stunting

Childhood malnutrition is a leading cause of under-five mortality, particularly in developing nations, like India. Despite some reductions in underweight and stunting rates among children under five from 2005-2016, progress has been inadequate given India’s economic growth. Moreover, one-third of children under five remain stunted and underweight, especially in populous, states such as Uttar Pradesh, Bihar, Rajasthan, and Madhya Pradesh, which rank low on the socio-demographic index (SDI). Further, identifying target areas can enable more focused resource allocation to meet community needs, which can be done using geospatial mapping and modeling of public health events. 

The study utilized data from the national family health survey, covering 82,784 children under five. A spatial analysis was conducted to examine the distribution of malnutrition in the low SDI states of India. Spatial lag models were used to assess the association between malnutrition and its determinants across these regions. 

The study found that 39.1% of children were stunted, 32.9% were underweight, and 19.3% were wasted. Significant spatial variation in malnutrition was identified across the regions, as indicated by the local Moran index for stunting (I=0.3464; P<0.0001), wasting (I=0.373; P<0.0001), and underweight (I=0.590; P<0.0001). Key factors contributing to regional malnutrition disparities included higher birth order, poor sanitation, non-institutional deliveries, low household wealth, poor maternal body mass index (BMI), and religion.

The study highlights significant spatial disparities in child malnutrition across low SDI states in India. Addressing malnutrition in these regions requires targeted public health interventions focusing on poverty alleviation, improving women’s education, and enhancing maternal health, particularly in areas with a high prevalence of undernutrition.

Stunting has a negative impact on the growth and development of children, which include their susceptibility to dental caries. Caries in primary teeth have been consistently related to malnutrition. Having a history of severe caries was connected with slower childhood growth. We aimed to explain the updated trend of association between stunting and dental caries among all age groups.

A review was done using PRISMA. PubMed and Science Direct was used as database from Jan 2022 to Jan 2023. Studies obtained using specific keywords was 1.748 then filtered. All of the studies that were obtained using specific keywords about stunting and DMFT and or PUFA index. There is no limited year in this systematic search. Endnote software was used to help with the inclusion process; data was extracted into a table that had been prepared.

There were 10 included studies in this systematic review. Eight studies that reported higher dental caries in stunting children than the normal children. Two studies showed a connection between developing stunting malnutrition and severe dental caries. Early childhood caries may increase vulnerability to dental caries by causing odontogenesis to fail, delayed tooth eruption and changes in the salivary glands. Children's ability to eat and sleep may be negatively impacted by untreated caries pain. It might result in decreased nutrient intake and poor appetite, while sleep disturbances might prevent growth hormones from being secreted.

There was a correlation between dental caries and growth stunting because of a decrease in the composition of saliva and defects in tooth formation in children suffered stunting. Thus, there were oral functional limitations and a decrease in food intake since severe dental caries.

The burden of childhood morbidity and mortality are still huge in most sub-Saharan African countries with West African sub-region contributing largely to the burden. Previous findings have demonstrated strong link between early life events such as low birth weight (LBW) with later events particularly malnutrition. We aim at estimating the specific and shared spatial patterns of LBW and stunting among under-five children in multiple West African countries.

Data set for the study was sourced from the Demographic and Health Surveys conducted in fourteen West African countries. We used a Bayesian shared component model allows us to split the spatial surface into those specific to each of the outcomes and one shared by the two, with inference based on a Bayesian approximation procedure through the integrated nested Laplace approximation.

The findings show spatial clustering in the shared and specific effects of the health outcomes, demonstrating high likelihood in northern Nigeria spanning through Niger and that the spatial pattern for the shared effects are similar to those of the specific effects of stunting. Furthermore, mother’s level of education, attendance in antenatal care and household wealth index are strongly associated with the shared health outcomes.

The study provides insight into the spatial pattern of LBW and stunting among West African children and can be useful in targeted interventions in regions with high burden of LBW and malnutrition which may include more advocacy that promote the use of antenatal care services during pregnancy.

Studies have shown that numerous variables were significantly associated with stunting including knowledge of mothers and level of education. However, the study on nutrition knowledge and nutrition benefits among mothers was limited in Papua. This study aims to explore the prevalence of stunted children in this area and to determine whether the knowledge on healthy nutrition and taking  iron supplements are associated with stunted children among mothers who have children under 5 years.

