International Journal of Child Health and Nutrition

Prevalence of Stunting among Children under Five in Pediatric Hospital Al-Hasahisa, Al Jazirah State, Sudan

Shaheeda Mohammed Alobid — 2024-11-28

A cross-sectional descriptive design study was conducted in the pediatric hospital in Al-Hasahisa-Algazera state -Sudan, to ascertain the prevalence of stunting in children under five years old. There are 100 patients in the samples (46 girls and 54 males). The questionnaire used to collect the study's primary data includes questions about participant content, sociodemographics, housing status, health, and nutrition. To estimate the patient's percentage of stunting, anthropometric measures, including height/length for age and mid-upper arm circumference (MUAC), were also obtained. The data showed that most of the children were raised in nuclear homes.

A significant correlation (P value <0.05) was seen between stunting and mother education. The parents' educational attainment showed that a sizable percentage of fathers (52%) and mothers (45%) were illiterate. According to the findings, 82% of mothers were housewives, and 75% of fathers were employed. This finding demonstrated a significant (P value 0.004) relationship between income level and stunting, with weak income (22%), moderate-income (78%), and no income level. Furthermore, 36% of completed breastfeeders and 37% of non-completers showed a highly significant (P value 0.003) correlation between breastfeeding and stunting. During the course of the study, diarrheal diseases affected 68% of the children, while anemia (27%), malaria (52%), parasitic infections (17%), and chest infections (69%)were the most common conditions. 39% of the kids had severe malnutrition, and 18% had moderate malnutrition. The bulk of them, 78%, were stunted, with the remaining 19% mild, 11% moderate, and 48% severely stunted. According to the report, 35% of stunted children were female, and 43% of stunted children were male.

Height and Weight Characteristics of 4-7-Year-Old Kyrgyz Children: Сonstitutional, Age, and Gender Differences

Kanykei Zhanybekkyzy — 2024-11-28

Background: Regular monitoring of anthropometric data of children aged 4-7 years is necessary to identify deviations from the norm, develop medical programs and recommendations that meet current needs, and update physical development standards to reflect demographic and socio-cultural changes in Kyrgyzstan.

Aims: The study's purpose was to investigate the height and weight of children aged 4-7, considering the dynamics of age, body type, and gender.

Methods: The physical status of 800 children aged 4-7 years was analyzed using anatomical-anthropometric and bioimpedance methods. The children who participated in the study were ethnic Kyrgyz who lived in the city of Osh and the Osh region.

Result: The study revealed that children aged 4-7 years in Kyrgyzstan exhibit a diverse distribution of body types, including asthenic (15-30%), thoracic (12-23%), muscular (15-20%), digestive (15-32%), and undetermined (16-36%), with no significant predominance of any somatotype between genders. The analysis highlighted that the most common body type in the 4-5 age group was undetermined, while the digestive type prevailed at age 7. Additionally, average body weight and length demonstrated consistent growth across both genders, with boys exhibiting higher values than girls at each age. Over the developmental period, body length increased by 1.01-1.08 times in boys and 1.01-1.05 times in girls, while body weight increased by 1.12-1.21 times in boys and 1.09-1.21 times in girls, indicating a steady growth pattern regardless of somatotype. These findings underscore the importance of monitoring growth parameters in early childhood to support healthy physical development.

Conclusions: The study highlights that children aged 4-7 years in Kyrgyzstan display diverse body types and consistent growth patterns in height and weight, emphasizing the need for ongoing monitoring to ensure healthy physical development.

Ventricular Dysfunction Secondary to Refeeding Syndrome in an Infant, A Case Report

Ana M. Aristizabal — 2024-11-28

Introduction: Refeeding syndrome is a complex of signs and symptoms that occur following the abrupt initiation of enteral or parenteral nutrition in malnourished patients, among other causes. Most data focuses on adolescents and adults, with limited neonatal information and other pediatric group ages. This case presents an infant who developed ventricular dysfunction due to refeeding syndrome following starvation.

