Medicine and Health Sciences Commons^™

Neurodevelopment And Recovery From Wasting, Harriet M. Babikako, Celine Bourdon, Emmie Mbale, Peace Aber, Annet Birabwa, Josephine Chimoyo, Wieger Voskuijl, Zaubina Kazi, John Mukisa, Ali Faisal Saleem

Department of Paediatrics and Child Health

Background and objectives: Acute illness with malnutrition is a common indication for hospitalization among children in low- and middle-income countries. We investigated the association between wasting recovery trajectories and neurodevelopmental outcomes in young children 6 months after hospitalization for an acute illness.
Methods: Children aged 2 to 23 months were enrolled in a prospective observational cohort of the Childhood Acute Illness & Nutrition Network, in Uganda, Malawi, and Pakistan between January 2017 and January 2019. We grouped children on the basis of their wasting recovery trajectories using change in mid-upper arm circumference for age z-score. Neurodevelopment was assessed with the …

Optimizing Prevention And Community-Based Management Of Severe Malnutrition In Children, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Zulfiqar A. Bhutta discusses prevention and treatment strategies for optimization of community-based management of severe acute malnutrition in children

Dietary Diversity And Social Determinants Of Nutrition Among Late Adolescent Girls In Rural Pakistan, Jo-Anna B. Baxter, Yaqub Wasan, Muhammad Islam, Simon Cousens, Sajid Bashir Soofi, Imran Ahmed, Daniel W. Sellen, Zulfiqar Ahmed Bhutta

Centre of Excellence in Women and Child Health

The conditions in which adolescent girls mature shape their health, development and nutrition. Nutrient requirements increase to support growth during adolescence, but gaps between consumption and requirements exist in low- and middle-income countries. We aimed to identify and quantify the relationship between dietary intake and diverse social determinants of nutrition (SDN) among a subset of adolescent girls 15-18.9 years (n = 390) enrolled within the Matiari emPowerment and Preconception Supplementation (MaPPS) Trial. The primary outcome, dietary diversity score (DDS), was derived by applying the Minimum Dietary Diversity for Women 10-item scale to 24-h dietary recall data collected three times per …

The Double Burden Of Malnutrition And Associated Factors Among South Asian Adolescents: Findings From The Global School-Based Student Health Survey, Sara Estecha Querol, Romaina Iqbal, Laura Kudrna, Lena Al-Khudairy, Paramijit Gill

Community Health Sciences

The health and nutrition of the global adolescent population have been under-researched, in spite of its significant size (1.2 billion). This study investigates the prevalence and associated factors of malnutrition (stunting, thinness and overweight) among adolescents living in South Asia. The sample analysed was 24,053 South Asian schooled adolescents aged 12-15 years that participated in the cross-sectional Global School-Based Student Health Survey (GSHS) between 2009 and 2016. The prevalence of stunting, thinness and overweight was calculated using the World Health Organization (WHO) Child Growth Reference 2007. Associations between the three forms of malnutrition and their possible associated factors were assessed …

Evaluating Motor Performance With The Bruininks-Oseretsky Test Of Motor Proficiency In Impoverished Pakistani Children, Zehra Habib Hasan, Fariha Shaheen, Arjumand Rizvi, Jelena Obradovic, Aisha Khan Yousafzai

Department of Paediatrics and Child Health

Objective: To evaluate the sensitivity of the modified Brief Form of Bruininks Oseretsky Test in identifying motor differences secondary to malnutrition and poverty.
Methods: This longitudinal cohort study was conducted at Nowshero Feroze, Sindh from 2013 to 2014 and comprised data drawn from children who participated in a randomised controlled trial, that assessed responsive stimulation and nutrition interventions in the first two years of life. Outcome measures included motor development assessed using Brief Form of Bruininks Oseretsky Test, child anthropometry and household economic and demographic information. Data was analysed using SPSS 15 and STATA 12.
Results: Of the 1058 children, …

Gestational Weight Gain In 4 Low- And Middle-Income Countries And Associations With Birth Outcomes: A Secondary Analysis Of The Women First Trial, Melissa S. Bauserman, Carla M. Bann, K Michael Hambidge, Ana L. Garces, Lester Figueroa, Jamie L. Westcott, Jackie K. Patterson, Elizabeth M. Mcclure, Sumera Ali Aziz, Sarah Saleem

Community Health Sciences

Background: Adequate gestational weight gain (GWG) is essential for healthy fetal growth. However, in low- and middle-income countries, where malnutrition is prevalent, little information is available about GWG and how it might be modified by nutritional status and interventions.
Objective: We describe GWG and its associations with fetal growth and birth outcomes. We also examined the extent to which prepregnancy BMI, and preconception and early weight gain modify GWG, and its effects on fetal growth.
Methods: This was a secondary analysis of the Women First Trial, including 2331 women within the Democratic Republic of Congo (DRC), Guatemala, India, and Pakistan, …

Adversity In Childhood Is Linked To Mental And Physical Health Throughout Life, Charles A. Nelson, Richard David Scott, Zulfiqar Ahmed Bhutta, Nadine Burke Harri, Andrea Danes, Muthanna Samara

Woman and Child Health

The prevalence of “toxic stress” and huge downstream consequences in disease, suffering, and financial costs make prevention and early intervention crucial, say Charles A Nelson and colleagues.

