Abstract Introduction To understand differences in vaccination coverage between population subgroups in the Netherlands over time, we studied sociodemographic factors associated with measles-mumps-rubella (MMR) and diphtheria-tetanus-pertussis-poliomyelitis (DTaP-IPV) vaccination. Methods We conducted a national retrospective database study including children born in 2008-2020. Individual-level data-linkage allowed examination of associations of sociodemographic variables with MMR and DTaP-IPV vaccination status at 2 years of age. Coverage for each variable, stratified by birth cohort, was calculated. Multivariable Poisson regression assessed independent associations and changes in coverage over time. Results MMR coverage decreased in all population subgroups (overall 95% to 89% in 2008 and 2020 cohorts), with more substantial declines in some groups. The multivariable analysis showed that Dutch children of non-Dutch origin, particularly those of Moroccan and Turkish origin showed more pronounced declines (−25% and -12% compared to children of Dutch origin in cohort 2020, respectively). Among children not attending day care and children living in larger families (≥4 children), a faster decline in coverage was observed compared to those attending day care and living in smaller families (both -12% in cohort 2020). Among children of self-employed mothers and children in the lowest income households, lower coverage was observed compared to children of mothers in employment and children in the highest income households (−8% and -7% in cohort 2020, respectively). Nearly identical trends were observed for DTaP-IPV vaccination. Conclusion Our study reveals a significant decline in childhood vaccination coverage in the Netherlands, with increasing disparities between sociodemographic groups. This is crucial for prioritising vaccination efforts to protect public health equitably.
Joyce Pijpers, Annika M. van Roon, Maarten Schipper et al.
The incidence of stunting in Liliba Village, Oebobo Subdistrict, Kupang City, recorded 185 children experiencing stunting. There are 20 malnourished children and 70 undernourished children. Methods of stunting education and foster parent program to overcome stunting. Activities were carried out in May-August 2023. Activities were carried out in the Liliba sub-district of Kupang City. The activity results are Child A's nutritional status before the foster parent movement: body weight 11.3 kg, TB 82.6, and Lila 14.5. After 90 days of feeding, the weight was 12.4 kg, TB 85.8, and Lila 15.4. For Child J, the nutritional status of Child A before the foster parent movement was 9 kg, TB 75.3, and Lila 14.5. After 90 days of feeding, the weight was 9.1 kg, TB 78.1, and Lila 14.8. The results of educational activities are that parents' knowledge of Posyandu Jasmine 12 increased. The knowledge test results found that most participants had good knowledge before education, namely 50%. After education, 80% of family knowledge about stunting is excellent. Education about stunting is excellent for families to prevent stunting. The OTA2S program has a good impact on the nutritional status of stunted children.
Yoani Maria Aty, Elisabeth Herawanti, Trifonia Srinurwela et al.
In 2016, around 22.9% or 154.8 million children worldwide suffered from stunting at the age of under 5 years. Stunting is defined as the length or height below the standard. Stunting is measured by a z-score of height and age of more than 2 standard deviations which is below the World Health Organization (WHO) Child Growth Standards. Based on the results of observations on November 25, 2022 in Kemuning Lor Village, the community service team found that cadres and mothers could be said to be of productive age with an average of already having smartphones which were underutilized in monitoring the nutritional status of toddlers. In community service activities, an application was developed that is useful in reducing and monitoring the number of stunting cases in Kemuning Lor Village, Jember Regency. The implementation methods carried out in this community service activity are literature (literary study), location surveys, application design and outreach. As for the results of this community service activity, 90% of posyandu cadres feel helped by the baby nutrition monitoring application. In the future this application will be integrated from each region so that stunting cases in Jember Regency can be monitored through one application.
Stunting and wasting are chronic nutritional problems that affect children's growth and development, particularly in rural areas. The village of Malutu Hulu Sungai Selatan has high prevalence rates of stunting and wasting, necessitating special efforts to address these issues. The Sik Asik movement (Sekumpulan Ibu Cerdas di Kelas ASI Eksklusif, or Group of Smart Mothers in Exclusive Breastfeeding Classes) was introduced as a community intervention strategy to improve the health of toddlers. This program involves educating mothers through exclusive breastfeeding classes, distributing milk to toddlers experiencing stunting and wasting, and using Smart Chart as a tool for monitoring and evaluating child development. The study aims to evaluate the effectiveness of the Sik Asik movement in reducing stunting and wasting rates in the village of Malutu. The research results show an increase in mothers' knowledge about the importance of exclusive breastfeeding and balanced nutrition, as well as a decrease in the prevalence of stunting and wasting in the intervention group. This movement has proven effective in raising awareness and community participation in stunting prevention efforts and can be replicated in other areas with similar issues.
