18 (AOR: 0.91; 95% CI: 0.83, 0.99) and 24 mo (AOR: 0.83; 95% CI: 0.74, 0.92). Higher zinc intakes decreased the risk of underweight (AOR: 0.12; 95% CI: 0.03, 0.55) and wasting (AOR: 0.19; 95% CI: 0.04, 0.92) at 12 mo, and wasting (AOR: 0.05; 95% CI: 0.00, 0.76) at 24 mo. Conclusions Higher intakes of energy and zinc in complementary feeding were associated with decreased risk of undernutrition in the studied children. Data suggest these are characteristics to be improved in children's complementary feeding across countries.
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Gudila Valentine Shirima, Obadia Venance Nyongole, Augustine Massawe, and Gad Kilonzo. "Factors associated with cognitive developmental delay among infants attending Reproductive and Child Health clinics in Dar es salaam, Tanzania." World Journal of Advanced Research and Reviews 9, no. 2 (February 28, 2021): 179–81. http://dx.doi.org/10.30574/wjarr.2021.9.2.0060.
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Background; Early child cognitive development is important throughout one’s life span. It is estimated that more than 200 million children under five years of age fail to achieve full cognitive development in the world and 80% of them are in south Asia and sub-Sahara-Africa. Genetic and environmental factors play a role in early child development (ECD). Most of the ECD occurs in the first 2years of life, but largely during infancy. Malnutrition, poverty and poor health care to children have been found to have association with poor cognitive development and create a vicious cycle of poverty. This study gives the proportion and factors that are associated with infants’ cognitive developmental delay in our setting. Knowing these factors enhance early intervention to break the viscious cycle.This study aimed to determine the proportion and factors associated with cognitive developmental delay among infants attending RCH clinics in Dar es Salaam. Patients/ Material and Methods; This was a health facility based descriptive cross-sectional study conducted by using a structured data collecting tool done in three health centers in Dar es Salaam from July to December 2012. A two- stage sampling technique and Lottery were used to get the health centers. The data were analyzed using SPSS software by Pearson’s chi-square, Fisher exact test and logistic regressions. Results; A total of 350 infants were assessed for cognitive development in a period of six months. Male infants were the majority by 50.6%. Our study Participants aged 1to 12 months with a mean (SD) of 7.26 (3.43) months with their birth weight ranging from 1.3 to 4.6kg with mean (SD) of 3.11(0.50) kg. The Proportion of infants with cognitive developmental delay was 12.3%. Age of the child, caretakers and wasting were significantly associated with cognitive developmental delays even after adjusting for confounders. Infants aged less than 6months were 14 times more likely to have cognitive developmental delay compared to those aged six months and above (adjusted oddis ratio{aOR=14; 95%CI 5.3-38.3, P<0.001}). Infants cared by assistant caretakers especially during day-time, were 12 times more likely to have cognitive developmental delay compared to infants who stayed with their mothers (aOR=12.1; 95%CI 3.0-53, P=0.001). Wasted infants were 4 times more likely to have cognitive developmental delay (aOR=3.9; 95%CI 1.1-13.3, P=0.032) compared to infants with good nutritional status. Conclusion; The proportion of cognitive developmental delay among infants attending Reproductive and Child Health( RCH) clinics in Dar es Salaam was 12.3%. Young age of the child, use of other caretakers in absence of the mother, and wasting were associated with cognitive developmental delays. Infants need Mothers to spend time with them and prevention of malnutrition plays a role in cognitive development.
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Darnton-Hill, I., and ET Coyne. "Feast and famine: Socioeconomic disparities in global nutrition and health." Public Health Nutrition 1, no. 1 (March 1998): 23–31. http://dx.doi.org/10.1079/phn19980005.
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AbstractObjective:To review current information on under- and over-malnutrition and the consequences of socioeconomic disparities on global nutrition and health.Design:Malnutrition, both under and over, can no longer be addressed without considering global food insecurity, socioeconomic disparity, both globally and nationally, and global cultural, social and epidemiological transitions.Setting:The economic gap between the more and less affluent nations is growing. At the same time income disparity is growing within most countries, both developed and developing. Concurrently, epidemiological, demographic and nutrition transitions are taking place in many countries.Results:Fully one-third of young children in the world's low-income countries are stunted because of malnutrition. One-half of all deaths among young children are, in part, a consequence of malnutrition. Forty per cent of women in the developing world suffer from iron deficiency anaemia, a major cause of maternal mortality and low birth weight infants. Despite such worrying trends, there have been significant increases in life expectancy in nearly all countries of the world, and continuing improvements in infant mortality rates. The proportion of children malnourished has generally decreased, although actual numbers have not in sub-Saharan Africa and south Asia. Inequalities are increasing between the richest developed countries and the poorest developing countries. Social inequality is an important factor in differential mortality in both developed and developing countries. Many countries have significant pockets of malnutrition and increased mortality of children, while obesity and non-communicable disease (NCDs) prevalences are increasing. Not infrequently it is the poor and relatively disadvantaged sectors of the population who are suffering both. In the industrialized countries. cardiovascular disease incidence has declined, but less so in the poorer socioeconomic strata.conclusions:The apparent contradicitions found represent a particular point in time (population responses generally lag behind social and environmental transitions). They do also show encouraging evidence that interventions can have a positive impact, sometimes despite disadvantageous circumstances. However, it seems increasingly unlikely that food production will continue to keep up with population growth. It is also unlikely present goals for reducing protein-energy malnutrition prevalence will be reached. The coexistence of diseases of undernutrition and NCDs will have an impact on allocation of resources. Action needs to be continued and maintained at the international, national and individual level.
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Schoeman, SE, MK Hendricks, SP Hattingh, AJS Benadé, JA Laubscher, and MA Dhansay. "The targeting of nutritionally at-risk children attending a primary health care facility in the Western Cape Province of South Africa." Public Health Nutrition 9, no. 8 (December 2006): 1007–12. http://dx.doi.org/10.1017/phn2006986.
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AbstractAimThe aim of this study was to determine the practices of primary health care (PHC) nurses in targeting nutritionally at-risk infants and children for intervention at a PHC facility in a peri-urban area of the Western Cape Province of South Africa.MethodologyNutritional risk status of infants and children < 6 years of age was based on criteria specified in standardised nutrition case management guidelines developed for PHC facilities in the province. Children were identified as being nutritionally at-risk if their weight was below the 3rd centile, their birth weight was less than 2500 g, and their growth curve showed flattening or dropping off for at least two consecutive monthly visits. The study assessed the practices of nurses in identifying children who were nutritionally at-risk and the entry of these children into the food supplementation programme (formerly the Protein–Energy Malnutrition Scheme) of the health facility. Structured interviews were conducted with nurses to determine their knowledge of the case management guidelines; interviews were also conducted with caregivers to determine their sociodemographic status.ResultsOne hundred and thirty-four children were enrolled in the study. The mean age of their caregivers was 29.5 (standard deviation 7.5) years and only 47 (38%) were married. Of the caregivers, 77% were unemployed, 46% had poor household food security and 40% were financially dependent on non-family members. Significantly more children were nutritionally at-risk if the caregiver was unemployed (54%) compared with employed (32%) (P = 0.04) and when there was household food insecurity (63%) compared with household food security (37%) (P < 0.004). Significantly more children were found not to be nutritionally at-risk if the caregiver was financially self-supporting or supported by their partners (61%) compared with those who were financially dependent on non-family members (35%) (P = 0.003). The weight results of the nurses and the researcher differed significantly (P < 0.001), which was largely due to the different scales used and weighing methods. The researcher's weight measurements were consistently higher than the nurses' (P < 0.00). The researcher identified 67 (50%) infants and children as being nutritionally at-risk compared with 14 (10%) by the nurses. The nurses' poor detection and targeting of nutritionally at-risk children were largely a result of failure to plot weights on the weight-for-age chart (55%) and poor utilisation of the Road to Health Chart.ConclusionsProblems identified in the practices of PHC nurses must be addressed in targeting children at nutritional risk so that appropriate intervention and support can be provided. More attention must be given to socio-economic criteria in identifying children who are nutritionally at-risk to ensure their access to adequate social security networks.
