International Journal of Child Health and Nutrition

44-50

Authors: Nigus Bililign Yimer, Misgan Legesse Liben

Background: A skilled birth attendance for every pregnant woman during childbirth is the most crucial intervention for improving maternal health. This study aimed to assess institutional delivery service utilization and associated factors among mothers who gave birth in the last 12 months in Raya Kobo district, Ethiopia. Methods: A community-based cross-sectional study was carried out in the Raya Kobo district of Amhara Regional State during March 2016. Logistic regression analysis was performed to assess the association between each independent variable and the outcome variable. Variables with a p-value <0.05 were considered significant. Results: A total of 493 mothers were included in the study, with a response rate of 95.4%. The mean (+SD) age of the study participants was 29.13 (±6.93) years. About 73% of the study participants had attended at least one antenatal care follow up for their last pregnancy, and 56.6% (95% CI: 52.0, 61.0%) gave birth at health institutions. Travelling for 30 minutes and less [AOR=2.95(1.89, 4.58)], attending antenatal care [AOR=6.0(3.55, 10.13)], having knowledge about intrapartum danger signs [AOR=2.48(1.44, 4.24)] and getting information from health extension workers (HEWs) regarding maternal health services were positively associated. Conclusion: The district health office should strengthen its effort to provide free ambulance accessibility and provide information on danger signs of intrapartum complications and the importance of using institutional delivery service to every mother who came to the antenatal clinic. Furthermore, the district health officials should focus on strengthening the capacity of HEWs in relation to maternal health services.

59-73

Authors: Vladyslav Deputatov, Mariana Velykodna

The body image is to be reconstructed during adolescence, which is more difficult in the case of somatic illness and social stigma. This research aimed to study adolescents' body image with scoliosis, students of a special educational institution in Ukraine socially identified with stigma as 'a school for scoliotics'.The participants (n=104) of the research were adolescents (13-15 years old) with scoliosis from the institution mentioned above (n=52, 24 males, 28 females) and adolescents without scoliosis from the same city (n=52, 24 males, 28 females). Two methods were used to collect the data: (1) Self-portraits; (2) Dembo-Rubinstein Self-Assessment Scale. The adolescents with scoliosis and labeled as 'scoliotics' face additional obstructions in their psychic body development compared to their peers. For instance, they tend to overinvest in the desired image of a healthy body and do not feel able to get it. We found the markers of four different ways to cope with the situation by the adolescents with scoliosis: (a) identification as 'a scoliotic' instead of hope to be cured soon; (b) psychological distancing from the others to preserv e the desire of a more attractive body image; (c) repression or denial of the body parts which could relate to scoliosis; (d) infantilization, aimed to slow down the discovery of their maturing corporeality. Consequently, adolescents with scoliosis affected by stigma experience the gap or conflict between their current, desired and perceived realistic body image

1-8

Authors: Aminata Ndene Ndiaye, Isabelle Galibois, Sonia Blaney

Intake of iron-rich foods was investigated in Senegalese adolescent girls. A cross-sectional survey was conducted among 136 girls aged 13 to 18, attending two colleges in Dakar. Data on the consumption of iron-rich foods over the previous week were collected through a food frequency questionnaire. Results show that 12% of the girls had consumed dishes made with iron-rich foods 3 times or less in the past seven days, 34%, 4 to 6 times, and 54%, 7 times and above. However, 83% of the girls had an intake of iron-rich foods below the 84 g per day recommended for animal protein sources by the EAT-Lancet Commission on Healthy Diets from Sustainable Food Systems. The diet of Senegalese adolescent girls seems conducive to iron deficiency. To define effective interventions to improve the situation, investigating underlying factors to the low consumption of iron-rich foods is warranted