Case Report: A 5-month-old female with a one-month history of generalized maculopapular rash and lower limb edema. Physical examination revealed severe malnutrition and significant electrolyte imbalances. The initial echocardiogram was unremarkable. Despite nutritional and dermatological management, the patient developed respiratory distress, generalized edema, and anuria, necessitating Pediatric Intensive Care Unit admission. Subsequent echocardiograms revealed dilated cardiomyopathy with systolic-diastolic dysfunction. After receiving inodilator therapy and diuretics, her condition temporarily improved but deteriorated again, requiring further intensive care. Imaging ruled out significant structural heart disease, and after a prolonged hospital stay, the patient was eventually stabilized and discharged with gradual nutritional and growth improvement.

Discussion: Cardiac complications following refeeding have been reported primarily in older patients with comorbidities, unlike our case, hence the rarity. Malnutrition-induced myocardial alterations and the stress of refeeding may have contributed to the observed ventricular dysfunction.

Conclusion: Any malnourished patient should be considered for the potential onset of refeeding syndrome. Risks and complications should not be underestimated despite the patient's age. A multidisciplinary approach is crucial for the proper management of this condition, although its presence does not seem to warrant special considerations for the care of cardiac complications.

Fetal Outcome Associated with COVID-19; Correlation between Ultrasound and Birth Measures in COVID-19 Pregnant Women

Mai Ibrahim Osama Abel Azim Elgamal — 2024-11-28

Background: Coronavirus disease 2019 (COVID-19), caused by the virus SARS-CoV-2, was declared a global pandemic in March 2020. Pregnant women might be especially vulnerable to COVID-19 because the physiological changes in their cardiorespiratory and immune systems during pregnancy could alter their response to SARS-CoV-2 infection.

Objective: to determine the association between SARS-CoV-2 infection and fetal outcomes, including SGA, FGR, preterm birth, and stillbirth.

Methods: This prospective study was conducted at the Ultrasound and Fetal Medicine Unit of Ain Shams University Maternity Hospital, a tertiary care center, from October 2021 to January 2023. The study included 45 pregnant women diagnosed with COVID-19 during the first or second trimester of their current pregnancy. Additionally, a control group of 45 pregnant women who were not infected with COVID-19 was included. Both groups were selected based on predefined inclusion and exclusion criteria.

Results: There were no statistically significant differences between the two groups regarding demographic characteristics, including age, body mass index, and parity. The timing of COVID-19 infection was nearly evenly distributed between the first and second trimesters. All cases in the infected group were non-hospitalized. No statistically significant differences were found between the groups regarding the need for induction or mode of delivery. Additionally, there were no significant differences in gestational age, estimated fetal weight, birth weight, or NICU admission rates. Stillbirth, prematurity, intrauterine growth restriction (IUGR), macrosomia, and neonatal mortality did not occur in either group.

Conclusion: As evident from the current study, there were no differences between first and second-trimester COVID-19-infected and non-infected pregnant women according to maternal and neonatal outcomes regarding fetal growth complications, APGAR score, preterm Labour, NICU admission, Placental abnormalities, and Liquor abnormalities. Consequently, clinical characteristics of first and second-trimester COVID-19 in pregnant patients and neonates seem to be similar to those in non-pregnant infected adults.

Assessment of Food Safety Knowledge among School-Going Adolescents: An Interventional Study

S. Indumathi — 2024-11-28

Background: Recognizing the complex health issues that school-going adolescents face due to ignorance of proper food handling techniques, which impact their general development and severely threaten the health of both the present and future generations in all developing nations. This interventional study aimed to compare food safety knowledge among school-going teenagers (13–15 years) before and after intervention, taking into account the significance of students' health importance in the early adolescent stages.

Materials and Methods: The cluster sampling method was used to choose 400 students from four different schools. A food safety intervention education was given online using the Google Meet platform. The World Health Organization's food safety questionnaire was used to gauge participant knowledge of food safety before and after the intervention. A committee of subject matter experts evaluated the research tool's relevance for content validity.

Results: Following the implementation of the intervention, significant increases in food safety knowledge were noticed among school-going adolescents in the post-test. A maximum of 81.5% of subjects gained a high-level knowledge regarding food safety after the food safety intervention. Statistics showed that the differences were substantial. After the intervention program, school-aged teenagers' overall understanding of food safety dramatically increased.