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Gardner, William, and Nicholas Kassebaum. "Global, Regional, and National Prevalence and Trends in Infant Breastfeeding Status in 204 Countries and Territories, 1990–2019." Current Developments in Nutrition 4, Supplement_2 (May 29, 2020): 992. http://dx.doi.org/10.1093/cdn/nzaa054_064.
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Abstract Objectives To estimate prevalence of breastfeeding (exclusive, predominant, partial, and none) and trends for infants under six months of age for 204 countries and territories from 1990 to 2019. Methods We conducted a systematic review for data on breastfeeding status for children under six months of age. We used survey and food diary data to categorize breastfeeding status into exclusive, predominant, partial, and none. Using a 3-step spatio-temporal Gaussian process regression, we modeled the prevalence of each breastfeeding category in 204 countries and territories, 1990 to 2019. Results Global prevalence of exclusive breastfeeding in infants less than six months of age was 43.5% (95% CI 42.7–44.3) in 2019, up from 34.0% (32.7–35.3) in 1990. Globally, non-exclusive breastfeeding was distributed 30.5% (29.8–31.1) predominant, 16.6% (16.2–17.0) partial, and 9.4% (8.9–10.0) no breastfeeding in 2019. Each of these categories experienced a decline in prevalence since 1990, when non-exclusive breastfeeding was 37.0% (36.0–38.1) predominant, 18.7% (18.1–19.4) partial, and 10.2% (9.5–11.0%) no breastfeeding. Exclusive breastfeeding was highest in Andean Latin America (59.7% [57.4–61.9]), Oceania (56.8% [53.2–60.0]), and South Asia (53.9% [53.2–60.0]). There was marked geographic variation in the distribution of non-exclusive breastfeeding types. Predominant breastfeeding was highest in Western Sub-Saharan Africa (51.5% [49.8–53.2]) and Central Asia (47.2% [45.3–49.0), partial breastfeeding was highest in Southern Latin America (31.1% [28.4–34.0]) and the Caribbean (29.3% [27.6–31.1]), and no breastfeeding was highest in High-income North America (36.7% [31.0–42.5]) and Australasia (32.4% [26.3–36.4]). Conclusions Since 1990, global prevalence of exclusive breastfeeding has increased nearly 10 percentage points. Nonetheless, many countries are not on track to meet the WHO Global Nutrition Target of at least 50% of infants under 6 months exclusively breastfeeding. These cross-nationally comparable estimates of current levels and trends in breastfeeding status provide useful data for targeting interventions to improve breastfeeding practices and to help alleviate the associated global burden of infant malnutrition. Funding Sources Funding for this research was provided by the Bill and Melinda Gates Foundation.
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Buck, Sean, Kevin Rolnick, Amanda A. Nwaba, Jens Eickhoff, Kelechi Mezu-Nnabue, Emma Esenwah, and Olachi J. Mezu-Ndubuisi. "Longer Breastfeeding Associated with Childhood Anemia in Rural South-Eastern Nigeria." International Journal of Pediatrics 2019 (June 10, 2019): 1–6. http://dx.doi.org/10.1155/2019/9457981.
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Introduction. Child mortality rate in sub-Saharan Africa is 29 times higher than that in industrialized countries. Anemia is one of the preventable causes of child morbidity. During a humanitarian medical mission in rural South-Eastern Nigeria, the prevalence and risk factors of anemia were determined in the region in order to identify strategies for reduction. Methods. A cross-sectional study was done on 96 children aged 1-7 years from 50 randomly selected families. A study questionnaire was used to collect information regarding socioeconomic status, family health practices, and nutrition. Anemia was diagnosed clinically or by point of care testing of hemoglobin (Hb) levels. Results. 96 children were selected for the study; 90 completed surveys were analyzed (43% male and 57% females). Anemia was the most prevalent clinical morbidity (69%), followed by intestinal worm infection (53%) and malnutrition (29%). Mean age (months) at which breastfeeding was stopped was 11.8 (±2.2) in children with Hb <11mg/dl (severe anemia), 10.5±2.8 in those with Hb = 11-11.9mg/dl (mild-moderate anemia), and 9.4±3.9 in children with Hb >12mg/dl (no anemia) (P=0.0445). Conclusions. The longer the infant was breastfed, the worse the severity of childhood anemia was. Childhood anemia was likely influenced by the low iron content of breast milk in addition to maternal anemia and poor nutrition. A family-centered preventive intervention for both maternal and infant nutrition may be more effective in reducing childhood anemia and child mortality rate in the community.
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Gross, Rainer, Archana Dwivedi, and Noel W. Solomons. "Introduction to the Proceedings of the International Research on Infant Supplementation (Iris) Initiative." Food and Nutrition Bulletin 24, no. 3_suppl_1 (January 2003): S3—S6. http://dx.doi.org/10.1177/15648265030243s101.
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In 2001, students and professionals from 13 nations were hosted by UNICEF for the International Workshop on Multi-Micronutrient Deficiency Control in the Life Cycle in Lima, Peru, May 30–June 1, 2001. Workshop participants engaged in both narrow and broad discussions of ways to combat multiple micronutrient deficiencies in developing countries. Preliminary data from four common-protocol studies conducted in Peru, South Africa, Indonesia, and Vietnam were presented. Participants also discussed the immediate, preliminary, and interim issues that could guide both policy and planning of future studies of multiple micronutrient deficiency. Among the studies highlighted was the International Research on Infant Supplementation (IRIS) I trial. A review of IRIS I yielded some confirmation of the efficacy using a crushable “foodlet” (i.e., cross between food and tablet) as a supplementation vehicle, as well as concerns about potential adverse consequences of nutrient-nutrient and nutrient-nutriture interactions. Other plenary topics illustrated the practical matters of how the IRIS I logistics and operations were built, and several focused on how to best design follow-up research on infant supplementation. Finally, a series of working groups allowed for in-depth discussions on the topics of community and policy, monitoring and implementation, and research. Researchers continue to try to identify efficient and effective programs suited to the low-income settings in which infant multi-micronutrient malnutrition occurs. The papers in these proceedings elaborate on several aspects of the IRIS study, and they are published in the hope that their analysis by readers will produce wider dissemination of the details of this devastating problem.
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Netshiheni, Khavhatondwi Rinah, Mpho Edward Mashau, and Afam Israel Obiefuna Jideani. "Nutritional and sensory properties of instant maize porridge fortified with Moringa oleifera leaves and termite (Macrotermes falciger) powders." Nutrition & Food Science 49, no. 4 (July 8, 2019): 654–67. http://dx.doi.org/10.1108/nfs-07-2018-0200.
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Purpose White maize-based porridge is a staple food for about 80 per cent consumers in South Africa and in other sub-Saharan African countries contributing significantly to the diet of rural population in developing countries. White maize is deficient in some amino acids and over-dependency on its porridge may lead to high prevalence of malnutrition-related health conditions. Moringa oleifera (MO) and termite (Macrotermes falciger) are known to contain substantial amount of protein. The purpose of this study was to determine the effect of powders from MO leaves and termite on the nutritional and sensory properties of instant maize porridge. Design/methodology/approach Inclusion of MO and termite powder in instant maize porridge, using different treatments were considered using a completely randomised design. Factor levels were control (maize flour) cooked, blanched and uncooked MO samples. Data were analysed using SPSS version 23. Findings Protein content of fortified instant maize porridge (FMP) significantly increased from 10.0 to 21.2 per cent compared to unfortified porridge, and this could be attributed to the substitution effect, as fresh uncooked MO leaves are reported to be high in protein. Mineral content of FMP was higher in zinc, iron, calcium and magnesium. Calcium values of FMP were higher (276.8 mg/100 g) compared to unfortified porridge (7.1 mg/100 g). Upon the addition of MO leaves and termite powder, the zinc content increased from 3.4 mg/100to 7.6 mg/100 g. Higher iron values (27.9-36.9 mg/100 g) were observed among fortified samples. The sensory result showed that control sample had higher acceptance than the fortified samples (p = 0.02). Sensory analysis showed that among fortified porridges, blanched sample was rated high for colour and texture, cooked sample was higher in taste and uncooked sample was higher for aroma. Control sample had higher acceptance than fortified porridges for taste. The results of this study showed that the addition of MO leaves and termite powder to instant maize porridge has led to a substantial increase in the nutritional value of FMP. Originality/value This study was carried out to develop instant maize porridge fortified with MO leaves and termite powder suitable for infants, pregnant mothers and other maize consumers. The author aimed at improving the nutritional content of instant maize porridge by combining it with MO leaves and termite powders. The results showed that the addition of MO leaves and termite powders to instant maize porridge has led to a substantial increase in the nutritional value of FMP. Therefore, powder from MO leaves and termites could be used in complementary foods to increase protein and mineral contents.
