Prevalence and assessment of malnutrition among children attending the Reproductive and Child Health clinic at Bagamoyo District Hospital, Tanzania
Background:
Malnutrition has long been associated with poverty, poor diet and inadequate access to health care, and it remains a key global health issue that both stems from and contributes to ill-health, with 50 % of childhood deaths due to underlying undernutrition. The purpose of this study was to determine the prevalence of malnutrition among children under-five seen at Bagamoyo District Hospital (BDH) and three rural health facilities ranging between 25 and 55 km from Bagamoyo: Kiwangwa, Fukayosi, and Yombo.
Methods:
A total of 63,237 children under-five presenting to Bagamoyo District Hospital and the three rural health facilities participated in the study. Anthropometric measures of age, height/length and weight and measurements of mid-upper arm circumference were obtained and compared with reference anthropometric indices to assess nutritional status for patients presenting to the hospital and health facilities.
Results:
Overall proportion of stunting, underweight and wasting was 8.37, 5.74 and 1.41 % respectively. Boys were significantly more stunted, under weight and wasted than girls (p-value < 0.05). Children aged 24–59 months were more underweight than 6–23 months (p-value = <0.0001). But, there was no statistical significance difference between the age groups for stunting and wasting. Children from rural areas experienced increased rates of stunting, underweight and wasting than children in urban areas (p-value < 0.05). The results of this study concur with other studies that malnutrition remains a problem within Tanzania; however our data suggests that the population presenting to BDH and rural health facilities presented with decreased rates of malnutrition compared to the general population.
Conclusions:
Hospital and facility attending populations of under-five children in and around Bagamoyo suffer moderately high rates of malnutrition. Current nutrition programs focus on education for at risk children and referral to regional hospitals for malnourished children. Even though the general population has even greater malnutrition than the population presenting at the hospital, in areas of high malnutrition, hospital-based interventions should also be considered as centralized locations for reaching thousands of malnourished children under-five.
Keywords:
Malnutrition, Tanzania, Bagamoyo, Undernutrition, Stunting, Wasting
Autoři:
Omar Ali Juma 1*; Zachary Obinna Enumah 2; Hannah Wheatley 1; Mohamed Yunus Rafiq 3; Seif Shekalaghe 1; Ali Ali 1; Shishira Mgonia 4; Salim Abdulla 1
Působiště autorů:
Ifakara Health Institute, Bagamoyo Branch, PO BOX 7 , Bagamoyo, Tanzania.
1; Johns Hopkins University School of Medicine, Baltimore, USA.
2; Department of Anthropology, Brown University, Providence, USA.
3; Bagamoyo District Hospital, Bagamoyo, Tanzania.
4
Vyšlo v časopise:
BMC Public Health 2016, 16:1094
Kategorie:
Research article
prolekare.web.journal.doi_sk:
https://doi.org/10.1186/s12889-016-3751-0
© 2016 The Author(s).
Open access
This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
The electronic version of this article is the complete one and can be found online at: http://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-016-3751-0
Souhrn
Background:
Malnutrition has long been associated with poverty, poor diet and inadequate access to health care, and it remains a key global health issue that both stems from and contributes to ill-health, with 50 % of childhood deaths due to underlying undernutrition. The purpose of this study was to determine the prevalence of malnutrition among children under-five seen at Bagamoyo District Hospital (BDH) and three rural health facilities ranging between 25 and 55 km from Bagamoyo: Kiwangwa, Fukayosi, and Yombo.
Methods:
A total of 63,237 children under-five presenting to Bagamoyo District Hospital and the three rural health facilities participated in the study. Anthropometric measures of age, height/length and weight and measurements of mid-upper arm circumference were obtained and compared with reference anthropometric indices to assess nutritional status for patients presenting to the hospital and health facilities.
Results:
Overall proportion of stunting, underweight and wasting was 8.37, 5.74 and 1.41 % respectively. Boys were significantly more stunted, under weight and wasted than girls (p-value < 0.05). Children aged 24–59 months were more underweight than 6–23 months (p-value = <0.0001). But, there was no statistical significance difference between the age groups for stunting and wasting. Children from rural areas experienced increased rates of stunting, underweight and wasting than children in urban areas (p-value < 0.05). The results of this study concur with other studies that malnutrition remains a problem within Tanzania; however our data suggests that the population presenting to BDH and rural health facilities presented with decreased rates of malnutrition compared to the general population.
Conclusions:
Hospital and facility attending populations of under-five children in and around Bagamoyo suffer moderately high rates of malnutrition. Current nutrition programs focus on education for at risk children and referral to regional hospitals for malnourished children. Even though the general population has even greater malnutrition than the population presenting at the hospital, in areas of high malnutrition, hospital-based interventions should also be considered as centralized locations for reaching thousands of malnourished children under-five.
