Nutritional Status of Pre-School Children Attending Anganwadi Centres in Chittoor, Andhra Pradesh, India

Sravana Deepthi C; Erigela Mallikarjuna  Reddy; Sirshendu Chaudhuri; Rizwana Syed

doi:10.55489/njcm.131120222415

Authors

C Sravana Deepthi Apollo Institute of Medical Sciences and Research, Chittoor, India
Erigela Mallikarjuna Reddy Apollo Institute of Medical Sciences and Research, Chittoor, India
Sirshendu Chaudhuri Indian Institute of Public Health, Hyderabad, India https://orcid.org/0000-0002-7375-7851
Syed Rizwana Apollo Institute of Medical Sciences and Research, Chittoor, India

DOI:

https://doi.org/10.55489/njcm.131120222415

Keywords:

India, Malnutrition, Preschool child, Severe acute malnutrition, Stunting

Abstract

Context/Background: Malnutrition among children is a long-standing public health problem in India.

Objective: To assess the nutritional status of pre-school children and to identify the socio-demographic determinants of malnutrition.

Methodology: In this community-based cross-sectional study, 194 under-five children were recruited from rural and urban areas of Chittoor district, Andhra Pradesh. Anthropometric measurements including weight, and mid upper arm circumference were measured and age standardized weight-for-age (WAZ), height-for-age (HAZ), and weight-for-height (WHZ) were calculated. The proportion of under nutrition (WAZ <-2 standard deviation (SD)), stunting (HAZ <-2SD), and wasting (WHZ <-2SD) were calculated along with the determinants.

Results: The mean age of the participants was 40.5 months (SD- 9.1 months), 101 (52.1%) were from rural areas, and 96 (495%) female. The median z-scores for WAZ, HAZ, and WHZ were -1.22, -0.98, and -0.78respectively. The HAZ values were significantly low in- urban children (-0.81; 95% CI: -0.4, -1.21), among the non-Hindu children (-0.92; 95% CI: -0.35, -1.5). The overall prevalence of underweight, stunting, and wasting were- 13.4% (95% CI: 8.5%, 18.3%), 23.7% (95% CI: 17.6%, 29.8%), and 19.6% (95% CI: 11.9%, 25.3%) respectively. There were a total 16 (8.3%, 95% CI: 5.6%, 11.0%) severely malnourished children. Urban residence (OR 6.75; 95% CI: 3.03 – 15.04) was a strong predictor of stunting.

Conclusion: Malnutrition remains to be a public health problem in this area. Strengthening of existing program implementation coupled with evidence generation on malnutrition can be the key strategies in combating malnutrition.

References

Black RE, Allen LH, Bhutta ZA, Caulfield LE, de Onis M, Ezzati M, et al. Maternal and child undernutrition: global and regional expo-sures and health consequences. Lancet. 2008 Jan 19;371(9608):243-60. Doi: https://doi.org/10.1016/S0140-6736(07)61690-0

Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, de Onis M, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet. 2013 Aug 3;382(9890):427-51. Doi: https://doi.org/10.1016/S0140-6736(13)60937-X

Bhutta ZA, Das JK, Rizvi A, Gaffey MF, Walker N, Horton S, et al. Evidence-based interventions for improvement of maternal and child nutrition: what can be done and at what cost? Lancet. 2013 Aug 3;382(9890):452-77. Doi: https://doi.org/10.1016/S0140-6736(13)60996-4

Morris SS, Cogill B, Uauy R, Maternal and Child Undernutrition Study Group. Effective international action against undernutrition: why has it proven so difficult and what can be done to accelerate progress? Lancet. 2008 Feb 16;371(9612):608-21. Doi: https://doi.org/10.1016/S0140-6736(07)61695-X

Katona P, Katona-Apte J. The Interaction between Nutrition and Infection. Clinical Infectious Diseases [Internet]. 2008 May 15 [cit-ed 2022 Jul 3];46(10):1582-8. Doi: https://doi.org/10.1086/587658 PMid:18419494

Martins VJB, Toledo Florêncio TMM, Grillo LP, Franco M do CP, Martins PA, Clemente APG, et al. Long-Lasting Effects of Undernutri-tion. Int J Environ Res Public Health [Internet]. 2011 Jun [cited 2022 Jul 3];8(6):1817-46. Doi: https://doi.org/10.3390/ijerph8061817 PMid:21776204 PMCid:PMC3137999

Abu-Fatima O, Abbas AAG, Racalbuto V, Smith L, Pizzol D. Child Undernutrition in Sudan: The Social and Economic Impact and Fu-ture Perspectives. Am J Trop Med Hyg [Internet]. 2021 Mar [cited 2022 Jul 3];104(3):1149-52. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7941838/

World Health Organization. Global nutrition targets 2025: policy brief series [Internet]. [cited 2022 Jul 3]. Available from: https://www.who.int/publications-detail-redirect/WHO-NMH-NHD-14.2

