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20,229 reports · page 826 of 2023

Peer-reviewed articleEurope PMC3 Mar 2026

Exploring the prevalence and determinants of stunting among children under 5 in Ethiopia: A cross-sectional analysis of the 2019 Ethiopia Mini Demographic and Health Survey.

Objectives Malnutrition is a critical global health issue impacting children's growth, with nearly 45% of child deaths associated with undernourishment. The 2019 Ethiopia Mini Demographic and Health Survey reported a stunting prevalence of about 37% among children under 5, positioning Ethiopia among the countries with the highest stunting prevalence. This study aimed to identify risk factors for stunting among children under 5 in Ethiopia. Methods A cross-sectional study was conducted from March 21 to June 28, 2019, enrolling 5126 children aged 0 to 59 mo through a stratified two-stage cluster sampling method. Binary logistic regression was used to identify factors associated with stunting, including variables with P values less than 0.2 from bivariate analysis in the multivariable analysis. Variables with P values less than 0.05 indicated significance. Results The prevalence of stunting among children under 5 in Ethiopia was 36.9%. Tigray had the highest prevalence of stunting (49%), whereas Addis Ababa had the lowest (9.6%). Multivariable logistic regression revealed several risk factors: rich households (adjusted odds ratio [AOR], 0.451, 95% confidence interval [CI], 0.123-0.931), middle-income households (AOR, 0.625, 95% CI, 0.345-0.725), mothers with secondary and higher education (AOR, 0.336, 95% CI, 0.252-0.937), primary education (AOR, 0.781, 95% CI, 0.231-0.872), child still breastfeeding (AOR, 0.261, 95% CI, 0.165-0.742), rural residence (AOR, 2.105, 95% CI, 1.415-3.471), and vitamin A supplementation (AOR, 0.841, 95% CI, 0.126-0.963). Other significant factors included child age, number of children under 5, vaccination status, water source, birth interval, and region. Conclusions Stunting remains a significant issue in Ethiopia, influenced by factors such as household wealth, maternal education, place of residence, and health practices. Policymakers must address these determinants to enhance nutritional outcomes in Ethiopia.

Peer-reviewed articleEurope PMC1 May 2026

Effect of Environmental Factors on Undernutrition Among Children Under 5 Years in Rural Puducherry, Southern Part of India-A Community-Based Cross-Sectional Study.

Background Childhood undernutrition continues to be a major public health concern in low- and middle-income countries, contributing substantially to morbidity and mortality and impairing growth and development among children under 5 years. Although inadequate diet and infections are well-established determinants, the influence of household environmental factors such as indoor air pollution, unsafe drinking water, poor sanitation and improper waste disposal remains underexplored in developing countries. Objectives To estimate the prevalence of undernutrition among children under 5 years in rural Puducherry and to examine its association with selected environmental factors. Methods A community-based cross-sectional study was conducted from March to May 2025 in selected rural areas in Puducherry, India. Using consecutive sampling, 308 children under 5 years were enrolled. Data on socio-demographic characteristics, feeding practices, morbidity and household environmental conditions were collected through a pretested semistructured questionnaire. With anthropometric measures, underweight, stunting and wasting were defined using World Health Organization Child Growth Standards. Data were analysed using STATA v14.0 and WHO Anthro software 3.2.2. The proportions of undernutrition indicators such as stunting, underweight and wasting were presented with a 95% confidence interval (CI). Associations were assessed using log-binomial regression to estimate prevalence ratios (PRs) with 95% CI. Results The prevalence of underweight, stunting and wasting was 13.3%, 17.5% and 10.7%, respectively. Higher birth order, low birth weight, non-exclusive breastfeeding, indoor air pollution and improper waste disposal were significantly associated with undernutrition. Indoor air pollution showed a strong association with both overall undernutrition (aPR: 2.86) and stunting (aPR: 2.37), whereas unimproved waste disposal was associated with underweight (aPR: 1.77). Conclusion Despite a relatively low burden than national averages, undernutrition among children under 5 years in rural Puducherry remains significantly influenced by adverse household environmental conditions. Strengthening environmental conditions with multisectoral interventions alongside existing nutrition programmes is essential for sustained improvements in child growth and health outcomes.

Mani J, Ramasubramani P, Raj E et al.

SurvivalDevelopmentINRead at source

Peer-reviewed articleEurope PMC8 Jul 2026

Prevalence and factors associated with undernutrition among preschoolers in low-income urban households in Malaysia.