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Gultie, Teklemariam, Desta Mebrahtu, and Girum Sebsibie. "Retrospective Assessment of Malnutrition among Under-five Children in Ayder Referral Hospital, Tigray Ethiopia." International Journal of Public Health Science (IJPHS) 4, no. 2 (June 1, 2015): 71. http://dx.doi.org/10.11591/ijphs.v4i2.4714.
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Currently worldwide there are about 60 million children with moderate acute and 13 million with severe acute malnutrition. About 9% of sub-Saharan African and 15%of south Asian children have moderate acute malnutrition and about 2% of children in developing countries have severe acute malnutrition. The objective of aim the study was<strong> </strong>to assess the magnitude of malnutrition in under five children in Ayder referral hospital using a retrospective cross-sectional study design. This study showed that male children, 168(58.1%), were higher than female, 121(41.9%).. Majority, 133(46%), were in the age group b/n 12 to 24 months .More than half, 186(64.4%) were rural dwellers. The types of malnutrition identified were Marasmus, kwashiorkor, Marasmic kwash and underweight which account for 116(40.1%), 69(23.9%), 54(18.7%) and 50(17.5%) respectively. Marasmus was the predominant type of malnutrition in all age groups of under five malnourished children with prevalence of 40.1% where as underweight was the prevalent type of malnutrition (17.3%). More over the infant feeding practices such as exclusive breast feeding, timely initiation of complementary feeding, and having history of breast feeding once in their life during infancy were relatively higher among the children as compared with other studies.
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Gultie, Teklemariam, Desta Mebrahtu, and Girum Sebsibie. "Retrospective Assessment of Malnutrition among Under-five Children in Ayder Referral Hospital, Tigray Ethiopia." International Journal of Public Health Science (IJPHS) 4, no. 2 (June 1, 2015): 71. http://dx.doi.org/10.11591/.v4i2.4714.
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Currently worldwide there are about 60 million children with moderate acute and 13 million with severe acute malnutrition. About 9% of sub-Saharan African and 15%of south Asian children have moderate acute malnutrition and about 2% of children in developing countries have severe acute malnutrition. The objective of aim the study was<strong> </strong>to assess the magnitude of malnutrition in under five children in Ayder referral hospital using a retrospective cross-sectional study design. This study showed that male children, 168(58.1%), were higher than female, 121(41.9%).. Majority, 133(46%), were in the age group b/n 12 to 24 months .More than half, 186(64.4%) were rural dwellers. The types of malnutrition identified were Marasmus, kwashiorkor, Marasmic kwash and underweight which account for 116(40.1%), 69(23.9%), 54(18.7%) and 50(17.5%) respectively. Marasmus was the predominant type of malnutrition in all age groups of under five malnourished children with prevalence of 40.1% where as underweight was the prevalent type of malnutrition (17.3%). More over the infant feeding practices such as exclusive breast feeding, timely initiation of complementary feeding, and having history of breast feeding once in their life during infancy were relatively higher among the children as compared with other studies.
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GILLMAN, JOSEPH, and THEODORE GILLMAN. "MALNUTRITION AND PELLAGRA IN SOUTH AFRICA." Nutrition Reviews 5, no. 12 (April 27, 2009): 353–55. http://dx.doi.org/10.1111/j.1753-4887.1947.tb05798.x.
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Nicolaou, Laura, Tahmeed Ahmed, Zulfiqar Ahmed Bhutta, Pascal Bessong, Margaret Kosek, Aldo A. M. Lima, Sanjaya Shrestha, et al. "Factors associated with head circumference and indices of cognitive development in early childhood." BMJ Global Health 5, no. 10 (October 2020): e003427. http://dx.doi.org/10.1136/bmjgh-2020-003427.
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BackgroundWhile head circumference (HC) has been related to intracranial volume and brain size, its association with cognitive function remains unclear. We sought to understand the relationship among various biological and socioeconomic risk factors, HC and cognitive development.MethodsWe analysed data across resource-poor settings in Bangladesh, India, Nepal, Peru, South Africa and Tanzania from the Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development longitudinal birth cohort study. Participating children were enrolled and followed up between 2009 and 2014. A final sample of 1210 children aged 0–24 months were included in the analyses. The main outcomes were HC for age Z-score and cognitive, gross motor and language scores from Bayley Scales of Infant Development-III tests. Length, weight and HC were measured monthly, and cognitive tests were administered at 6, 15 and 24 months of age. To disentangle the associations between risk factors and HC from linear growth and to distinguish the direct and indirect effects of these risk factors on cognitive function, we conducted mediation analysis using longitudinal models to account for all data measured during follow-up.ResultsAverage HC-for-age Z-score (HCAZ) was −0.54 (95% CI −0.47 to −0.62) near birth and −1.01 (95% CI −0.94 to −1.08) at 24 months. Children with higher enrolment weight (p<0.0001), higher socioeconomic score (p=0.00037) and taller mothers (p=0.00084) had higher HCAZ at all ages, while enteropathogen infection (p=0.013) and more febrile episodes (p=0.013) were associated with lower HCAZ. The associations between HCAZ and enrolment weight-for-age, maternal height, socioeconomic status or pathogen burden were partly mediated through their associations with length-for-age. HCAZ showed no association with cognitive, gross motor or language skills at 6, 15 and 24 months of age.ConclusionsThe main risk factors associated with HC are similar to those associated with body length, and HC is not related to cognitive function.
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Amrutha Veena, K., S. Kowsalya, and S. Kothandapani. "Micronutrient malnutrition profile of infants in South India." Journal of Human Nutrition and Dietetics 27, no. 1 (June 21, 2013): 54–57. http://dx.doi.org/10.1111/jhn.12101.
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Alaba, Olufunke A., Charles Hongoro, Aquina Thulare, and Akim Tafadzwa Lukwa. "Leaving No Child Behind: Decomposing Socioeconomic Inequalities in Child Health for India and South Africa." International Journal of Environmental Research and Public Health 18, no. 13 (July 2, 2021): 7114. http://dx.doi.org/10.3390/ijerph18137114.
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Background: The United Nations’ 2030 Agenda for Sustainable Development argues for the combating of health inequalities within and among countries, advocating for “leaving no one behind”. However, child mortality in developing countries is still high and mainly driven by lack of immunization, food insecurity and nutritional deficiency. The confounding problem is the existence of socioeconomic inequalities among the richest and poorest. Thus, comparing South Africa’s and India’s Demographic and Health Surveys (DHS) of 2015/16, this study examines socioeconomic inequalities in under-five children’s health and its associated factors using three child health indications: full immunization coverage, food insecurity and malnutrition. Methods: Erreygers Normalized concentration indices were computed to show how immunization coverage, food insecurity and malnutrition in children varied across socioeconomic groups (household wealth). Concentration curves were plotted to show the cumulative share of immunization coverage, food insecurity and malnutrition against the cumulative share of children ranked from poorest to richest. Subsequent decomposition analysis identified vital factors underpinning the observed socioeconomic inequalities. Results: The results confirm a strong socioeconomic gradient in food security and malnutrition in India and South Africa. However, while full childhood immunization in South Africa was pro-poor (−0.0236), in India, it was pro-rich (0.1640). Decomposed results reported socioeconomic status, residence, mother’s education, and mother’s age as primary drivers of health inequalities in full immunization, food security and nutrition among children in both countries. Conclusions: The main drivers of the socioeconomic inequalities in both countries across the child health outcomes (full immunization, food insecurity and malnutrition) are socioeconomic status, residence, mother’s education, and mother’s age. In conclusion, if socioeconomic inequalities in children’s health especially food insecurity and malnutrition in South Africa; food insecurity, malnutrition and immunization in India are not addressed then definitely “some under-five children will be left behind”.