This study as a cross-sectional study was done in 2022. It involved mothers who brought their children under 5 years old to integrated health posts and signed informed consent. Data on balanced nutrition and nutritional benefits for children were collected through a questionnaire consisting of 26 questions with true/false answers. While mothers completed questionnaires on nutrition knowledge, nutrition benefits, and sociodemographic data, height and weight of their children were measured.

A total of 496 mothers participated in this study, the mean age of mothers was 30.42±6.40 years. Based on mothers’ characteristics, the majority of mothers went to high school, were unpaid, and consumed iron supplements during pregnancy (98.2%). There was a 10% stunting incidence in this study. After adjusting for potential confounding factors, having children aged 1 to 20 months old (odds ratio (OR)=0.11; 95% confidence interval (CI)=0.03–0.64) and knowledge of nutritional benefits (OR=0.62; 95% CI=0.40–0.95) decreased the odds of stunting.

A comprehensive program about nutrition should be available, particularly for mothers. This study also suggests that interventions to increase nutrition knowledge among mothers with children aged under 2 years should be prioritized.

Although previous literature has assessed the association of household food insecurity with nutritional outcomes among children, the findings are inconsistent across different study populations.

We aimed to evaluate the association of household food insecurity with nutritional outcomes among children residing in Khalkhal city, Iran.

The present cross-sectional study was conducted on 300 Iranian children aged 2 - 5 years who visited urban and rural health care centers between November 2021 and March 2022. Subjects were included in the survey using multi-stage cluster sampling. Household food security status was assessed using the United States Department of Agriculture (USDA) 18-item food security questionnaire. Odds ratios (95% confidence interval) for stunting according to the food insecurity score were estimated using multivariable logistic regression in three models.

In the present study, 39% of participants had food security, while the prevalence of food insecurity without hunger, food insecurity with moderate hunger, and food insecurity with severe hunger were 22.3%, 23%, and 15.7%, respectively. In all models, both categorized and continuous food insecurity scores correlated negatively with weight (P for all < 0.001). Food insecurity did not predict the risk of stunting in all subjects before and after adjustment (Model 1: OR (CI) = 1.008 (0.96-1.05), P = 0.72; Model 2: OR (CI) = 1.01 (0.96 - 1.05), P = 0.65; Model 3: OR (CI) = 0.98 (0.92-1.04), P = 0.53).

In the current study, we found that Iranian families with the lowest income had the highest food insecurity scores. Household food insecurity was negatively correlated with weight status among children aged 2 - 5 years.

One of the problems currently faced by Indonesia is nutritional problems in the form of stunting. Stunting is a disruption in the growth and development of children due to chronic malnutrition and recurrent infections, characterized by their length or height being below the standard. 

This descriptive research aimed to describe the condition of stunting in Tegal City and the efforts of the Tegal City government in contributing to the reduction of the stunting rate. 

This activity has shown good results, this can be seen from the reduction in the stunting rate in Tegal City from 9.94% in 2022 to 8.21% in 2023. The program to reduce stunting rates in Tegal City was established through the formation of the stunting reduction acceleration team (SRAT). Some of the activities carried out by SRAT include sensitive services linked to poverty management program activities, such as providing integrated healthy livable houses, interventions in the use of yard land, expanding family planning acceptors, refining social assistance recipients, and providing access to drinking water and sanitation management. Specific services are carried out by strengthening specific interventions on a provincial scale, enhancing communication and behavior change by strengthening communication and behavior change and planning and monitoring the evaluation of regional apparatus organizations’ program integration. Collaboration with potential partners is also key in accelerating stunting reduction, along with ongoing monitoring and evaluation of performance. This activity has shown positive outcomes, as evidenced by the reduction in the stunting rate in Tegal City from 9.94% in 2022 to 8.21% in 2023.

The prevalence of stunted children in Tegal City has decreased. Effective leadership, a strong civil society, and targeting vulnerable communities during the implementation of specific and sensitive nutrition interventions are the main factors that support the achievement of these targets.