17-23

Authors: Maryam Mirmotalebi, Behshid Garrusi* and Mina Danaei

Background and Objective: Evaluation of the severity of pain in children can help the medical team diagnose the type of disease. In this study, anxiety and pain intensity in children were examined based on self-report. Materials and Methods: This cross-sectional study was performed in 2018 on 300 children aged 3 to 12 years, referring to outpatient treatment centres in Kerman. To measure the severity of pain felt by children, FPS-R was used. The level declared by children was evaluated by the pain intensity estimated by parents and doctors using a visual analogue scale (VAS) and the standard FLACC (Face, Legs, Activity, Cry, Consolability scale) for correlation. The data were analysed using SPSS software version 25. Results: The pain reported by children was obtained by VAS (4.16 ± 3.49), and the estimated pain by the doctor was obtained by FPS-R (2.87±1.68). The pain severity estimated by the doctor using FLACC had the highest correlation with the pain estimated by the doctor using VAS and the lowest correlation with the pain estimated by the mother using VAS. Conclusion: The results of this study showed that FPS-R could be used as a suitable self-report tool in children and, along with the standard FLACC, can help the medical team recognize the severity of children's pain

34-43

Authors: Fassikaw Kebede, Nemera Eticha, Belete Negese, Mastewal Giza, Tadesse Tolossa, Bizuneh Wakuma

Malnutrition (over and undernutrition) is a major public health problem across the globe, especially undernutrition is responsible for one-third of the death of children in underprivileged populations. Each year more than 25 to 35 million under-five children have suffered from Severe Acute Malnutrition (SAM). The sub-Saharan African countries account for the lion's share of this case fatality rate. The case in Ethiopia is not different from other countries. This study's main aim is to assess predictors for the cure rate of Severe Acute Malnutrition in 6-59 month Children in stabilizing center at Pawe General Hospital, Northwest Ethiopia. A retrospective cohort study. Methods: Hospital-based retrospective cohort study was employed among 454 admitted under-five SAM children from Januarys1st 2015-to December 30, 2019. Data were cleaned, coded, and entered into Epi-Data 3.1; then exported to STATA/SE- 14/R for analysis. Survival analysis was used to check each variable's proportional hazard assumption and no variable Schoenfield test <0.05. Variable with AHR at 95 % CI at P-value less than 0.05 considered as significant. Final model adequacy was checked by Nelson Alana and Cox Snell residual plot test. Result: Totally 454 (90.4%) individual data were included for final analysis; Sixty-five percent of 65.4% (95%CI: 50.1- 69.2) admitted children declared as cured, 16.52 % of them defaulted and 11.5% of children reported as dead. The median age and median cure time of SAM children were found at 2.2 years and 13 days (±7), respectively. Children diagnosed marasmus (AHR=1.56: 95% CI 1.08--2.2, p<0.018), with No nasal-gastric intubation (NGT) during admission (AHR= 1.31: 95%CI (1.04 --1.67, P<0.029) and taking F-100 milk (AHR=5.42 95% CI (2.92--9.85, p<0.001) were associated with treatment cure rate. The conclusions: The overall treatment cure rate of this study was remaining low at 65.4% compared to the sphere standard sets reference (i.e., >75-77.9 %). Concerning associated factors addressing F-100 milk, making SAM underfive children with no NGT and increased treatment cure rate was independently associated with treatment cure rate