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Kimani-Murage, Elizabeth W. "Exploring the paradox: double burden of malnutrition in rural South Africa." Global Health Action 6, no. 1 (January 24, 2013): 19249. http://dx.doi.org/10.3402/gha.v6i0.19249.
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Steele, A. D., J. J. Alexander, and I. T. Hay. "Rotavirus-associated gastroenteritis in black infants in South Africa." Journal of Clinical Microbiology 23, no. 5 (1986): 992–94. http://dx.doi.org/10.1128/jcm.23.5.992-994.1986.
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Govender, Laurencia, Kirthee Pillay, Muthulisi Siwela, Albert Thembinkosi Modi, and Tafadzwanashe Mabhaudhi. "Assessment of the Nutritional Status of Four Selected Rural Communities in KwaZulu-Natal, South Africa." Nutrients 13, no. 9 (August 24, 2021): 2920. http://dx.doi.org/10.3390/nu13092920.
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Under- and over-nutrition co-exist as the double burden of malnutrition that poses a public health concern in countries of the developing regions, including South Africa (SA). Vulnerable groups such as pregnant women and children under five years are the most affected by malnutrition, especially in rural areas. Major contributing factors of malnutrition include food and nutrition insecurity, poverty, and unhealthy lifestyles. The current study aimed to assess the nutritional status, using selected anthropometric indices and dietary intake methods (repeated 24 h recall and food frequency), of four rural communities in KwaZulu-Natal (SA). Purposive sampling generated a sample of 50 households each in three rural areas: Swayimane, Tugela Ferry, and Umbumbulu and 21 households at Fountain Hill Estate. The Estimated Average Requirement cut-point method was used to assess the prevalence of inadequate nutrient intake. Stunting (30.8%; n = 12) and overweight (15.4%; n = 6) were prevalent in children under five years, whilst obesity was highly prevalent among adult females (39.1%; n = 81), especially those aged 16–35 years. There was a high intake of carbohydrates and a low intake of fibre and micronutrients, including vitamin A, thus, confirming the need for a food-based approach to address malnutrition and micronutrient deficiencies, particularly vitamin A deficiency.
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Gordon, N. "Oral health care for children attending a malnutrition clinic in South Africa." International Journal of Dental Hygiene 5, no. 3 (August 2007): 180–86. http://dx.doi.org/10.1111/j.1601-5037.2007.00261.x.
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Lartey, Anna. "Maternal and child nutrition in Sub-Saharan Africa: challenges and interventions." Proceedings of the Nutrition Society 67, no. 1 (January 30, 2008): 105–8. http://dx.doi.org/10.1017/s0029665108006083.
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Women of child-bearing age (especially pregnant and lactating women), infants and young children are in the most nutritionally-vulnerable stages of the life cycle. Maternal malnutrition is a major predisposing factor for morbidity and mortality among African women. The causes include inadequate food intake, poor nutritional quality of diets, frequent infections and short inter-pregnancy intervals. Evidence for maternal malnutrition is provided by the fact that between 5 and 20% of African women have a low BMI as a result of chronic hunger. Across the continent the prevalence of anaemia ranges from 21 to 80%, with similarly high values for both vitamin A and Zn deficiency levels. Another challenge is the high rates of HIV infection, which compromise maternal nutritional status. The consequences of poor maternal nutritional status are reflected in low pregnancy weight gain and high infant and maternal morbidity and mortality. Suboptimal infant feeding practices, poor quality of complementary foods, frequent infections and micronutrient deficiencies have largely contributed to the high mortality among infants and young children in the region. Feeding children whose mothers are infected with HIV continues to remain an issue requiring urgent attention. There are successful interventions to improve the nutrition of mothers, infants and young children, which will be addressed. Interventions to improve the nutrition of infants and young children, particularly in relation to the improvement of micronutrient intakes of young children, will be discussed. The recent release by WHO of new international growth standards for assessing the growth and nutritional status of children provides the tool for early detection of growth faltering and for appropriate intervention.
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Onofiok, N. O., and D. O. Nnanyelugo. "Weaning Foods in West Africa: Nutritional Problems and Possible Solutions." Food and Nutrition Bulletin 19, no. 1 (January 1998): 27–33. http://dx.doi.org/10.1177/156482659801900105.
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Weaning practices and the problems of weaning foods in West Africa are reviewed. The low nutrient density and high bulk of the weaning foods, early introduction of solid foods, and unhygienic practices predispose infants to malnutrition, growth retardation, infection, and high mortality. Multi-approach strategies, involving the development of improved recipes and processing, nutrition education, access to safe water, good sanitation, economic empowerment of women, reduction in workload, and promotion of breastfeeding, are recommended solutions to the problems.
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Steele, A. D., and J. J. Alexander. "Molecular epidemiology of rotavirus in black infants in South Africa." Journal of Clinical Microbiology 25, no. 12 (1987): 2384–87. http://dx.doi.org/10.1128/jcm.25.12.2384-2387.1987.
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Schoub, B. D., S. Johnson, J. M. McAnerney, and B. J. Vorster. "Antibodies to Tetanus Toxin in Black Infants in South Africa." Journal of Infectious Diseases 153, no. 3 (March 1, 1986): 643. http://dx.doi.org/10.1093/infdis/153.3.643.
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Slogrove, Amy L., Leigh F. Johnson, and Kathleen M. Powis. "Population-level Mortality Associated with HIV Exposure in HIV-uninfected Infants in Botswana and South Africa: A Model-based Evaluation." Journal of Tropical Pediatrics 65, no. 4 (October 12, 2018): 373–79. http://dx.doi.org/10.1093/tropej/fmy064.
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Abstract We aimed to quantify the contribution of excess mortality in HIV-exposed uninfected (HEU) infants to total mortality in HIV-uninfected infants in Botswana and South Africa in 2013. Population attributable fractions (PAFs) and excess infant deaths associated with HIV exposure in HIV-uninfected infants were estimated. Additionally, the Thembisa South African demographic model estimated the proportion of all infant mortality associated with excess mortality in HEU infants from 1990 to 2013. The PAF (lower bound; upper bound) of mortality associated with HIV exposure in HIV-uninfected infants was 16.8% (2.5; 31.2) in Botswana and 15.1% (2.2; 28.2) in South Africa. Excess infant deaths (lower bound; upper bound) associated with HIV exposure in 2013 were estimated to be 5.6 (0.5; 16.6)/1000 and 4.9 (0.6; 11.2)/1000 HIV-uninfected infants in Botswana and South Africa, respectively. In South Africa, the proportion of all infant (HIV-infected and HIV-uninfected) mortality associated with excess HEU infant mortality increased from 0.4% in 1990 to 13.8% in 2013.
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STEPHENSON, L. S., M. C. LATHAM, and E. A. OTTESEN. "Global malnutrition." Parasitology 121, S1 (October 2000): S5—S22. http://dx.doi.org/10.1017/s0031182000006478.