Undernutrition remains a persistent public health concern, particularly among preschool-aged children, despite significant economic progress in Malaysia. This study aimed to determine the prevalence of undernutrition and identify its associated factors among preschoolers from low-income urban families. A cross-sectional survey was conducted from April to August 2025 among 326 children aged 4-6 years attending government subsidised preschools in Kuala Lumpur, the capital city of Malaysia. Anthropometric measurements including weight, height, Body Mass Index (BMI), mid-arm circumference (MUAC) were taken, and mothers completed a structured questionnaire covering sociodemographic characteristics, child health history, and the Malaysian Comprehensive Feeding Practices Questionnaire (CFPQ-M). Undernutrition was defined as the presence of underweight, stunting, or wasting that complied to WHO standards. Multivariate binary logistic regression performed to identify factors associated with undernutrition. The prevalence of undernutrition was 34.7% with underweight, stunting, and wasting recorded at 29.8%, 16.0%, and 12.0%, respectively. Factors associated with undernutrition included child age ≥ 60 months (adjusted odds ratio [aOR] = 2.42; 95% CI 1.17-5.00), low birth weight (aOR = 0.24; 95% CI 0.11-0.53), presence of chronic disease (aOR = 3.49; 95% CI 1.08-11.36), and maternal underweight (aOR = 13.40; 95% CI 1.13-159.38). Higher parental involvement in feeding (aOR = 1.31; 95% CI 1.07-1.61) and lower restriction for weight control (aOR = 0.92; 95% CI 0.87-0.97) were also associated with increased odds of undernutrition, whereas socioeconomic variables such as parental income and education level were not significant. Undernutrition among preschoolers from urban low-income households in Kuala Lumpur remains prevalent and was more consistently associated with biological and familial factors, including intergenerational influences, than with socioeconomic characteristics within this study population. These findings highlight the importance of integrated interventions focusing on maternal nutrition, early growth monitoring, and evidence-based caregiver feeding support to reduce intergenerational undernutrition risk.

Abdul Wahid AH, Abdul Manaf Z, Hamzaid NH et al.

SurvivalMYRead at source

Evaluation reportEurope PMC10 Aug 2026

Dual Burden of Malnutrition Among Mother-Child Dyads in Mozambique: Findings from the Demographic and Health Survey 2022-2023

ABSTRACT Introduction Nutritional challenges are a global public health concern, especially among children under five in sub-Saharan African countries. The coexistence of an overweight/obese mother and an underweight child in the same household is recognized as a dual burden of malnutrition (DBM). Our study aimed to examine the prevalence and associated factors of DBM among mother-child dyads in Mozambique. Methods We used nationally representative, cross-sectional data from the Mozambique Demographic and Health Survey 2022-2023 (n=3,605 mother-child dyads). The children’s undernutrition condition and maternal BMI status were calculated using the WHO standard reference guidelines. The outcome variable, dual burden of malnutrition, was then created if the children had any undernutrition condition (stunting, wasting, or undernutrition) and the corresponding mother was overweight/obese. Multivariable binary logistic regression, Erreygers’s concentration index, and concentration curve were analyzed to determine associated factors and social inequalities. Results The prevalence of the dual burden of malnutrition was about 5.51%. Mothers aged ≥ 34 years [aOR (95% CI): 4.01(1.44, 11.14); p<0.05] and mothers with four or more children [aOR (95% CI): 2.68(1.29, 5.57); p<0.05] had higher odds of DBM. Rural residence and using unimproved toilet facilities (latter an indicator) were also significantly associated with experiencing DBM. Additionally, maternal age modified the association between women’s empowerment and mother-child DBM. Women aged 15–19 years at the lowest and highest empowerment levels were more likely to experience DBM compared to women 20 years or older. A positive and statistically significant concentration index indicates that wealth-related inequalities exist, with DBM more concentrated among wealthier mother-child dyads. Conclusion Our study highlights the persistence of household-level DBM in Mozambique. These findings emphasize the need for targeted interventions addressing social and economic inequalities, including poor sanitation marker of broader household deprivation. Prioritizing integrated maternal-child nutrition interventions within national strategies is essential to improving equity in nutrition and health outcomes.

Shakurun N, Andre F, Muhajarine N

SurvivalDevelopmentMZRead at source

Peer-reviewed articleEurope PMC9 Sept 2026

Advancing early identification of at-risk children: a consensus-based refinement and validation roadmap for the pediatric malnutrition screening algorithm.