Keywords:
Malnutrition, Tanzania, Bagamoyo, Undernutrition, Stunting, Wasting
Zdroje
1. Mamiro PR, Van Camp J, Roberfroid D, Kolsteren P, Huyghebaert A. Prevalence of malnutrition and anaemia among infants aged 4–12 months in Kilosa district-rural Tanzania. MededRijksuniv Gent FakLandbouwkdToegepBiol Wet. 2001;66(4):69–73.
2. Mwanri L, Worsley A, Ryan P, Masika J. Supplemental vitamin A improves anemia and growth in anemic school children in Tanzania. J Nutr. 2000; 130(11):2691–6.
3. Alderman H, Hoogeveen H, Rossi M. Reducing child malnutrition in Tanzania: combined effects of income growth and program interventions. Econ Hum Biol. 2006;4(1):1–23.
4. Black RE, Allen LH, Bhutta ZA, et al. Maternal and child undernutrition: global and regional exposures and health consequences. Lancet. 2008; 371(9608):243–60. doi:10.1016/S0140-6736(07)61690-0.
5. Rice AL, Sacco L, Hyder A, Black RE. Malnutrition as an underlying cause of childhood deaths associated with infectious diseases in developing countries. Bull World Health Organ. 2000;78(10):1207–21. doi:10.1590/S0042-96862000001000007.
6. Bryce J, Boschi-Pinto C, Shibuya K, Black RE, Group WCHER, others. WHO estimates of the causes of death in children. Lancet. 2005;365(9465):1147–52.
7. Murray CJ, Lopez AD. Global mortality, disability, and the contribution of risk factors: global burden of disease study. Lancet. 1997;349(9063):1436–42.
8. Van de Poel E, Hosseinpoor AR, Speybroeck N, Van Ourti T, Vega J. Socioeconomic inequality in malnutrition in developing countries. Bull World Health Organ. 2008;86(4):282–91.
9. Shubis K, Juma O, Sharifu R, Burgess B, Abdulla S. Challenges of establishing a Community Advisory Board (CAB) in a low-income, low-resource setting: experiences from Bagamoyo, Tanzania. Heal Res Policy Syst. 2009;7(1):16–20.
10. National Bureau of Statistics in the Ministry of Finance and the Office of Chief Government Statistician at the Ministry of State, President Office, State House and Good Governance. Basic Demographic And Socio-Economic Profile Report Tanzania Mainland. Dar es Salaam: Ministry of Finance; 2015.
11. WHO Anthro for personal computers, version 3.2.2. 2011: Software for assessing growth and development of the world’s children. Geneva: WHO; 2010.
12. Heltberg R. “Malnutrition, poverty, and economic growth”. Health Econ. 2009;18(no. S1):S77-88.
13. Brown KH, Nyirandutiye DH, Jungjohann S. Management of children with acute malnutrition in resource-poor settings. Nat Rev Endocrinol. 2009;5(11):597–603.
14. Garenne M. Urbanisation and child health in resource poor settings with special reference to under-five mortality in Africa. Arch Dis Child. 2010;95(6):464–8.
15. Fotso J-C. Urban–rural differentials in child malnutrition: trends and socioeconomic correlates in sub-Saharan Africa. Health Place. 2007;13(1):205–23.
16. Smith LC, Ruel MT, Ndiaye A. Why is child malnutrition lower in urban than in rural areas? Evidence from 36 developing countries. World Dev. 2005; 33(8):1285–305.
17. Sahn DE, Stifel DC. Urban–rural inequality in living standards in Africa. J Afr Econ. 2003;12(4):564–97.
18. Howard M. Socio-economic causes and cultural explanations of childhood malnutrition among the Chagga of Tanzania. SocSci Med. 1994;38(2):239–51.
19. Kassouf AL, Senauer B. Direct and indirect effects of parental education on malnutrition among children in Brazil: a full income approach. Econ Dev Cult Change. 1996;44(4):817–38.
20. Waber DP, Vuori-Christiansen L, Ortiz N, et al. Nutritional supplementation, maternal education, and cognitive development of infants at risk of malnutrition. Am J ClinNutr. 1981;34(4):807–13.
21. Wagstaff A, Van Doorslaer E, Watanabe N. On decomposing the causes of health sector inequalities with an application to malnutrition inequalities in Vietnam. J Econom. 2003;112(1):207–23.
22. Gupta MC, Mehrotra M, Arora S, Saran M. Relation of childhood malnutrition to parental education and mothers’ nutrition related KAP. Indian J Pediatr. 1991;58(2):269–74.
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