Herda Ariyani, Ridha Millati, Annisa Annisa et al.
Background: Stunting is defined as low height-for-age caused by chronic or recurrent undernutrition. Undernutrition is the leading risk factor for tuberculosis (TB) globally. It is usually associated with poverty, poor maternal health and nutrition, frequent illness and/or inappropriate feeding and care in early life. Stunting prevents children from reaching their physical and cognitive potential, so appropriate management is needed. Case: weight for age but severely stunted and suggestive TB. Blood study result showed anemia with Mentzer index >13. Bone age showed the age of A 4 year-old girl was referred with breathing difficulty since 2 weeks accompanied with decreased appetite and weight. She was in normal 3 years and below chronological age. Management was focused on TB, nutritional, and anemia treatment. Conclusion: Nutritional assessment should be integrated into standard TB care and also simultaneously treat iron deficiency anemia.
Asterisa Retno Putri, Runi Arumndari, Claudia Natasha Liman et al.
Background: The problem of malnutrition in Indonesia is a health problem that has not been fully resolved by the government. Short nutritional status or stunting is a condition in which a person's height is less than normal based on age and gender. Height is one type of anthropometric examination and indicates poor nutritional status (malnutrition) in the long term/chronic. Stunting will have an impact on functional disorders such as cognitive abilities and poor academic achievement so that it can lead to a lack of income in the future, up to the loss of labor market productivity, which results in the loss of 11% of GDP (Gross Domestic Products) and reduces the income of adult workers by 20%. Objective: This study aims to determine the relationship between short nutritional status (stunting) and dental caries (dmft) in children preschool in Sukabumi Indah Village, Bandar Lampung City. Method: survey method with a cross-sectional approach, the sample of this study was children 3-5 years old in Sukabumi Indah Village, Bandar Lampung City totaling 150 children. The measuring instrument used was Microtoise staturemeter as well as dental examination status, data analysis Data analysis was carried out by calculating the Chi Square test. Result: Nutritional status with caries experience (dmft) had a significant relationship, where the mean dmfs in the stunted child group was 14.03 ± 6.16, while the mean dmfs in the normal child group was 7.47 ± 3.74 (p=0.0001). Conclusion: nutritional status affects the occurrence of caries.
Background: In recent years, Tanzania has made good progress in addressing the problem of chronic malnutrition in children, but the levels are still unsatisfactory, at almost three in ten of its children are stunted. The government of Tanzania has taken significant measures to establish and strengthen multi-sectoral governance as part of national efforts to reduce the unacceptably high level of malnutrition. However, few studies have qualitatively documented stakeholder's perspectives at sub-national and community level with regards to performance of multi-sectoral governance in improving nutrition status of children in Tanzania. Objective: This study aimed to explore the achievements, facilitating factors and challenges of multi-sectoral governance in improving child nutrition in Buhigwe District Council. Methods: This was cross-sectional study, which employed qualitative method of data collection whereby semi-structured interviews were used to conduct in-depth interviews with members of the multisectoral steering committee for nutrition in Buhigwe Council and parents/caregivers of under-five children. Results: There is significant improvement in allocating funds for multisectoral governance interventions targeting under five children across sectors, improved inter-sectoral coordination and increased knowledge on feeding practices among parents/caregivers. Strong leadership and political commitment, inter-sectoral linkage and Presence of Non-Governmental Organizations (NGOs) supporting nutrition were identified as factors for improving child nutrition in the context of multisectoral governance. The issue of insufficient funding, inadequate spending of allocated funds, inadequate capacity, lack of cross-sectional financial mechanism and tools to collect nutrition information were raised by stakeholders as factors hindering the implementation of multi-sectoral governance in improving child nutrition. Conclusion: Smooth implementation of multi-sectoral interventions targeting under-five children requires strong multi-sectoral governance, which is supported by adequate spending of the allocated funds, strong leadership and political commitment, presence of NGOs supporting nutrition and inter-sectoral linkage among line sectors. However, key stakeholders including central and local government authorities should address the challenge of insufficient funds, inadequate capacity, lack of cross-sectoral co-financing mechanism and tools to collect nutrition information, which were reported as barriers to the implementation of multi-sectoral governance in improving child nutrition.