 Tapering alternate-day doses of corticosteroid forms the cornerstone of the management of steroid-dependent nephrotic syndrome (SDNS) and frequently relapsing nephrotic syndrome nephrotic syndrome (FRNS). This study compares the reduction of relapses over a one-year follow-up, using equivalent steroid doses given as either daily or alternate-day therapy.

 This was an open-label, randomized controlled trial. The participants were children with SDNS or FRNS, aged 2-10 years. After remission, steroid doses were tapered until a threshold below 0.75 mg/kg/day. Then, subjects were randomized to one of two arms as follows: Daily prednisolone at 0.15-0.30 mg/kg/day (intervention arm) or alternate-day dose of 0.5-0.75 mg/kg (control arm). Both groups were compared after 12 months for a reduction in relapse frequency. Secondary outcome measures included time to first relapse, proportion of relapse-free patients, mean steroid dose used, infection episodes, need for alternative medications, and side effects of corticosteroids.

 Median (interquartile range [IQR]) changes in relapse frequency did not differ between the groups, 0 (IQR: -1.0, 0.25) vs 0 (IQR: 0.0, 1.0) in intervention and control groups, respectively (P=0.46). The mean percentage change in relapse frequency was -18.1±42.4% (negative denotes decreased) in the intervention group and 6.0±26.9% in the control group (P=0.05). The median relapse frequencies during the trial period were 3 (IQR: 2, 3) and 3 (IQR: 3, 4) in the intervention group and control groups, respectively (P=0.021). At study completion, prednisolone dose was lower in the intervention group, 0.33±0.12 vs 0.40±0.05 (P=0.02). Both groups did not differ by other secondary outcome variables.

 In patients with SDNS and FRNS, daily low dose (0.15-0.30 mg/kg/day) administration of prednisolone is not superior to conventional alternate-day dosing.

 The Maluku region encompasses thousands of islands. The study analyzed factors related to stunting among children under two years old in the Maluku Region of Indonesia.

Study Design: 

A cross-sectional study.

 This cross-sectional study examined 4764 children under two years. In addition to nutritional status (stature), the study analyzed ten independent variables (province, residence, maternal age, marital status, maternal education, employment, wealth, children’s age, gender, and early initiation of breastfeeding [EIBF]). Finally, the contribution of various factors to stunting was examined using logistic regression.

 Children in Maluku province were 1.13 times more likely than those in North Maluku province to become stunted. In addition, children aged 12-13 months were 4.09 times more likely than<12 months, and boys were 1.87 times more likely than girls to have the patterns of stunting. Children in rural areas were 1.10 times more likely to become stunted than those in urban areas (95% confidence interval: 1.06, 1.14). Divorced/widowed mothers were 1.88 times more likely than married mothers. Mothers of all education levels were more likely than those without formal education, and unemployed mothers were 1.07 times more likely than employed mothers to have stunted children. The possibility of becoming stunted was lower when the children were wealthier.

 Nine variables were related to stunted incidence, including province, residence, maternal age, marital status, maternal education, employment, wealth, children’s age, and gender.

Stunting is a chronic malnutrition problem to which developing countries are faced. Stuntingincreases the risk of child death, affects cognitive and motor development, and reduces performanceand productivity in adulthood. Globally, 1 out of 4 children under the age of 5 suffers from stunting,which causes developmental and growth delays.1

Amis:

 Interconnected factors can cause increased stunting cases. One of the risk factors for stunting is adolescents’ lack of knowledge and attitudes. Various media, including Instagram, can be the reason behind the issue. This study aimed to determine the effect of providing the pre-marital education program through Instagram to increase the literacy and attitude of pre-marital couples regarding stunting prevention.

This quasi-experimental research with a pre-test and post-test design with a control group was conducted in pre-marital couples in the Gunung Kidul Regency from December 2021 to January 2022. The instruments were questionnaires (Google Forms) and educational media such as posters and videos via Instagram. Data were analyzed using the Wilcoxon and Mann-Whitney tests.

After receiving the pre-marital education program through Instagram, pre-marital couples were stunted in both the intervention and control groups. There was an increase in attitude in the intervention group after the intervention. The literacy and attitudes about stunting prevention were increased in pre-marital couples of the intervention compared to the control groups after being given pre-marital education through Instagram.