Victora CG, Christian P, Vidaletti LP, Gatica-Domínguez G, Menon P, Black RE. Revisiting maternal and child undernutrition in low-income and middle-income countries: variable progress towards an unfinished agenda. The Lancet [Internet]. 2021 Apr 10 [cited 2022 Jul 3];397(10282):1388-99. Doi: https://doi.org/10.1016/S0140-6736(21)00394-9

UNICEF, WHO, World Bank Group. Levels and trends in child malnutrition: Key findings of the 2019 edition [Internet]. [cited 2022 Jul 3]. Available from: https://www.unicef.org/media/60626/file/Joint-malnutrition-estimates-2019.pdf

da Silva ICM, França GV, Barros AJD, Amouzou A, Krasevec J, Victora CG. Socioeconomic Inequalities Persist Despite Declining Stunt-ing Prevalence in Low- and Middle-Income Countries. J Nutr. 2018 Feb 1;148(2):254-8. Doi: https://doi.org/10.1093/jn/nxx050 PMid:29490104 PMCid:PMC6084584

World Health Organization. WHO | Double burden of malnutrition [Internet]. WHO. World Health Organization; [cited 2022 Jul 3]. Available from: http://www.who.int/nutrition/double-burden-malnutrition/en/

Swaminathan S, Hemalatha R, Pandey A, Kassebaum NJ, Laxmaiah A, Longvah T, et al. The burden of child and maternal malnutrition and trends in its indicators in the states of India: the Global Burden of Disease Study 1990-2017. The Lancet Child & Adolescent Health [Internet]. 2019 Dec 1 [cited 2022 Jul 3];3(12):855-70. Doi:https://doi.org/10.1016/S2352-4642(19)30273-1

Ministry of Health and Family Welfare. India Fact Sheet National Family Health Survey- 5 [Internet]. International Institute of Popu-lation Sciences; [cited 2022 Jul 3]. Available from: http://rchiips.org/nfhs/NFHS-5_FCTS/India.pdf

Mamatha IV, Reddy DNK. Nutritional Status of Pre-School Children Attending Anganwadi Centres in Tirupati, Andhra Pradesh, In-dia. :5.

Silva VGP, Silva SGP. Nutritional Status of Anganwadi Children under the Integrated Child Development Services Scheme in a Rural Area in Goa. INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY [Internet]. 2015 [cited 2022 Jul 3];3(7):217-21. Available from: https://galaxyjeevandhara.com/index.php/ijss/article/view/3277

Islam S, Mahanta TG, Sarma R, Hiranya S. Nutritional Status of under 5 Children belonging to Tribal Population Living in Riverine (Char) Areas of Dibrugarh District, Assam. Indian J Community Med. 2014 Jul;39(3):169-74. Doi: https://doi.org/10.4103/0970-0218.137155 PMid:25136158 PMCid:PMC4134533

Singh J, Gupta S, Shrotriya V, Singh P. Study of Nutritional Status Among Under Five Children Attending Out Patient Department at A Primary Care Rural Hospital, Bareilly(UP). undefined [Internet]. 2013 [cited 2022 Jul 3]; Available from: https://www.semanticscholar.org/paper/Study-of-Nutritional-Status-Among-Under-Five-Out-at-Singh-Gupta/9b22b7bfcefb602c66fd300a086dcda1f3cdefc1

Ray SK, Biswas AB, Gupta SD, Mukherjee D, Kumar S, Biswas B, et al. RAPID ASSESSMENT OF NUTRITIONAL STATUS AND DIETARY PATTERN IN A MUNICIPAL AREA. Indian Journal of Community Medicine [Internet]. 2000 Mar [cited 2022 Jul 3];25(1):14-8. Available from: https://journals.lww.com/ijcm/Abstract/2000/25010/RAPID_ASSESSMENT_OF_NUTRITIONAL_STATUS_AND_DIETARY.3.aspx

Psaki S, Bhutta ZA, Ahmed T, Ahmed S, Bessong P, Islam M, et al. Household food access and child malnutrition: results from the eight-country MAL-ED study. Popul Health Metr. 2012 Dec 13;10(1):24. Doi: https://doi.org/10.1186/1478-7954-10-24 PMid:23237098 PMCid:PMC3584951

Banerjee B, Mandal ON. An Intervention Study in Malnutrition Among Infants in a Tribal Community of West Bengal. Indian Journal of Community Medicine [Internet]. 2005 Mar [cited 2022 Jul 3];30(1):27. Available from: https://journals.lww.com/ijcm/Abstract/2005/30010/An_Intervention_Study_in_Malnutrition_Among.10.aspx

Devi PY, Geervani P. Determinants of Nutrition Status of Rural Preschool Children in Andhra Pradesh, India. Food Nutr Bull [Inter-net]. 1994 Dec 1 [cited 2022 Jul 3];15(4):1-8. Doi: https://doi.org/10.1177/156482659401500402

Dhakal M, Rai A, Singh CM, Mohapatra S. Health impact assessment: A futuristic approach in under-five care. India J Prev Soc Med [Internet]. 2005 [cited 2022 Jul 3];36(3):114-20.