148-155

Authors: Komal Manerkar, Jane Harding, Cathryn Conlon, Christopher McKinlay

Background: We previously validated a four-day complementary food frequency questionnaire (CFFQ) to estimate the nutrient intake in New Zealand infants aged 9-12 months. However, manual entry of the CFFQ data into nutritional analysis software was time-consuming. Therefore, we developed an automated algorithm and evaluated its accuracy by comparing the nutrient estimates with those obtained from the nutritional analysis software. Methods: We analysed 50 CFFQ completed at 9- and 12-months using Food Works nutritional analysis software. The automated algorithm was programmed in SAS by multiplying the average daily consumption of each food item by the nutrient content of the portion size. We considered the most common brands for commercially prepared baby foods. Intakes of energy, macronutrients, and micronutrients were compared between methods using Bland-Altman analysis. Results: The automated algorithm did not have any significant bias for estimates of energy (kJ) (MD 15, 95% CI -27, 58), carbohydrate (g) (MD -0.1, 95% CI -1.2,1.0), and fat (g) (-0.1, 95% CI -0.3,0.1), but slightly underestimated intake of protein (MD -0.4 g, 95% CI -0.7,-0.1), saturated fat, PUFA, dietary fibre, and niacin. The algorithm provided accurate estimates for other micronutrients. The limits of agreement were relatively narrow. Conclusion: This automated algorithm is an efficient tool to estimate the nutrient intakes from CFFQ accurately. The small negative bias observed for few nutrients was clinically insignificant and can be minimised. This algorithm is suitable to use in large clinical trials and cohort studies without the need for proprietary software.

164-170

Authors: F.E. Gunes, S. Aktac, A.H. Islamoglu, G. Akduman

Introduction:Parents have a significant impact on child nutrition and the child's eating habits in long-term behavior. This study aims to examine the effects of mothers' attitudes on the eating behaviors of children and the determination of their nutritional status.Method: Children's eating habits and mothers' eating attitudes were examined in 417 children with face-to-face interviews using the Child Feeding Questionnaire (CFQ). The participants' anthropometric characteristics were determined, and body mass indexes (kg/m2) were calculated. AnthroPlus software was used to determine the children’s BMI-for-age Z-scores. BeBiS nutrition information system was used to assess children’s food intake.Results: The mothers' median BMI was above the overweight threshold. The lowest CFQ score was for perceived child weight, and the maximum score was for food restriction. Significant differences were found in mothers ages, mothers' BMIs, children's WAZ and BAZ scores, and BMIs, weight (p<0.001), perceived parent weight scores (p=0.04), and pressure to eat (p=0.04). Families should be conscious about nutrition for the protection and promotion of children's health.

188-190

Authors: R.L. Markosyan, L.V. Navasardyan

Central precocious puberty results from the premature activation of the hypothalamic-pituitary-gonadal axis. Rarely congenital adrenal hyperplasia and/or its inappropriate treatment can be a peripheral cause of CPP. There are very few case reports of this etiology. Chronic mildly to moderately elevated adrenal androgens or intermittent hyperandrogenemia in congenital adrenal hyperplasia may trigger the precocious activation of the hypothalamic-pituitary axis, leading to CPP. In the current work, we describe 6 cases of late diagnosis of congenital adrenal hyperplasia associated with central precocious puberty. Central precocious puberty seems to be a complication of congenital adrenal hyperplasia, particularly in countries where a routine neonatal screening program for this condition is lacking. It is unclear whether these patients could avoid central precocious puberty development if the congenital adrenal hyperplasia was diagnosed in the neonatal period and appropriately treated. The current work underlines the need for congenital adrenal hyperplasia neonatal screening implementation and further investigation of the association of these two endocrine disorders

202-211

Authors: Fentaw Wassie Feleke, Getahun Fentaw Mulaw

Background:Optimal infant and young child feeding practices are essential for normal growth, better health, and mental and physical development. Even though there are a lot of nutrition intervention programs in Ethiopia, still suboptimal feeding practices are prevalent. This study was devised to assess a level of minimum acceptable diet (MAD) and predictors among children aged 6-23 months in Mareka District, south Ethiopia. Method: A community-based cross-sectional study was employed on 662 study participants from August 15 to September 15/ 2015. They were selected by a multi-stage sampling technique. Data were collected by interviewer-administered semi-structured questionnaires. Statistical significance was declared at p-value <0.05 at multivariable logistic regression.Result: The study showed that 35.5 % of the children aged 6-23 months met the recommended MAD. Maternal primary and secondary education (AOR: 1.90; 95% CI: 1.15-3.16 and AOR: 2.06, 95% CI: 1.12-3.77), Media exposure (AOR: 2.16; 95% CI: 1.46-3.29), health facility delivery (AOR:2.52; 95% CI: 1.54-4.13), child age of 9-11 and 12-23 months (AOR:2.73; 95% CI: 1.41-5.49 and AOR:2.55; 95% CI: 1.39-4.69) and GMP service utilization (AOR: 4.09; 95% CI: 2.51-6.65) were associated with MAD of children. Conclusion: The level of MAD among children was low. Maternal educational status, media exposure, institutional delivery, child age, and GMP service utilization were associated with MAD. Increasing utilization of GMP service, health facility delivery, maternal education, and media promotion was recommended to increase the level of MAD