The pre-marital education program improves the literacy and attitudes about stunting prevention in pre-marital couples.

The objective of this research was to examine whether there exists a correlation between certain attributes of a mother and her determination to make decisions independently and how these factors impact her actions toward stunted toddlers.
Instrument &

A quantitative approach with a cross-sectional design was utilized in the work area of the Manuju Health Center from January to March 2023. By census method, the sample size was determined to be 102. Data was collected using a combination of interviews, observations, and questionnaires.

Knowledge, intrinsic motivation, extrinsic motivation, and amotivation had significant effects on the stunting toddler care behavior (χ2=83.95; df=8; p<0.001). The coefficient of determination indicated that 75.8% of the stunting toddler care behavior was influenced by knowledge, intrinsic motivation, extrinsic motivation, and amotivation. The characteristics had no significant effect on behavior (p=0.576), but the motivation had a direct significant effect on behavior (p<0.001).

Intrinsic and extrinsic motivation are the most influential parameters in stunting toddler care behavior.

During the COVID‑19 pandemic, stunting is estimated to increase 2.4 times higher (It seems that some information is missing here because the usage of the word ‘higher’ hints at a comparison with some other statistic. Or please consider making the following changes in the statement: “...stunting is estimated to be 2.4 times higher than the normal trend.” which can increase mortality, morbidity, and cause economic losses in the future. This study aims to identify the risk factors for stunting during the COVID‑19 pandemic.

An unmatched case‑control study was conducted to compare the exposure of stunted (cases) and non‑stunted (controls) children. There were 127 children aged 6‑24 months, 43 cases, and 84 controls.

The probability of stunting was two times greater in children who experienced good changes in the consumption of tofu/tempeh (p: 0.047; AdjustedOR (aOR): 2.296; 95% CI 1.013‑5.205) and fourtimes greater in children who have a mother that did not receive iron supplementation during pregnancy (p: 0.030; aOR: 4.344; 95% CI: 1.154‑16.355).

Based on the above results, increasing access to nutritious food, and the delivery of services and information related to maternal and child health services during the pandemic needs to be intensified by using innovative low‑risk platforms.

Because low levels of maternal knowledge can cause stunting, developing an education system and web-based stunting anticipation system is needed to increase mothers' ability to improve stunting prevention efforts. This study aimed to evaluate the effectiveness of the Education System and Stunting Anticipation on mothers' knowledge, attitudes, and practices in preventing stunting in Pekanbaru City.

This research adopted a quantitative analytic approach using a quasi-experimental pre-and post-test design with controls. The study was conducted in the working area of Rejosari Health Center for the intervention group and Sapta Taruna Health Center for the control group from April to July 2022. There were 148 mothers in each group. The intervention group received exposure to the Education System and Anticipation of Stunting. The Wilcoxon and Mann-Whitney tests were used to analyze data.

Before the intervention, the mean ranks of knowledge, attitude, and practice were 27.47, 51.39, and 30.88, respectively. After the intervention, the mean ranks of knowledge, attitude, and practice reached 71.50, 61.46, and 35.54, respectively. The increase in scores in the intervention group was significantly higher than the control group (p<0.001).

Implementing the Stunting Education and Anticipation System effectively increases mothers' knowledge, attitudes, and practices in stunting prevention.

This research focuses on the correlation among underweight Babies at Birth (BBLR) with giving Fe pills, parity, Ante Natal Care (ANC), and the age women of giving birth. Though the cause of stunting is multi-factorial, BBLR is one of the causes of stunting. So it is important to investigate deeply BBLR itself. Based on any references, BBLR is caused by many factors as well.  Anemia acute happened to pregnant women, long stress the pregnant women which make them lost appetite and age of women relatively takes effect of BBLR. This research uses Demographic and Health Surveys (DHS) 2018 as secondary data. Based on it, there were 340 respondents and 355 births. The total population who suffered stunting is 5,4% of 355 births. From 5,4% of BBLR occurred at under 20 old women, birth order (parity). The result of the research, there is no correlation between the Fe pill, parity, ANC, and age of women at first-time birth to the BBLR even though in many references four variables are closely related. As a follow-up, this secondary data research should be verified by primary data.