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The four most important forms of malnutrition worldwide (protein-energy malnutrition, iron deficiency and anaemias (IDA), vitamin A deficiency (VAD), and iodine deficiency disorders (IDD)) are examined below in terms of their global and regional prevalences, the age and gender groups most affected, their clinical and public health consequences, and, especially, the recent progress in country and regional quantitation and control. Zinc deficiency, with its accompanying diminished host resistance and increased susceptibility to infections, is also reviewed. WHO estimates that malnutrition (underweight) was associated with over half of all child deaths in developing countries in 1995. The prevalence of stunting in developing countries is expected to decline from 36% in 1995 to 32·5% in 2000; the numbers of children affected (excluding China) are expected to decrease from 196·59millions to 181·92millions. Stunting affects 48% of children in South Central Asia, 48% in Eastern Africa, 38% in South Eastern Asia, and 13–24% in Latin America. IDA affects about 43% of women and 34% of men in developing countries and usually is most serious in pregnant women and children, though non-pregnant women, the elderly, and men in hookworm-endemic areas also comprise groups at risk. Clinical VAD affects at least 2·80million preschool children in over 60 countries, and subclinical VAD is considered a problem for at least 251millions; school-age children and pregnant women are also affected. Globally about 740million people are affected by goitre, and over two billions are considered at risk of IDD. However, mandatory salt iodisation in the last decade in many regions has decreased dramatically the percentage of the population at risk. Two recent major advances in understanding the global importance of malnutrition are (1) the data of 53 countries that links protein-energy malnutrition (assessed by underweight) directly to increased child mortality rates, and (2) the outcome in 6 of 8 large vitamin A supplementation trials showing decreases of 20–50% in child mortality.
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Frison, Severine, Francesco Checchi, and Marko Kerac. "Omitting edema measurement: how much acute malnutrition are we missing?" American Journal of Clinical Nutrition 102, no. 5 (September 16, 2015): 1176–81. http://dx.doi.org/10.3945/ajcn.115.108282.
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ABSTRACT Background: Acute malnutrition is a major public health issue in low-income countries. It includes both wasting and edematous malnutrition, but the terms wasting and acute malnutrition are often used interchangeably. Little is known about the burden of edematous malnutrition, and few large-scale surveys measure it. Objective: Most acute malnutrition might be captured by the measurement of wasting alone, but this is unknown. This article aims to fill this gap. Design: This article presents a secondary data analysis of 852 nutrition cross-sectional survey data sets of children aged 6–59 mo. The data sets assembled included surveys from East, West, South, and Central Africa; the Caribbean; and Asia. The overlap between edematous malnutrition and wasting was assessed, and the impact of including/excluding edema on acute malnutrition prevalence estimates was evaluated. Results: The prevalence of edematous malnutrition varied from 0% to 32.9%, and children were more likely to have bilateral edema in Central and South Africa (OR: 4; 95% CI: 2.8, 5.6). A large proportion of children with edematous malnutrition were not wasted [62% and 66% based on midupper arm circumference (MUAC) and weight-for-height (WFH), respectively], and most were not severely wasted (83% and 86% based on MUAC and WFH, respectively). When wasting and global acute malnutrition prevalence estimates as well as severe wasting and severe acute malnutrition prevalence estimates overall were compared, the differences between estimates were small (median of 0.0% and mean of 0.3% based on WFH and MUAC for global estimates and slightly higher median of 0.1% and mean of 0.4% based on MUAC and WFH, respectively, for the severe forms), but the picture was different at the regional level. Conclusions: The terms acute malnutrition and wasting should not be used interchangeably. The omission of the measurement of edema can have important repercussions, especially at the nutrition program level.
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Moyo, Busiso Helard, and Anne Marie Thompson Thow. "Fulfilling the Right to Food for South Africa: Justice, Security, Sovereignty and the Politics of Malnutrition." World Nutrition 11, no. 3 (September 29, 2020): 112–52. http://dx.doi.org/10.26596/wn.2020113112-152.
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Despite South Africa’s celebrated constitutional commitments that have expanded and deepened South Africa’s commitment to realise socio-economic rights, limited progress in implementing right to food policies stands to compromise the country’s developmental path. If not a deliberate policy choice, the persistence of hunger, food insecurity and malnutrition in all its forms is a deep policy failure. Food system transformation in South Africa requires addressing wider issues of who controls the food supply, thus influencing the food chain and the food choices of the individual and communities. This paper examines three global rights-based paradigms – ‘food justice’, ‘food security’ and ‘food sovereignty’ – that inform activism on the right to food globally and their relevance to food system change in South Africa; for both fulfilling the right to food and addressing all forms of malnutrition. We conclude that the emerging concept of food sovereignty has important yet largely unexplored possibilities for democratically managing food systems for better health outcomes.
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Mabaya, Lucy, Hilda Tendisa Matarira, Donald Moshen Tanyanyiwa, Cuthbert Musarurwa, and Johannes Mukwembi. "Growth Trajectories of HIV Exposed and HIV Unexposed Infants. A Prospective Study in Gweru, Zimbabwe." Global Pediatric Health 8 (January 2021): 2333794X2199033. http://dx.doi.org/10.1177/2333794x21990338.
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Background: With the increasing HIV seroprevalence among women of childbearing age in sub-Saharan Africa, limited data on growth outcomes of HIV exposed infants under current policies of universal maternal antiretroviral therapy exist. Methods: The longitudinal growth patterns of 114 HIV exposed and unexposed infants were assessed and compared. The prevalence and factors associated with malnutrition were established. Infants under prevention of mother to child transmission care were recruited at 6 weeks post-delivery as were their HIV unexposed counterparts. Weight and length measurements were recorded at birth, 6 and 16 weeks postpartum. Results: HIV vertical transmission rate was 8.8%. HIV exposed infants had significantly lower mean birth weights compared to HIV unexposed infants (2.9 ± 0.3; 3.2 ± 0.5; P < .001) respectively. Mean weight/length-for-age z-scores for HIV exposed, uninfected (HEU) infants were significantly below those of the HIV unexposed infants during follow up. By 6 weeks of age, 28.5% of HEU infants were malnourished while no malnutrition was evident in HIV unexposed infants. A gestational age <37 weeks (OR: 3.83; 95% CI: 1.03-14.30; P = .045) and HIV exposure (OR: 1.62; 95% CI: 0.17-15.73; P = .017) substantially increased the risk of stunting. Conclusion: Growth deficits were witnessed in HIV exposed infants compared to HIV unexposed infants. There is need for early nutritional monitoring and support among HIV exposed infants.
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Mkhize, Mbalenhle, and Melusi Sibanda. "A Review of Selected Studies on the Factors Associated with the Nutrition Status of Children Under the Age of Five Years in South Africa." International Journal of Environmental Research and Public Health 17, no. 21 (October 30, 2020): 7973. http://dx.doi.org/10.3390/ijerph17217973.
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Malnutrition is a considerable contributor to child mortality and morbidity. Child malnutrition further affects the country’s economic development. Child malnutrition in South Africa is persistent, continuing to be an alarming burden. The nutritional status of kids under the age of five years is a critical indicator of the country’s economic condition and health status. An understanding of the influencers of the nutritional status of children can act as a catalyst in combatting all forms of malnutrition. The purpose of this paper was to review selected studies concerning the factors that affect the nutritional status of children in South Africa. Studies were selected from electronic databases, which were PubMed, Google Scholar, Science Direct, Sabinet African Journals, and the University of Zululand library catalog. The keywords that were used to search studies and articles from the selected database were: risk factors, child nutritional status, children under the age of five years, South Africa, malnutrition, underweight, stunted, wasting, and over-nutrition. Studies and surveys published from 2010–2019 that reported on the factors influencing the nutritional status of children under the age of five years were included in this review. Twenty-seven articles met the inclusion criteria of the study. The 27 articles were made up of 21 cross-sectional articles and six longitudinal articles. The finding from this review highlights that there is a lack of studies conducted in urban areas. The results show that the nutritional status of children is affected by several factors. These include household food insecurity, low household income, illiterate caregivers, unemployment, inadequate dietary intake, low birth weight, consumption of monotonous diets, poor caregiver’s nutritional knowledge, poor access to water and sanitation, poor weaning practices, age of the caregiver, and demographic characteristics of a child (age and gender). It is critical to have an understanding of the factors that affect the nutritional status of children. Such knowledge can significantly contribute to formulating policies that can enhance nutrition security and the country’s economy. Moreover, insights into strategic interventions to eradicate all forms of malnutrition can be made.