Conclusion: In order to reduce the health problems caused by unsafe food among school-going teenagers, awareness of food safety must be greatly raised through a variety of food safety training programs in the early stages of adolescence.

Factors Associated with Utilization of Antenatal Care Services among Women in Noakhali District, Bangladesh

Lincon Chandra Shill — 2024-11-28

A cross-sectional study sought to uncover the determinants affecting antenatal care (ANC) utilization among pregnant women in Noakhali District, Bangladesh. Data from 400 women were gathered utilizing a standardized questionnaire, and the analysis was performed using SPSS software (version 23.0), incorporating descriptive statistics, Chi-square tests, and multinomial logistic regression. The research revealed that merely 47.8% of individuals attended a minimum of four antenatal care visits, as advised by healthcare recommendations.

The frequency of ANC visits was substantially correlated with socioeconomic status, educational attainment, work status, and obstacles to receiving ANC services. Mothers with 1-3 antenatal care visits encountered 26.58 times more barriers to attending visits than those who completed four or more visits (OR: 26.58, 95% CI: 11.28-62.62). Moreover, income levels were 0.53 times greater among mothers with fewer antenatal care appointments in comparison to those with four visits (OR: 0.53, 95% CI: 0.32-0.86).

The report emphasizes the need to address the constraints preventing women from getting enough ANC. This necessitates enhancements in transportation, the quality of healthcare facilities, and the training and accessibility of healthcare staff. Enhancing awareness of the significance of ANC through focused campaigns is essential at the local, national, and worldwide levels. Addressing these challenges is crucial for enhancing ANC utilization and promising improved maternal and newborn health outcomes in the region.

Impact of “Immediate Kangaroo Mother Care” on Survival of Low Birth Weight Neonates in a Tertiary Care Centre: A Prospective Cohort Study

Mallikarjun Talikoti — 2024-11-28

Background: “Kangaroo mother care,” a type of newborn care involving skin-to-skin contact with the mother or other caregiver (grandmother), reduces mortality in neonates with low birth weight (< 2 kg) when initiated after stabilization, but the majority of deaths occur before stabilization. The safety and efficacy of kangaroo mother care initiated soon after birth among neonates with low birth weight iKMC is uncertain.

Methods: We conducted a prospective cohort study involving neonates with a birth weight < 1.8 kg who were assigned to receive immediate kangaroo mother care (intervention) or conventional care in a radiant warmer until their condition stabilized and kangaroo mother care after that (control). The primary outcomes were death in the neonatal period (the first 28 days of life) and the first 72 hours of life.

Results: Two hundred eleven neonates and their mothers were assigned to the intervention group (106 neonates with their mothers) or the control group (105 neonates with their mothers). The median daily duration of skin-to-skin contact in the neonatal intensive care unit was 9.9 hours (interquartile range, 6.0 to 15.7) in the intervention group and 3.5 hours (interquartile range, 1.3 to 6.3) in the control group. Neonatal death occurred in the first 28 days in 12% neonates in the intervention group and 15.7% neonates in the control group (relative risk of death, 0.75; 95% confidence interval [CI], 0.64 to 0.89; P=0.001); neonatal death in the first 72 hours of life occurred in 4.6% neonates in the intervention group and 5.8% neonates in the control group (Relative risk of death, 0.77; 95% CI, 0.58to 1.04; P = 0.09).

Conclusions: Among neonates with a birth weight < 1.8 kg, those who received immediate kangaroo mother care had lower mortality at 28 days than those who received conventional care with kangaroo mother care initiated after stabilization; the between-group difference favoring immediate kangaroo mother care at 72 hours was not significant.

Prevalence and Interplay between Borderline Personality Disorder and Adverse Childhood Experiences Among Saudi Arabian University Students: A Case Study

Sulhi Ali Alfakeh — 2024-11-28

Study: Borderline personality disorder (BPD) is a personality disorder characterized by instability in affect regulation, impulse control, and social interactions. There has been a long-term curiosity among researchers about the reasons for underlying BPD. One such implication is Adverse Childhood Experiences (ACE). This study aimed to find out the correlation between BPD and ACE in the context of Saudi Arabian University students. Adverse Childhood Experiences (ACE) play a significant role in the personality traits leading to BPD in adults, and we hypothesize that there is a significant relationship between ACEs and the occurrence of BPD among young college students at King Abdulaziz University. There is very limited published data regarding Gulf countries, including case reports, reviews, and meta-analyses.