Malnutrition is a major contributor to children’s low growth, development and also disease. To inform policymakers’ planning and action, this study aimed to assess malnutrition in under-5 children and its relationship with the household socioeconomic status.

The data of this cross-sectional survey was collected through a valid and reliable questionnaire including demographic, nutritional and socioeconomic data. Through proportional and random cluster sampling, 3980 children aged 6 to 59 months old were selected as the participants of the study. The data were analyzed through Chi-Square and ANOVA tests using EpiNut and Stata software.

138 (3.5%) had severe stunting (height for age), 58 (1.5%) severe low weighting (weight for age), 81 (2%) severe weight loss, 87 (2.2%) obesity based on BMI for age, 66 (1.7%) severe wasting and 84 (2.1) obese based on weight for height. Height and weight for age were significantly associated with father’s job and BMI for age was associated with household socio-economic status (p<0.05).

In spite of performing nationwide programs targeting under 5 children, the prevalence of malnutrition problems was high. This study indicated that the household socio-economic status is an effective factor. This indicates that the supporting measures such as insurance and free services for the poor are not well designed, targeted and administered.

Maternal health is essential for the growth and development of the child. Mothers’ depression can cause great harm to their children. Many studies have investigated stunting in children and its relationship with maternal depression. However, these studies have yielded different results. This systematic review aims to answer the question of “what is the relationship between maternal depression and stunting in children” in published articles.

This study used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The databases used included ScienceDirect, PubMed, ProQuest, and Cochrane Library setting the publication period between 2010 and 2021. The studies with observational designs, measuring maternal depression at any stage after childbirth, and examining child (under five) stunting status, using z-score or percentile were included. The quality of the studies was assessed using the Downs and Black tool, and the risk of bias was evaluated by the Cochrane Collaboration’s Risk of Bias Tool. Two authors extracted the data independently and the findings were synthesized qualitatively.

The literature search yielded 611 articles, and only 14 articles were found to meet the inclusion criteria after removing duplicates, dissertations, editorials, comments, not full texts, and case reports. A total of eight articles showed a significant relationship between maternal depression and stunting. In contrast, the remaining six studies did not show an association between these variables. It seems that the tools for measuring depression and the age difference of children participating in the studies were important factors that affected the outcome of the relationship between maternal depression and children’s stunting. Also, episodic maternal depression does not appear to be associated with stunting.

The findings suggest that to prevent childhood stunting, initiatives may be needed to identify and support mothers with chronic depression. Future systematic reviews are suggested to investigate the relationship between maternal depression and children’s stunting in urban and rural communities or in high- and low-income countries in a broader time frame.

Children under five years of age are the primary victims of malnutrition. This study aimed to investigate risk factors of stunting among children less than 5 years in North-Western Iran.

This cross-sectional study was performed on 3300 children under 5 years of age in West Azerbaijan province. Selected households were visited by fifteen trained teams. Collected data were consisted of name, date of birth, height, weight, sex, breastfeeding status, age, stunting status (Without stunting, moderate, severe), place of residence, care quality, completion of growth curve and knowledge of mothers about heath cares. The data were analyzed using STATA version 20. Chi-square, binary logistic, and ordinal regression were used. P-values less than 0.05 were considered significant.

Among 3300 children, a total of 436 individuals (13.2%) had stunting (moderate: 302 children/severe: 134 children). The Mean weight, height, BMI, month of birth and breast feeding duration in children were 11.89±3.76, 86.26±15.05, 15.88±2.44, 6.23±3.47 and 4.13±5.20, respectively. No significant independency was found among children with/without stunting regarding having breast feeding or cow milk, using baby pacifier and number of under-5-year children in each family (p>0.05). Other qualitative variables were not homogenous (p<0.05). In binary logistic regression analysis, age and weight were presented as risk factors in the model, that is, by increasing one unit of the age, provided that the other variables remain constant in the model, the risk of stunting increases for approximately four times, because the odds ratio (OR = 4.034) is significant (p = 0.021 ). Weight variable also produced such a situation (OR = 4.437, p = 0.007). Assuming that other variables remain constant in the model, the risk of shifting to the higher order of the stunting variable is roughly doubled in the model, because the odds ratio (OR = 2.285) is significant (p = 0.005).  Height was a preventive variable in the model for developing stunting (OR = 0.204, p = 0.002). In ordinal regression analysis, weight was presented as a risk factor in the model (OR = 2.285, p = 0.005) and height was a preventive variable (OR = 0.450, p = 0.001).