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Danquah, Ina, Ekkehart Dietz, Philipp Zanger, Klaus Reither, Peter Ziniel, Ulrich Bienzle, and Frank P. Mockenhaupt. "Reduced Efficacy of Intermittent Preventive Treatment of Malaria in Malnourished Children." Antimicrobial Agents and Chemotherapy 53, no. 5 (February 17, 2009): 1753–59. http://dx.doi.org/10.1128/aac.01723-08.
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ABSTRACT Intermittent preventive treatment in infants with sulfadoxine-pyrimethamine (IPTi-SP) reduces malaria episodes by 20 to 59% across Africa. This protective efficacy, however, may be affected by the high frequency of malnutrition in African infants. We analyzed the impact of malnutrition as defined by anthropometry on the incidence of malaria and on the protective efficacy of IPTi in a cohort of 1,200 children in northern Ghana, where malaria is hyperendemic. These children received IPTi-SP or placebo at 3, 9, and 15 months of age and were monitored until 24 months of age. Malnutrition was present in 32, 40, and 50% of children at ages 3, 9, and 15 months, respectively. It was associated with increased risks of severe anemia and death but not an increased risk of malaria. Although malaria slightly contributed to chronic malnutrition, IPTi did not substantially improve child growth. Importantly, the protective efficacies of IPTi in malnourished children were roughly half or even less of those observed in nonmalnourished children. In the first year of life, IPTi reduced the incidence of malaria to a significantly lesser extent in infants who received both doses in a malnourished condition (25%; 95% confidence interval [CI], −7 to 48%) compared to that of nonmalnourished children (46%; 95% CI, 30 to 58%; P = 0.049). Moreover, in contrast to nutritionally advantaged children, the rate of severe malaria appeared to be increased in malnourished children who took IPTi. IPTi might exhibit reduced efficacy in regions of abundant malnutrition. Concomitant nutrition programs may be needed in these places to achieve the desired impact.
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Matseke, Motlagabo Gladys, Robert A. C. Ruiter, Violeta J. Rodriguez, Karl Peltzer, Deborah L. Jones, and Sibusiso Sifunda. "Male Partner Involvement and Development of HIV-exposed Infants in Rural South Africa." AIDS and Behavior 25, no. 9 (June 7, 2021): 2712–19. http://dx.doi.org/10.1007/s10461-021-03326-5.
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AbstractMale partner involvement (MPI) during the prenatal and postnatal periods has been proven to have a beneficial effect on infant development. Infants born to HIV seropositive mothers with lacking or no prenatal and postnatal male partner support may be at a higher risk for adverse developmental outcomes. This study examined the effect of MPI on cognitive, communicative, fine, and gross motor development in 160 infants born to HIV seropositive mothers attending Prevention of Mother-to-Child Transmission of HIV (PMTCT) services in rural South Africa. Results of the bivariate logistic regression showed that both prenatal (OR 1.13; 95% CI 1.01, 1.26; p < 0.05) and postnatal MPI (at 12 months) (1.19; 1.07, 1.31; p < 0.005) were associated with risk for delayed gross motor development in HIV exposed infants. Decreased postnatal MPI (0.85; 0.75, 0.98; p < 0.05) was significantly associated with risk for delayed cognitive development. Not living together with a male partner (2.01; 1.06, 3.80; p < 0.05) was significantly associated with risk for delayed cognitive development. In the multivariate logistic regression analysis, decreased postnatal MPI (0.85; 0.75, 0.98; p < 0.05) was significantly associated with risk for delayed cognitive development. On the other hand, postnatal MPI (1.30; 1.12, 1.50; p < 0.005) was associated with risk for delayed gross motor development among HIV exposed infants. Increased MPI can have beneficial effects on infants’ cognitive development. Interventions in PMTCT programs should promote increased prenatal and postnatal MPI to improve cognitive development in HIV exposed infants.
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Archary, Moherndran, Hugh Adler, Philip La Russa, Prasha Mahabeer, and Raziya A. Bobat. "Bacterial infections in HIV-infected children admitted with severe acute malnutrition in Durban, South Africa." Paediatrics and International Child Health 37, no. 1 (July 4, 2016): 6–13. http://dx.doi.org/10.1080/20469047.2016.1198561.
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Sidley, Pat. "South Africa blames deaths of 22 infants on the legacy of apartheid." BMJ 333, no. 7559 (July 13, 2006): 115.2. http://dx.doi.org/10.1136/bmj.333.7559.115-a.
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Bain, Katherine. "The challenge to prioritise infant mental health in South Africa." South African Journal of Psychology 50, no. 2 (October 31, 2019): 207–17. http://dx.doi.org/10.1177/0081246319883582.
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Despite clear evidence that infant mental health intervention is imperative, mental health services for infants and their caregivers worldwide remain under-prioritised, under-funded, and inaccessible to most populations. South Africa is no exception. This article proposes some potential explanations for this, exploring both practical constraints and possible resistances within the currents of our collective unconscious.
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Saloojee, Haroon, Tim De Maayer, Michel L. Garenne, and Kathleen Kahn. "What's new? Investigating risk factors for severe childhood malnutrition in a high HIV prevalence South African setting1." Scandinavian Journal of Public Health 35, no. 69_suppl (August 2007): 96–106. http://dx.doi.org/10.1080/14034950701356435.
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Aim: To identify risk factors for severe childhood malnutrition in a rural South African district with a high HIV/AIDS prevalence. Design: Case-control study. Setting: Bushbuckridge District, Limpopo Province, South Africa. Participants: 100 children with severe malnutrition (marasmus, kwashiorkor, and marasmic kwashiorkor) were compared with 200 better nourished (>-2 SD weight-for-age) controls, matched by age and village of residence. Bivariate and multivariate analyses were conducted on a variety of biological and social risk factors. Results: HIV status was known only for a minority of cases (39%), of whom 87% were HIV positive, while 45% of controls were stunted. In multivariate analysis, risk factors for severe malnutrition included suspicion of HIV in the family (parents or children) (OR 217.7, 95% CI 22.7—2091.3), poor weaning practices (OR 3.0, 95% CI 2.0—4.6), parental death (OR 38.0, 95% CI 3.8—385.3), male sex (OR 2.7, 95% CI 1.2—6.0), and higher birth order (third child or higher) (OR 2.3, 95% CI 1.0—5.1). Protective factors included a diverse food intake (OR 0.53, 95% CI 0.41—0.67) and receipt of a state child support grant (OR 0.44, 95% CI 0.20—0.97). A borderline association existed for family wealth (OR 0.9 per unit, 95% CI 0.83—1.0), father smoking marijuana (OR 3.9, 95% CI 1.1— 14.5), and history of a pulmonary tuberculosis contact (OR 3.2, 95% CI 0.9—11.0). Conclusions: Despite the increasing contribution of HIV to the development of severe malnutrition, traditional risk factors such as poor nutrition, parental disadvantage and illness, poverty, and social inequity remain important contributors to the prevalence of severe malnutrition. Interventions aiming to prevent and reduce severe childhood malnutrition in high HIV prevalence settings need to encompass the various dimensions of the disease: nutritional, economic, and social, and address the prevention and treatment of HIV/AIDS.
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Cooper, Peter A. "Invited commentary on the paper 'Exploring the paradox: double burden of malnutrition in rural South Africa'." Global Health Action 6, no. 1 (January 24, 2013): 19785. http://dx.doi.org/10.3402/gha.v6i0.19785.
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Modjadji, Perpetua, and Josephine Mashishi. "Persistent Malnutrition and Associated Factors among Children under Five Years Attending Primary Health Care Facilities in Limpopo Province, South Africa." International Journal of Environmental Research and Public Health 17, no. 20 (October 19, 2020): 7580. http://dx.doi.org/10.3390/ijerph17207580.
