International Journal of Child Health and Nutrition

189-200

Authors: Theresa A. Nicklas, Carol E. O’Neil, Victor L. Fulgoni

Snacking is very common among Americans; the impact of variety of snacking patterns on nutrient intake and weight status is unclear. This study examined the associations of snacking patterns on nutrient intake and weight in U.S. children 2-18 years (n=14,220) participating in the 2001-2008 National Health and Nutrition Examination Survey. Cluster analysis generated 12 distinct snacking patterns, explaining 57% of variance in total calories consumed. Only 8% of the children did not consume snacks on the day of the 24-hour recall. Cakes, cookies and pastries was the most common snacking pattern (16%) followed by miscellaneous snacks (e.g. whole milk, orange juice and meat/fish/poultry; 13%), and crackers and salty snacks (10%). Most snacking patterns resulted in higher total energy intake than the no snack pattern. After controlling for energy intake, most snacking patterns resulted in higher intakes of fiber; vitamins A, C, B12, and K; riboflavin; folate; potassium; calcium; zinc; and magnesium than the no snack pattern. However, most of the snacking patterns resulted in higher total intake of saturated fatty acids, solid fats, added sugars, and sodium (nutrients to limit). Several of the snacking patterns (i.e. cakes/cookies/pastries, crackers/salty snacks, sweets, and other grains) were associated with a reduced risk of overweight and abdominal obesity. Overall, several snacking patterns compared with non-snackers had better diet quality and were less likely to be overweight or obese and less likely to have abdominal obesity. Education is needed to improve snacking patterns in terms of nutrients to limit in the diet.

223-229

Authors: Rowshan Ara Begum, Jesmin Akter, Iqbal Kabir, Lars-Ake Persson

Background: Children under five years, particularly aged 2-4 years (24-48 months), are more vulnerable to intestinal parasitic infections. This is because, children with this ages may contract infective agents during their intense activities, and adventures such as crawling or walking on bare ground, sand or grasses or eating mud/pica. Increased population density, lack of awareness, poor sanitation, and poor public health practices, and environmental sanitations, affect the prevalence of parasitic infection in tropical countries. Moreover, the prevalence of intestinal parasitic infectionsamong the asymptomatic children aged under fiveis not well studied. Objectives: The objectives of this study was to investigate the prevalence of intestinal parasitic infections among the asymptomatic children aged 6-59 months in selected Southern Ethiopia including Gedeo, Amaro, Walyta and Kambata. Methods: A cross-sectional study was carried out and the sampling design combined multistage sampling methods including, both simple random sampling technique, population density and systematic random sampling techniques. The course of this study took over a period of 5 months, from September 2009 to January 2010. Study participants were estimated by convenient sampling method to include 406 asymptomatic children (217 females and 189 males) from the systematically selected households of the study sites. Parasitological diagnosis of the parasites was done using the standard parasite and ova method. A total of 406 stool specimens were examined by a direct microscopy using a normal saline (0.9%) and lugol’s iodine wet mount techniques to determine the infection of intestinal parasites and the analysis of the data was made manually using thematic framework method. Results: Of the total 406 study participants, 170 (41.9%) children were found to have single and double intestinal parasitic infections whilst 236 (58%) children were free from the suspected parasites. Ascaris, lumbricoides, amoeba spp, Giardia lamblia, Trichuris trichiura, hookworms spp, Strongyloides stercoralis, and Hymenolepis nana were identified in both single and double infections. Double infections were found in 19 (11.2%) asymptomatic children of the total positive cases and the rest were single infections. In both single and double infections, ascaris was found to be the most dominant infective agent accounted 111(59%) out of the total 187 parasitic load of infection, followed by amoeba spp.31 (16.6%) and Trichuris trichiura 17(9%). Higher proportions of infected age groups were 25-48 while the least infected age groups were 6-24 and 49-59 months. Concluding Remarks and Recommendations: This baseline study indicated higher prevalence of intestinal parasitic infections in the study area and therefore, much effort is remaining to fight against parasitic infection. Along with regular deworming intervention, health education including infection cycle, environmental sanitation, personal hygiene, use of potable water and proper use of latrine should be given due attention to prevent and control parasitic infections among children in both urban and rural areas.