Background & Aims Child stunting (impaired height-for-age) is a marker of chronic undernutrition and results from insufficient energy and nutrient uptakes. Stunting has severe consequences for future physical and mental development. A WHO target is to reduce the prevalence of stunting by 40% within 2025. In contrast to other parts of the world, stunting has been a major public health problem in many African countries for a long time. Here we present a narrative review on stunting during the last 20 years among children ≤ 5 years in Sub-Saharan Africa (SSA), where stunting is rampant. Methods We identified 13 articles from 2000-2020 based on pre-defined criteria. Results Children in SSA are highly affected by stunting, with an average prevalence of 41%. Stunting is significantly higher in children >1 year, in boys, in low birth weight, in shorter interpregnancy interval, in mothers with lower education, and in poor and food insecure households. Maternal education, feeding practices and environmental factors (e.g. climate change) are important risk factors. Conclusions Although the prevalence of stunting has been reduced over the last two decades, great effort remains to reach the global target. Policies and interventions should target education for women, child feeding practices and environmental factors including climate change.
Objective: This study aimed to develop and validate a novel scoring system and prediction algorithm integrating growth, nutritional, and biochemical indicators for the identification of infant stunting, defined as length-for-age Z-score < -2 standard deviations according to the World Health Organization (WHO) Child Growth Standards. Methods: < 0.05). Multivariate logistic regression and Least Absolute Shrinkage and Selection Operator (LASSO) regression were subsequently used to select independent predictors and prevent overfitting. Three machine learning models-Random Forest, Gradient Boosting, and Support Vector Machine-were constructed. Model performance was evaluated using the Area Under the Receiver Operating Characteristic Curve (AUC), calibration curves, and Decision Curve Analysis. Interpretability was assessed via SHapley Additive exPlanations (SHAP) values. A visual nomogram was developed. Results: < 0.001). LASSO regression confirmed infant weight Z-score, length Z-score, length growth velocity, number of complementary food types, and Hb as the optimal variable combination. The Gradient Boosting model demonstrated superior performance, with an AUC of 0.861 (95% CI: 0.784-0.938) in the training set and 0.850 (95% CI: 0.699-1.000) in the internal validation set. Its calibration was excellent, and decision curve analysis indicated a higher net benefit across a wide risk threshold range. SHAP analysis identified infant weight Z-score as the most critical predictive variable. The nomogram provided a practical tool for quantitative risk assessment. Conclusion: The developed nutritional scoring system and Gradient Boosting prediction algorithm exhibited robust performance in identifying infants at risk of stunting. This tool facilitates early quantitative risk assessment and supports targeted clinical interventions.
Child malnutrition is one of the most pressing public health problems in the low-income urban settlements. This article describes the magnitude, cause and consequences of this nutritional problem in the children of Mirpur slums of Dhaka in Bangladesh. The issue is made even worse by poverty, food insecurity, maternal illiteracy, poor access to health care, clean water, and sanitation to name a few. Families are resorting to high calorie low nutrient foods and children are now being exposed to protein-energy malnutrition (lack of protein and/or energy) and deficiencies of micronutrients (Iron, Vitamin A, Zinc, and Iodine). These all have strong links to stunting, wasting, poor cognitive development, weakened immunity and illness, perpetuating a cycle of ill health and poverty. This study adopts a mixed-methods approach which encompasses household surveys, parental interviews, focus group discussions, and field observations to assess the nutritional status of children under five and the social, economic and environmental risk factors associated with it. Results indicate alarming prevalence rates of stunting and underweight children, and approximately 88% of the analyzed population was classified as having an unhealthy BMI. Conditions such as diarrhea and respiratory infections impede the absorption of nutrients and worsen the state of malnutrition. The paper highlights the urgent need for an Integrated Program of Actions which goes beyond short-term food aid. There is a need for Community-Based Nutrition (CBN) programs along with maternal and child health services, food fortification, and policies that ensure the availability of safe water and sanitation. Such structural constraints can be lifted, and the intergenerational cycle of malnutrition broken, which would give a chance to children from the Mirpur slums to be healthier, attain superior cognitive abilities and have improved life prospects.
Mohammad Naeem Hosain, Mahfuj Sarder, Motiur Rahman