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Despite years of interventions intended to reduce child malnutrition in South Africa, its negative effects, stunting in particular, persist mainly among children under five years old living in under-resourced regions. A cross-sectional study was conducted to determine the prevalence of malnutrition and associated factors among 404 children under age five attending childcare services with their mothers in selected healthcare facilities of Limpopo Province, South Africa. Anthropometry, socio-demographics and obstetric history were collected. Height-for-age, weight-for-age and body mass index-for-age Z-scores were used to determine stunting, underweight and thinness among children, respectively. Logistic regression analyses were performed to generate the factors associated with malnutrition. Stunting (45.3%) was the prevalent form of malnutrition among children under age five, affecting boys (51.7%) more than girls (38.8%) and children aged 12–23 months (62.4%) more than those <11 months old (40.1%), in addition to the overall prevalence of underweight (29.0%) and thinness (12.6%). Boys had increased odds of stunting (adjusted odds ratio, AOR = 2.07, 95% CI: 1.26–3.41, p = 0.004) and underweight (AOR = 2.17, 95% CI: 1.32–3.57, p = 0.002) than girls. Children aged 12–23 months were more likely to be stunted (AOR = 4.79, 95% CI: 2.36–9.75, p ≤ 0.0001) than children aged ≤11 months. Delayed introduction of solid foods increased the odds of stunting (AOR = 5.77, 95% CI: 2.63–12.64, p ≤ 0.0001) and underweight (AOR = 2.05, 95% CI: 1.08–3.89, p = 0.028). Children with normal birth weight were less likely to be thin (AOR = 0.42, 95% CI: 0.19–0.92, p = 0.029) and underweight (AOR = 0.34, 95% CI: 0.17–0.68, p = 0.003) than children who had low birth weight. Children whose mothers had obtained secondary school education (AOR = 0.39, 95% CI: 0.16–0.97, p = 0.044), and Grade 12 or post-Grade 12 education (AOR = 0.32, 95% CI: 0.12–0.83, p = 0.020) were less likely to be stunted than were children of mothers who had only primary school education. Suboptimal complementary feeding predisposed children to stunting and underweight. National nutrition programs should be context-specific to improve the introduction of complementary foods among children, especially in the remote and poor areas.
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Schultheiß, Michael, Sharon Kling, Ulrike Lenker, Miriam von Bibra, Bernd Rosenkranz, and Hartwig Klinker. "Lopinavir serum concentrations of critically ill infants: a pharmacokinetic investigation in South Africa." Medical Microbiology and Immunology 207, no. 5-6 (July 4, 2018): 339–43. http://dx.doi.org/10.1007/s00430-018-0550-5.
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Oelofse, A., JMA Van Raaij, AJS Benadé, MA Dhansay, JJM Tolboom, and JGAJ Hautvast. "Disadvantaged black and coloured infants in two urban communities in the Western Cape, South Africa differ in micronutrient status." Public Health Nutrition 5, no. 2 (April 2002): 289–94. http://dx.doi.org/10.1079/phn2002263.
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AbstractObjectives:To determine the nutritional and health status of urban infants in two disadvantaged communities in the Western Cape, South Africa with special reference to micronutrient status. The results of this study will serve to plan an intervention study in these communities in the same age group.Design:Cross-sectional study.Setting:Two disadvantaged urban black and ‘coloured’ communities in the Western Cape, South Africa.Subjects:Sixty infants aged 6–12 months from each community.Outcome measures:Dietary intake, anthropometric measurements, micronutrient status and psychomotor development.Results:Stunting and underweight were more prevalent in coloured infants (18% and 7%, respectively) than in black infants (8% and 2%, respectively). Anaemia (haemoglobin (Hb)<11 g dl−1) was prevalent in 64% of coloured and 83% of black infants. Iron-deficiency anaemia ( Hb<11 g dl−1and ferritin < 10 ng ml−1) was found in 32% of coloured infants and in 46% of black infants. Zinc deficiency was prevalent in 35% and 33% of the coloured and black infants, respectively. Marginal vitamin A deficiency (serum retinol < 20 μg dl−1) was observed in 23% of black infants compared with 2% of coloured infants. Of black infants, 43% and of coloured infants 6% were deficient in two or more micronutrients. Six per cent of coloured infants had C-reactive protein concentrations above 5 mg l−1compared with 38% of the black infants. The dietary intake of micronutrients was in general lower in black infants than in coloured infants. The overall psychomotor development, assessed by the Denver Developmental Screening Test, was different between the two groups. The coloured infants scored higher in three out of the four categories as well as in their overall score.Conclusions:This study shows that information on stunting and wasting only in urban disadvantaged infants is not sufficient to make recommendations about specific community intervention programmes. Information on the micronutrient status, independent of wasting and stunting, is necessary to design nutrition programmes for different communities. The study also showed a substantially higher prevalence of micronutrient deficiencies among black infants.
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Brits, Hanneke, Gina Joubert, Keshia Eyman, Rosie De Vink, Katleho Lesaoana, Sello Makhetha, and Katiso Moeketsi. "An assessment of the integrated nutrition programme for malnourished children aged six months to five years at primary healthcare facilities in Mangaung, Free State, South Africa." South African Family Practice 59, no. 2 (May 11, 2017): 35. http://dx.doi.org/10.4102/safp.v59i6.4791.
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Background: According to the World Health Organization (WHO), malnutrition can be linked to 45% of deaths in children under the age of five years. The Integrated Nutrition Programme (INP) was introduced in 1994 to address malnutrition in South Africa. There had been no systematic evaluation of how well clinics perform regarding nutritional services. Malnutrition rates worsened in the Free State from 3.9% in 2009 to 10.7% in 2013. This study aimed to assess the effectiveness of the INP Supplementary Feeding Programme in primary healthcare facilities in the Mangaung University of the Free State Community Partnership Project, known as MUCPP, catchment area of Bloemfontein, Free State, in children aged six months to five years.
Methods: This was a retrospective, descriptive cohort study. All children between six months and five years entering the feeding scheme between July 2014 and June 2015 at the MUCPP, which is the hub of the feeding scheme, and three primary healthcare clinics were included. Data were collected from September to November 2015 from the INP registers and captured on dataextraction forms.
Results: In total, 730 children were included in the study, 38.8% at risk for malnutrition and 61.2% malnourished. Most of the children (80.7%) stopped attending before change was seen. Only 14.1% exited the INP successfully with a normal weight for age and 3.0% deteriorated despite nutrition interventions. Of all children with one or more follow-up visits, 50.4% (119/236) improved from severe malnutrition to underweight or exited at target weight.
Conclusions: The follow-up of the children and the monitoring and implementation of the INP are inadequate. There is some evidence that children who attend the INP regularly benefit from the programme.
(Full text of the research articles are available online at www.medpharm.tandfonline.com/ojfp)
S Afr Fam Pract 2017; DOI: 10.1080/20786190.2017.1340252
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Taylor, M. B., S. Parker, W. O. K. Grabow, and W. D. Cubitt. "An epidemiological investigation of Norwalk virus infection in South Africa." Epidemiology and Infection 116, no. 2 (April 1996): 203–6. http://dx.doi.org/10.1017/s0950268800052444.
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SUMMARYA study was carried out to determine the incidence and seroprevalence of Norwalk virus (NV) in the Pretoria area, South Africa, using a recombinant NV (rNV) immunoassay for the detection of serum IgG antibodies. Maternal antibody was detectable in infants' sera up to approximately 6 months of age. Infection with NV was detected serologically in the second year of life and the seroprevalence of NV IgG rose from 37·1% at 7–11 months of age to 62·1% by the age of 40 years. No significant differences in seroprevalence of NV IgG antibody was evident between subjects of European or African ethnic origin, where overall seroprevalence rates were 56·4% and 53·9% respectively.
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Faber, Mieke. "Complementary foods consumed by 6 – 12-month-old rural infants in South Africa are inadequate in micronutrients." Public Health Nutrition 8, no. 4 (June 2005): 373–81. http://dx.doi.org/10.1079/phn2004685.