237-249

Authors: Mahama Saaka, Abdulai Abdul Rauf

Objective: Little is known about the relative contribution of prenatal care utilization on pregnancy outcome in developing country setting where other equally important predictors of low birth weight (LBW) including malarial infection and poor diet predominate. This study investigated whether the utilization of antenatal care (ANC) services is an independent predictor of LBW in Northern Ghana. Methods:Inthis community based cross sectional study, we compared pregnancy outcome (birth weight) across groups of 407 women who received different amounts of ANC. Results:The incidence of low birth weight (LBW) of newborn babies was 18.2 % (74/407). The main finding was that women who made at least four ANC visits had 63.0 % protection against delivering a LBW (AOR = 0.37, 95 % CI: 0.19, 0.69). Conclusion:The results of this study suggest that adequate antenatal care is effective in preventing LBW in a rural setting but its effect was more discernible among women who were not in gainful employment (suggestive of low socio-economic status)

264-269

Authors: Abok Ibrahim Ishaya, Yilgwan Christopher Sabo, John Collins

Background: To determine the prevalence of food insecurity and some socio demographic predictors of food insecurity among Vulnerable Children (VC) in Jos, North- central Nigeria. Methods: A cross-sectional comparative study involving 202 VC selected using multi-stage sampling technique across two orphanages and three communities located in sub-urban areas in Jos East, Jos North and Jos South Local Government Area was carried out. A VC was defined as a child who has loss mother, father or both or children who reside with chronically ill parents or reside in institution during the study. Only VC greater than five years but less than 18years were enrolled. Food security was measured using four questions that were adapted from existing questionnaires. Food insecurity was defined and graded has mild, moderate or high if there was an affirmative response to any one, two or three of four questions. Data generated were analyzed using EPI Info version 3.65 software. The independent variables orphan status, age, gender, place of residence, child level of education, child work, were compared with the dependent variables of food insecurity using bivariate and multivariate analysis. In all statistical test p < 0.05 was considered statistically significant. Results: Of the 202 VC analyzed 38.6 %(78) were girls and 61.4 %(124) were boys with a mean age of 12.7+ 2.6 years. One hundred and two (50.5%) were IVC while 100(49.5%) were HVC. The VC were mostly orphans (83.2% [168]) while 16.8 %(34) were non orphans. All children were enrolled into school, 137 were in primary school, while the rest were in secondary school. Majority of the HVC were cared for by their mother (24.8% 50[VC]), father (1.9% [4]), uncles (8.4% [17]), aunts (10% [5.0]), grandparents (5.4% [11]), and non relatives (8% [4.0]). The overall prevalence of food insecurity was 48.5%. Of the 98 Food insecure VC 65% were HVC compared to 35% observed among IVC(p <0.05); 69.6 % were children older than 12 years compared to 30.4% obsereved in VC who were <12 years. The odds of food insecurity was 2.1 times in older VC aged 13-18 years (CI=1.1-3.9). VC attending Secondary School were 1.9 time likely to be food insecure compared to those in primary school (CI=1.1-3.5). Similarly, HVC were 3.6 times more likely to be food insecure compared to IVC. (CI=1.9-6.9). VC who worked to earn money had a 2.8times odd to be food insecure (CI=1.2-6.24). Paternal orphans were 2.4 times more likely to be food insecure (CI= 1.0-6.5) compared to other group of VC. Being a maternal orphan, a double orphan or non orphan VC does not predict food insecurity. Sexual experience was also not a predictor of food insecurity. Conclusion: The implication of hunger, in an adolescent child who considered himself/herself overworked is enormous on child physical, emotional and social development. This might lead to more children living their homes to seek shelter in orphanages were the food security status even though not perfect is better than the household. This can be prevented if Household VC are actively identified and their families supported with programs that can make them food secure