According to the results of the study, prevalence of stunting is high indicating the necessary measures in this regard. Weight, height and age are appropriate predictors to predict stunting in children

Xp22.3 region is characterized by low frequency of interspersed repeats and low GC content. Several clinically important genes including ANOS1 (KAL1) reside in this region. This gene was first identified due to translocation between chromosomes X and Y in a patient with Kallmann syndrome.

A 20 year old male presented with complaints of delayed secondary sexual characteristics, impaired sense of smell, and poor scholastic performance. On examination, he had short stature (151 cm; <3rd centile). His sexual maturity corresponded to Tanner stage 3. Stretched penile length was 3.6 cm (<3rd centile). Right testis was undescended with low left testicular volume (12 ml). There was mild ichthyosis over abdomen and back. He had hyposmia, hoarse voice, and synkinesia. Investigations were suggestive of hypogonadotrophic hypogonadism. Karyotype revealed an extra chromosomal material on p arm of chromosome X (46,Xp+,Y). On cytogenetic microarray, deletion of 8.3 Mb on Xp22.33 region and duplication of 12.8 Mb on Yq11.22 region were identified. The breakpoint on X chromosome resulted in deletion of exons 7-14 of ANOS1 gene and complete STS, NLGN4X, ARSL (ARSE), SHOX, and VCX genes.

Patients diagnosed with Kallmann syndrome should receive careful clinical evaluation to detect presence of a contiguous gene syndrome.

The first stage of Universal Health Coverage (UHC) was founded Iran to achieve better access to needed health services.

The aim of present study was to illustrate the prevalence rate of malnutrition’s subtypes in under 5‑year old children after UHC in comparison with before that. Settings and Design: In a cross‑sectional study in 2018, anthropometric indices of 970 under 5 years old children in rural and small towns of Isfahan province were gathered from their health files by cluster randomized sampling method.

Children whose weight for age, height for age, and weight for height were lower than ‑2SD based on Z score, were marked as underweight, stunting, and wasting, respectively. Children, whose weight for age was upper than +2SD, were marked as overweight. Statistical Analysis Used: The T‑test, Chi‑square, and logistic regression tests were used for determination of association between malnutrition’s subtypes and demographic variables.

A total of 78 (8.04%) of under 5 years old children were wasting, 74 (7.63%) were underweight, and 82 (8.45%) were stunting. Also, 12 (1.23%) of the children from the same group were overweight.

The prevalence rate of underweight and stunting in under 5 years old children were less than before UHC implementation period. The prevalence rate of overweight children below 5 in Isfahan province’s villages and small towns was low.

Unhealthy environmental sanitation contributes to stunting among under-five children that correlated several factors, such as the house components, sanitation facilities, and behavior of poor food sanitation hygiene. This study aims to identify the relationship between family and stunting's environmental sanitation among under-five children in the Public Health Center in Indonesia.

Methods & Materials: 

A cross-sectional study was conducted among 393 families with under-five children in the public health center of Panti of Jember district, East Java of Indonesia, using consecutive sampling from December 2019 to January 2020. A self-administered questionnaire was used to measure participants’ characteristics and environmental sanitation. A Chi-square test was used to analyze the data.

Among 67.2% of families were unhealthy environmental sanitation. Meanwhile, children who suffer from stunting were 56.2%. There was a significant correlation between environmental sanitation of family and stunting among under-five children (χ2=38,440; p <0,001), The environmental sanitation of family had 0.254 times for a chance of stunting among under-five children (OR= 0.254; 95% CI= 0.163-0.397).

The family’s unhealthy environmental sanitation of family is a relationship with stunting among under-five children. Improving healthy environmental sanitation should be maintained by involving the family to fulfill under-five children’s nutrition requirement based on height for age.