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AbstractObjectiveTo determine the nutrient composition of complementary foods consumed by 6–12-month-old South African infants.DesignNutrient intake was determined for infants who were recruited to participate in a randomised controlled trial using a single 24-hour dietary recall.Setting/subjectsInfants aged 6–12 months (n = 475) residing in The Valley of a Thousand Hills, a rural area in KwaZulu-Natal, South Africa.ResultsEnergy and protein intakes from complementary foods were adequate. Infants who consumed infant products (commercially available fortified infant cereals/ready-to-eat canned baby foods/formula milk powder) had significantly higher intakes of calcium, iron, zinc, vitamin A, thiamine, riboflavin, niacin, vitamin B6, vitamin B12 and vitamin C than infants who did not consume any infant products. For infants who consumed infant cereals (n = 142), these cereals provided 51% of total iron intake. Infant cereals provided more than 25% of total intake for magnesium, thiamine, niacin and vitamin B12. For infants consuming ready-to-eat canned baby foods (n = 77), these products contributed less than 15% of total intake for all the micronutrients. The nutrient density of the complementary diet was less than half the desired density for calcium, iron and zinc. Animal products were consumed by 17% of infants, 26% consumed dairy products and 18% consumed vitamin-A-rich fruit and vegetables during the 24-hour recall period.ConclusionThe nutrient composition of complementary foods among rural South African infants was inadequate, especially for iron, zinc and calcium. Strategies should be developed to improve the nutritional quality of their diets.
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Springer, Priscilla E., Amy L. Slogrove, Barbara Laughton, Julie A. Bettinger, Henriëtte H. Saunders, Christopher D. Molteno, and Mariana Kruger. "Neurodevelopmental outcome of HIV-exposed but uninfected infants in the Mother and Infants Health Study, Cape Town, South Africa." Tropical Medicine & International Health 23, no. 1 (December 7, 2017): 69–78. http://dx.doi.org/10.1111/tmi.13006.
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Chotun, Nafiisah, Etienne Nel, Mark F. Cotton, Wolfgang Preiser, and Monique I. Andersson. "Hepatitis B virus infection in HIV-exposed infants in the Western Cape, South Africa." Vaccine 33, no. 36 (August 2015): 4618–22. http://dx.doi.org/10.1016/j.vaccine.2015.06.076.
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Mokwena, Kebogile, and Itumeleng Masike. "The Need for Universal Screening for Postnatal Depression in South Africa: Confirmation from a Sub-District in Pretoria, South Africa." International Journal of Environmental Research and Public Health 17, no. 19 (September 24, 2020): 6980. http://dx.doi.org/10.3390/ijerph17196980.
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Although postnatal depression (PND) is a worldwide public health problem, it is relatively higher in developing countries, including countries in Sub-Saharan Africa. Postnatal depression is not routinely screened for in primary healthcare facilities in South Africa, despite its reported compromise on mother and child health. The purpose of this study was to determine the prevalence of, as well as factors associated with, postnatal depression in a sample of clinic attendees in a sub district in Tshwane, South Africa. A quantitative and cross-sectional survey was conducted in a sample of 406 women in three healthcare facilities. The Edinburgh Postnatal Depression Scale (EPDS) was used to collect data from women who had infants between the ages of 0 and 12 months. The cut-off point for the EPDS for the depressed category was a score of 13 out of a maximum of 30. The majority of the women (57.14%, n = 232) had scores of 13 and above, which is indicative of postnatal depressive symptoms. On logistic regression, postnatal depressive symptoms were significantly associated with lack of support in difficult times (p < 0.001, 95% CI 10.57–546.51), not having the preferred sex of the baby (p = 0.001, 95% CI 0.37–0.58), low household income (p < 0.001, 95% CI 1.23–1.67), and an older baby (p = 0.005, 95% CI 1.21–1.49). The results show the high proportion of women who have postnatal depression but remain undiagnosed and untreated, and therefore confirm the need for routine screening for postnatal depressive symptoms in primary healthcare facilities, which are used by the majority of women in South Africa.
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Blaauw, Renée, Esther Achar, Robin C. Dolman, Janetta Harbron, Merel Moens, Faith Munyi, Dzifa Nyatefe, and Janicke Visser. "The Problem of Hospital Malnutrition in the African Continent." Nutrients 11, no. 9 (August 30, 2019): 2028. http://dx.doi.org/10.3390/nu11092028.
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This study aims to determine the prevalence of risk of malnutrition on admission and discharge in African hospitals, and to identify the association with selected indicators. In this multi-center prospective cohort study, adult patients from hospitals in South Africa, Kenya, and Ghana were screened on admission and discharge and contacted 3 months post-discharge. Relevant morbidity and mortality outcomes were assessed. At risk of malnutrition was indicated if NRS-2002 score ≥3. Adult patients (n = 2126; 43.11 years, IQR: 31.95–55.60; 52.2% female) were screened on admission and 61% were identified as at risk of malnutrition. The proportion of at-risk patients for the three hospitals in Kenya and Ghana (66.2%) were significantly higher than that of the three South African hospitals (53.7%) (Chi2 = 31.0; p < 0.001). Discharge risk of malnutrition was 71.2% (n = 394). Mean length of stay (LOS) was 6.46 ± 5.63 days. During hospitalization, 20.6% lost ≥5% body weight, 18.8% were referred for nutrition support, and discharge BMI (23.87 ± 7.38 kg/m2) was significantly lower than admission BMI (24.3 ± 7.3 kg/m2) (p < 0.001). Admission nutrition risk was associated with lower admission and discharge BMI (p < 0.001), longer LOS (p < 0.001), increased 3-month re-admission rates (Chi2 = 1.35; p = 0.245) and increased mortality (Chi2 = 21.68; p < 0.001). Nearly two-thirds of patients were at risk of malnutrition on admission. This was associated with longer LOS and greater hospital mortality. The nutritional status of patients deteriorated during hospitalization. Routine screening practices with appropriate nutrition support action should be implemented as a matter of urgency.
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Meiring, Susan, Gregory Hussey, Prakash Jeena, Salim Parker, and Anne Von Gottberg. "Recommendations for the use of meningococcal vaccines in South Africa." Southern African Journal of Infectious Diseases 32, no. 3 (October 1, 2017): 82–86. http://dx.doi.org/10.4102/sajid.v32i3.43.
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Background: Although meningococcal disease (MD) incidence in South Africa is low, Neisseria meningitidis (NM) causes severe disease that is often life-threatening and can cause long-term disabilities. A quadrivalent protein-conjugated meningococcal vaccine (MCV4) is available, and provides protection against 75% of disease causing serogroups in South Africa. Recommendations: We advise vaccination of persons at high risk of meningococcal disease including those with complement deficiency and asplenia; laboratory personnel from reference laboratories who work with NM; and travellers to Saudi Arabia. The need for routine vaccine against meningococcal disease in South Africa is controversial given the current burden of disease. However, due to the high morbidity/mortality of MD we recommend that clinicians consider vaccination of healthy infants and children; HIV-infected persons with a CD4 count 25%; students attending college /university /military academies; and miners.Conclusion: Protein-conjugated meningococcal vaccine is preferable to the polysaccharide vaccine given the ability of the protein-conjugated meningococcal vaccine to induce immune memory, allow for booster responses and eliminate carriage of the organism in the person vaccinated.
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Tydeman-Edwards, Reinette, Francois Cornel Van Rooyen, and Corinna May Walsh. "Obesity, undernutrition and the double burden of malnutrition in the urban and rural southern Free State, South Africa." Heliyon 4, no. 12 (December 2018): e00983. http://dx.doi.org/10.1016/j.heliyon.2018.e00983.
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Themane, M. J., K. D. Monyeki, M. E. Nthangeni, H. C. G. Kemper, and J. W. R. Twisk. "The relationship between health (malnutrition) and educational achievements (Maths and English) in the rural children of South Africa." International Journal of Educational Development 23, no. 6 (November 2003): 637–43. http://dx.doi.org/10.1016/s0738-0593(03)00063-4.
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