Material and Methods: The study was conducted among Saudi Arabian University students aged between 18 and 30. This cross-sectional study at King Abdul-Aziz University involved a total of 1970 subjects. The questionnaire comprised sociodemographic characteristics, the Mclean Screening Instrument for BPD (MSI-BPD), and the Adverse Childhood Experiences (ACE) Questionnaire for Adults.

Results: Our study found that amongst the total subjects undertaken, 41.2% were at a high risk of developing BPD. This is in direct correlation with 61.4% that suffered previous childhood trauma. Amongst the total subjects undertaken for the study, 43.6% of university students experienced ACE; symptoms were associated with smoking, having at least one family member diagnosed with a mental disorder, being divorced, and having a deceased mother.

Conclusion: BPD and ACE are positively correlated, as both have implications for other life-determining factors of the subjects. The study presents the first cross-sectional data set for Saudi Arabian students involving BPD and ACE. This study is significant as it specifically focuses on university students in Saudi Arabia. It suggests that counseling services on all university campuses should be required to facilitate regular evaluation and support for students' mental health.

Assessment of Psychological Impact among Hospitalized Children; Single Centre Study

Salwa Amin Abd Elhamid — 2024-11-28

Background: The goal of the contemporary hospital setting is to give patients suffering from a range of diseases a secure and therapeutic space. Aim: Psychosocial and mental health assessment among hospitalized children between 7 to 12 years of age.

Methods: This Cross-Sectional Study was carried out at the Children's Hospital Faculty of Medicine for 1-year duration.

Results: Higher statistically significant positive results were found in cases than in control regarding all Vanderbilt subscales except in the conduct subscale. Higher results were found in chronic cases than control in all subscales except for oppositional defiant disorder results.

Conclusion: Hospitalized Children, due to chronic or acute conditions, are at a higher risk for Psychosocial and mental health disorders such as depression, anxiety, ADHD, PTSD, and pain in comparison with healthy children.

The Relationship between 25-Hydroxyvitamin (OH) D Levels and Nutritional Status in Children with Family History of Atopy

Galuh Hardaningsih — 2024-11-28

Background: Deficiency in vitamin D can result in growth retardation and skeletal abnormalities. Children with a familial history of atopy are at a heightened risk of atopic dermatitis and growth impairments. These growth disorders associated with atopy may stem from chronic inflammation and nutrient malabsorption. Evidence suggests vitamin D deficiency may exacerbate atopic conditions, further impacting growth and development. Thus, this study investigates the link between vitamin D levels and anthropometric status in children with a history of atopy.

Method: Seventy-eight patients were selected and recruited from Diponegoro University Hospital between June and October 2021. Inclusion criteria comprised pediatric patients aged between one month and six years, either diagnosed with atopic disease or having a family history of the ailment. Exclusion criteria included chronic illnesses other than atopic disease, ongoing infections, and lack of medical records. Nutritional status was assessed using HAZ, WAZ, and WHZ. Additional data on vitamin D levels, dietary intake (calories, protein, and fat), iron and zinc sufficiency, and history of exclusive breastfeeding were also collected.

Results: The study encompassed 78 children. Nutritional assessment revealed that 63 children had good nutritional status, 10 were overweight, 2 were malnourished, and 3 were severely malnourished. The 25-OH D level was 3 children classified as deficient, 15 as insufficient, and 60 as having normal levels. Analysis bivariate indicated no significant impact of vitamin D levels on anthropometric parameters. This lack of significant correlation was consistent in both the general population (n=78) and those with atopic manifestations (n=56), suggesting that vitamin D levels do not significantly affect growth parameters in this pediatric cohort.

Conclusions: This study concludes that vitamin D levels have no significant impact on anthropometric parameters in children, irrespective of their atopic status. Despite the acknowledged role of vitamin D in growth and development, the data suggests that vitamin D levels do not substantially influence growth parameters in this pediatric cohort with a history of atopy. Further investigation may be warranted to explore other potential factors influencing growth in children with atopic conditions.