The Intertwined Relationship Between Malnutrition And Poverty, Faareha Siddiqui, Rehana Salam, Zohra S. Lassi, Jai K. Das

Woman and Child Health

Despite social and economic development, the burden of malnutrition across the globe remains unacceptably high. A vital relationship exists between nutritional status, human capital, and economic standing. Malnutrition adversely affects the physiological and mental capacity of individuals; which in turn hampers productivity levels, making them and their respective countries more susceptible to poverty. A two-way link exists between malnutrition and poverty, creating a vicious cycle with each fueling the other. Malnutrition produces conditions of poverty by reducing the economic potential of the population and likewise, poverty reinforces malnutrition by increasing the risk of food insecurity. The aim of the paper …

Determinants Of Linear Growth Faltering Among Children With Moderate-To-Severe Diarrhea In The Global Enteric Multicenter Study, Rebecca L. Brander, Patricia B. Pavlinac, Judd L. Walson, Grace C. John-Stewart, Marcia R. Weaver, Abu S. G Faruque, Anita K. M. Zaidi, Dipika Sur, Samba O. Sow, M Jahangir Hossain

Department of Paediatrics and Child Health

Background: Moderate-to-severe diarrhea (MSD) in the first 2 years of life can impair linear growth. We sought to determine risk factors for linear growth faltering and to build a clinical prediction tool to identify children most likely to experience growth faltering following an episode of MSD.
Methods: Using data from the Global Enteric Multicenter Study of children 0-23 months old presenting with MSD in Africa and Asia, we performed log-binomial regression to determine clinical and sociodemographic factors associated with severe linear growth faltering (loss of ≥ 0.5 length-for-age z-score [LAZ]). Linear regression was used to estimate associations with ΔLAZ. A …

Assessment Of Malnutrition In Patients With Liver Cirrhosis Using Protein Calorie Malnutrition (Pcm) Score Verses Bio-Electrical Impedance Analysis (Bia), Om Parkash, Wasim Jafri, S. M. Munir, Romaina Iqbal

Section of Gastroenterology

Objective: Malnutrition is a common problem in patients with liver cirrhosis and tools for nutritional assessment are under debate. We conducted this study to assess prevalence of malnutrition in cirrhotic patients using PCM score and BIA. Additionally we compared BIA to PCM score for detecting malnutrition in this patient population.

Results: This was a cross sectional study conducted in two tertiary care hospitals of Karachi Pakistan on adults with liver cirrhosis. Malnutrition was assessed by PCM score using anthropometric measurements and biological specimens and (ii) Body cell mass was assessed using BIA. Malnutrition as estimated by the PCM score was …

Nutritional Status And Physical Abuse Among The Children Involved In Domestic Labour In Karachi Pakistan: A Cross-Sectional Survey., Saima Zainab, Muhammad Masood Kadir

Community Health Sciences

OBJECTIVE:

To determine the prevalence of physical abuse among domestic child labours and to assess the nutritional status by calculating the Body Mass Index of children involved in domestic labour in Karachi.

METHODS:

A cross sectional study was conducted in the squatter settlements of Karachi. Questionnaire based interviews were conducted to capture physical abuse with 385 children who worked as domestic labour in the household of their employer. The ages of the children were between 10 to 14 years belonging to both genders. The children were enrolled in study by snow-ball sampling technique.

RESULTS:

The overall prevalence of physical abuse …

Obesity, An Emerging Epidemic In Pakistan-A Review Of Evidence., Sana Tanzil, Tanzil Jamali

Community Health Sciences

BACKGROUND:

In Pakistan, the disease pattern is facing a huge changeover from acute and communicable diseases to the non-communicable diseases. Moreover, an emerging epidemic of obesity is still under recognized in Pakistan. A detailed review and dissemination of the existing knowledge to determine the extent of burden of obesity can help understand this important public health issue.

METHODS:

A detailed literature review was conducted through PubMed search engines, regarding obesity burden in Pakistan. The original peer reviewed research articles, reports of WHO in English language, non-government organizations reports were included in the review. "Obesity AND Pakistan" were used as a …