Introduction Mild malnutrition risk remains an underrecognized yet clinically important contributor to impaired growth and development in children aged 1-10 years across the Middle East. Regional estimates indicate that 15-25% of children in the Gulf Cooperation Council (GCC) fall within the mild malnutrition risk category (Weight-for-Height Z-score [WHZ] between -1 and -2 SD), a subgroup vulnerable to progressive growth faltering yet excluded from conventional malnutrition diagnostic thresholds (WHZ < -2 SD). The Pediatric Malnutrition Screening Algorithm (PMSA-2025) was refined through a structured regional expert consensus process to enable early, standardized detection of these at-risk children in outpatient and community healthcare settings. Methods A 14-member multidisciplinary expert panel from different countries (KSA, UAE, Egypt, Kuwait, Oman, Russia, United States, and Türkiye) refined the PMSA-2025 using a three-round, hybrid modified Delphi approach conducted in September 2025. Expert selection criteria included a minimum of 10 years of clinical or academic experience in pediatric nutrition or gastroenterology, active involvement in malnutrition-related clinical practice or research, and representation of diverse regional healthcare contexts. Content validity was assessed using the Item-level Content Validity Index (I-CVI), with a threshold of ≥0.80 for domain retention. Six clinical domains were retained from an initial pool of eight candidate domains after Delphi-based consensus: perinatal history, growth trajectory, prior nutritional diagnosis, hospitalization frequency, infection recurrence, and feeding behavior. Each domain was operationalized with measurable, age-appropriate criteria and incorporated into a binary (Yes/No) scoring system (total score: 0-6). The tool is designed for use by pediatricians, family physicians, nurses, and trained community health workers in children aged 1-10 years with WHZ between -1 and -2 SD. Exclusion criteria include children with primary chronic systemic disease driving growth impairment and those already receiving formal nutritional support. Results All six retained domains achieved an Item-level CVI (I-CVI) ≥ 0.85 in the final consensus round. Two initial candidate domains (dietary diversity score, caregiver nutritional literacy) were excluded due to insufficient agreement (I-CVI < 0.70). Three domains required definitional refinement during Round 2, achieving ≥90% final agreement in Round 3. The PMSA-2025 stratifies mild malnutrition risk across three tiers: low (0-1), moderate (2-3), and high (4-6). It requires no specialized equipment beyond a standard scale and can be completed within routine consultations. Conclusion The PMSA-2025 represents a consensus-based, multidimensional screening tool with established content validity designed to address the unmet need for early mild malnutrition risk identification in outpatient and community pediatric settings across the Middle East.

Murray RD, Shaaban SY, Shamsah A et al.

SurvivalDevelopmentPractitionerEGKWOMTRRead at source

Peer-reviewed articleEurope PMC7 May 2026

Does stunting modify the impact of salivary factors and early childhood caries on oral health-related quality of life?

Background Stunting, a form of chronic malnutrition, is associated with impaired growth and potential changes in salivary function that may increase susceptibility to early childhood caries (ECC). These oral conditions may further influence a child's oral health-related quality of life (OHRQoL). However, the extent to which stunting modifies the impact of salivary factors and ECC on OHRQoL remains unclear. Methods This analytical cross-sectional study included 210 preschool children aged 24-59 months in Bandung, Indonesia, equally divided into stunted and non-stunted groups based on height-for-age z-scores (HAZ <-2 SD for stunted). Dental caries was assessed using the deft index, while salivary pH and buffering capacity were measured using the GC Saliva Check Buffer Test. OHRQoL was evaluated using a modified Early Childhood Oral Health Impact Scale (ECOHIS) with a dichotomous response format (never = 0, ever = 1) validated through pilot testing (Cronbach's α = 0.870). Statistical analyses included Mann-Whitney U, Chi-square, and t-tests, followed by logistic regression with interaction terms to examine effect modification by stunting. Results Non-stunted children had higher mean deft scores (6.50 ± 4.43) compared to stunted children (5.12 ± 4.38, p = 0.020). Acidic Saliva was more frequent among stunted children (11.4%) than non-stunted children (3.8%, p = 0.037). However, no significant differences were observed in ECOHIS total scores or in the impact of OHRQoL between groups (p > 0.05). Logistic regression revealed no significant interactions between stunting, ECC, salivary pH, or buffering capacity (all p > 0.05). Conclusion Stunting did not affect the association between salivary factors, early childhood caries, and oral health-related quality of life in preschool children. Although children with stunted had slightly higher salivary acidity, these differences did not result in measurable differences in quality of life. Prevention should combine oral health education and nutritional interventions to comprehensively address the risk of stunting and dental caries.

Setiawan AS, Caesarini M, Musnamirwan IA et al.

SurvivalDevelopmentPractitionerIDRead at source

Every report we find, newest first.

How to use the reports

Exploring the prevalence and determinants of stunting among children under 5 in Ethiopia: A cross-sectional analysis of the 2019 Ethiopia Mini Demographic and Health Survey.

Maternal feeding knowledge and practices as determinants of nutritional status in under-five children.

Effect of Environmental Factors on Undernutrition Among Children Under 5 Years in Rural Puducherry, Southern Part of India-A Community-Based Cross-Sectional Study.

Prevalence and factors associated with undernutrition among preschoolers in low-income urban households in Malaysia.

Dual Burden of Malnutrition Among Mother-Child Dyads in Mozambique: Findings from the Demographic and Health Survey 2022-2023

Advancing early identification of at-risk children: a consensus-based refinement and validation roadmap for the pediatric malnutrition screening algorithm.

Does stunting modify the impact of salivary factors and early childhood caries on oral health-related quality of life?

Higher Pre- and Post-Monsoon Temperatures and Their Impact on Child Undernutrition in Bangladesh.

Multilevel Analysis of Severe Anthropometric Failure among Under-Five Children in Benin: A Cross-Sectional Study Using 2017 to 2018 Demographic and Health Survey Data.

Community-driven strategies for preventing childhood stunting: perspectives from parents and front-line workers in Rwanda.

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