93-99

Authors: Fatma Kubra Sayin, Muammer Buyukinan, Derya Arslan, Cigdem Damla Deniz

Purpose: This study aimed to determine whether emotional eating (EE) and uncontrolled eating (UCE) scores affect the metabolic risk factors in obese adolescents. Methods: A sample of 100 adolescents have BMI-SDS between 1.41 and 2.83 (aged 12-17 years) was selected. EE and UCE scores were estimated using the TFEQ21. The association of EE and UCE with anthropometric data, lipid profile, glucose profile, liver enzymes, and inflammation factors was assessed in boys and girls. Results: Using Spearman rank correlation, EE scores significantly correlated with uric acid (r = 0.393 and P = 0.001), CRP (r = 0.273 and P = 0.017), TG (r = 0.317 and P = 0.001), TC (r = 0.258 and P = 0.019) and VAI (r = 0.276 and P = 0.034). Also UCE scores were showed positive correlation with CRP (r = 0.257 and P = 0.024). Conclusion: In conclusion, interrelationships tend to exist between EE and triglyceride, uric acid, visceral adiposity index, and CRP levels among obese adolescents

115-124

Authors: Anthony Ike Wegbom, Clement Kevin Edet, Victor Alangibi Kiri

Background: Despite low birth weight (LBW) role on child growth, development, and survival in developing countries, it has not been given the desired priority in terms of research, at the national level in Nigeria. Our study aims to estimate the trend in the prevalence of small size babies and to identify its predictors using nationally representative data. Methods: We used the 2013 and 2018 data from the Nigeria Demographic and Health Survey using the statistical methods of descriptive analysis and logistic regression modelling. Results: The proportion of babies reported to have small size at birth in Nigeria declined from 14.9% in 2013 to 13.7% in 2018. Various factors from demographic, socio-economic, and health-seeking behaviour were identified as significant predictors. Women who received iron pills and tetanus toxoids during pregnancy had at most 79% and 80% less risk of having small size babies, respectively, than those who received none of these two. Female children had at least 21% more chance of being small in size than male children. Other key predictors were geopolitical region, maternal age at child birth, maternal literacy level, wealth status, religion, source of water supply, number of ANC visits during pregnancy, and desirousness of pregnancy. Conclusion: In light of the adverse effects of low birth weight on child well-being, we recommend the implementation and prioritization of active, resourceful public health interventions that account for the findings of this study, if Nigeria is to sustain the progress achieved so far in reducing its current high rate

133-138

Authors: Brij Pal Singh, Mahak Sharma

Child malnutrition is a public health problem in developing countries, and dietary diversity is one of the important determinants of undernutrition. Different nutrients are obtained from different food groups and to meet the requirement of recommended Dietary Allowances entitled as Dietary Diversity. The current review revealed that the nutrition status of children is directly related to the food groups consumed. Food diversity depends on many factors such as Socio-economic Status, education level, sex, and age of the subjects. The food group consumed and food items taken from each group were low in the low Socio-Economic Status (SES) subjects, rural areas, females, and less educated families, resulting in malnutrition among children of various countries. Low level of Dietary Diversity can be the reason for undernutrition in children worldwide, especially in developing countries. Many studies thus supported that Dietary Diversity and Food Variety can provide nutritional adequacy.

47-54

Authors: Artemio M. Gonzales Jr., Marciel N. Salvador

Nutritionally adequate and safe complementary feeding starting from the age of 6 months up to 59 months is one of the effective intervention to reduce infant and child morbidity and malnutrition. This study aims to determine the nutritional status of children ages 6-59 months and their caregiver’s infant and young child feeding (IYCF) practices of the Buhid community in Rizal, Occidental Mindoro.The design used in this study was a descriptive cross-sectional carried out between December 2016-February 2017. A survey questionnaire was utilized as an instrument in this study. It includes an anthropometric survey of 6-59 months old and infant and young child feeding practices using WHO and UNICEF IYCF indicators. Vaccination, vitamin A supplementation and deworming coverage were also measured.Findings revealed a prevalence of global acute malnutrition (GAM) at a critical level. There is a low but significant prevalence of stunting and underweight among children. There is a good infant and young feeding practice in the community except for the minimum acceptable diet during complementary feeding. Lastly, there is low BCG and measles vaccination coverage in the community that could be a threat to the impending disease outbreak

65-73

Authors: Suzan Tami, Debra Reed

The purpose of this study was to explore the effects of parenting styles and family contributors on physical activity behaviors in Arab children living in the US. This mixed-method study included the Caregiver's Feeding Style Questionnaire (CFSQ), Family Nutrition Physical Activity (FNPA) survey, and five focus group discussions (FGD), guided by the Social Cognitive Theory (SCT). Twenty-three Arab mothers of 37 children aged 6-10 years old participated in this study. Seventeen mothers were overweight or obese, and six children were overweight or obese. Although all Arab mothers self-assessed that they were authoritative, only seven mothers were categorized as having an authoritative feeding style based on their CFSQ scores. The FNPA overall mean was 3.15, indicating less obesogenic family environments and behaviors. Across FGDs, common physical activity barriers included lack of time, the child being distracted by technology, and lack of a mother's interest in a child's physical activity due to culture and fear. Positive approaches included considering the child's interest in sports and involvement in physical activity with the child. Negative attitudes included pushing the child to do sports and the mother's lack of interest in physical activity. In correlation analyses, the mother's BMI was significantly correlated with the child's BMI z-scores (r = 0.325, p = 0.005). No significant associations were found between reported feeding styles (CFSQ), obesogenic family environments (FNPA), and child's BMI z-scores. This study can guide future efforts in developing effective education programs, including physical activity behaviors for Arab families

81-92

Authors: Suzan Tami, Debra Reed

Parenting styles and family contributors are the main determinants of obesity risk in children. To date, no research has been reported on parenting styles/practices and family contributors to the development of dietary behaviors in Arab children living in the US. The objectives of this exploratory mixed-method study were to collect data on parenting feeding styles (Caregiver’s Feeding Style Questionnaire- CFSQ) of Arab mothers and family contributors (Family Nutrition Physical Activity- FNPA) to the development of dietary behaviors in their children; and to collect data on Arab mothers' challenges and strategies to promote healthier dietarybehaviors in their children. Although all Arab mothers (n=23) self-assessed that they were authoritative, only seven mothers were categorized as having an authoritative feeding style based on their CFSQ scores. The FNPA overall mean was 3.15, indicating less obesogenic family environment and behaviors. Across focus groups, barriers to desirable dietary intake included low vegetable intake and child being distracted by sweets, junk foods, and technology. All mothers wanted their children to have healthier dietary habits and used positive and negative approaches to achieve that. Positive approaches included no pressure to eat and providing healthier alternative foods. Negative approaches included pressuring the child to eat and rewarding with sweets and technology. In correlation analyses, the mother's BMI was significantly correlated with the child's BMI z-scores (r = 0.325, p = 0.005). This study can guide future efforts in assessing parenting style and assessing the home environment regarding the dietary behaviors of Arab families.