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Child Malnutrition In Developing Countries Pdf Free ^NEW^

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Child Malnutrition In Developing Countries Pdf Free ^NEW^

Iodine, vitamin A, and iron are the most important in global public health terms; their deficiency represents a major threat to the health and development of populations worldwide, particularly children and pregnant women in low-income countries.

Around 45% of deaths among children under 5 years of age are linked to undernutrition. These mostly occur in low- and middle-income countries. At the same time, in these same countries, rates of childhood overweight and obesity are rising.

Without enough nutritious food to eat or the ability to absorb the right nutrients due to illness, children under five are at high risk of acute malnutrition which can lead to death - or if a child survives, can cause stunting, and impede mental and physical developmentlonger term.

Poverty is the number one cause of malnutrition in developing countries. Often times, families living in poverty lack access to fresh fruits and vegetables. Many communities do not have full-service grocery stores that regularly stock fresh produce.

Chronic malnutrition is becoming concentrated in countries with the fewest resources, where 1 in 3 children have stunted growth. Today, 9 in 10 stunted children, roughly 139 million children, live in low- and lower-middle-income countries.

At least 240 million children live in countries affected by conflict and fragility.[iii] These children are at heightened risk of death before age 5, stunted growth due to malnutrition and so much more.

In Yemen, where children are growing up in the worst humanitarian crisis in the world, the indirect effects of the five-year conflict there are putting huge numbers of children at risk of death due to malnutrition.

Although the world as a whole has been accelerating progress in reducing the under-5 mortality rate, difference exist in under-5 mortality across regions and countries. Sub-Saharan Africa remains the region with the highest under-5 mortality rate in the world, with 1 child in 13 dying before his or her fifth birthday, 20 years behind the world average which achieved a 1 in 13 rate in 1999. Two regions, sub-Saharan Africa and central and southern Asia, account for more than 80 per cent of the 5.2 million under-5 deaths in 2019, while they only account for 52 per cent of the global under-5 population. Half of all under-5 deaths in 2019 occurred in just 5 countries: Nigeria, India, Pakistan, the Democratic Republic of the Congo and Ethiopia. Nigeria and India alone account for almost a third of all deaths.

At the country level, mortality rates for older children ranged from 0.2 to 16.8 deaths per 1000 children aged 5 years. As for children under 5, higher mortality countries are concentrated in sub-Saharan Africa. Countries with the highest number of deaths for 5-to-9-year-olds include India, Nigeria, Democratic Republic of the Congo, Pakistan and China.

Globally, infectious diseases, including pneumonia, diarrhoea and malaria, along with pre-term birth, birth asphyxia and trauma, and congenital anomalies remain the leading causes of death for children under five. Access to basic lifesaving interventions such as skilled delivery at birth, postnatal care, breastfeeding and adequate nutrition, vaccinations, and treatment for common childhood diseases can save many young lives. Malnourished children, particularly those with severe acute malnutrition, have a higher risk of death from common childhood illness such as diarrhoea, pneumonia, and malaria. Nutrition-related factors contribute to about 45% of deaths in children under-5 years of age.

The high prevalence of bacterial and parasitic diseases in developing countries contributes greatly to malnutrition there.3,5,9,10,11 Similarly, malnutrition increases one's susceptibility to and severity of infections, and is thus a major component of illness and death from disease.3,5,12,13,14 Malnutrition is consequently the most important risk factor for the burden of disease in developing countries.12,15 It is the direct cause of about 300 000 deaths per year and is indirectly responsible for about half of all deaths in young children (Fig. 1).5,15,16,17 The risk of death is directly correlated with the degree of malnutrition.17,18,19,20,21,22

Kwashiorkor usually manifests with edema, changes to hair and skin colour, anemia, hepatomegaly, lethargy, severe immune deficiency and early death. Despite decades of debate, sometimes quite intense, the pathologic features of kwashiorkor are still not fully understood.3 The role of aflatoxins and insufficient protein intake has been stressed because the presence of edema and ascites seems related to reduced osmolarity in the blood, which is thought to be caused mostly by severe anemia.34 It is puzzling that total protein concentrations in the plasma do not differ between children with marasmus and those with kwashiorkor.35 More recently, a role for free radicals in the etiology of kwashiorkor has been considered,36,37,38,39,40,41,42,43 but the findings of initial intervention studies have not been up to expectations. This may possibly be the result of inappropriate experimental design.44,45

Severe malnutrition is furthermore associated with chronic hypovolemia, which leads to secondary hyperaldosteronism, and further complicates fluid and electrolyte balance. Because the development of muscular dystrophy mobilizes much of the body's potassium, which is then lost through urinary excretion, affected children do not show signs of hyperkalemia.50

In 2020*, three regions had very high stunting prevalence, with approximately one third of children affected. On the other hand, two regions Europe and Central Asia and Northern America, had low stunting prevalence. However, vast disparities within regions can exist. In Latin America and the Caribbean, for example, despite the 11.3 per cent regional prevalence, some individual countries are faced with high, and very high stunting prevalence, while others have very low prevalence below 2.5 per cent. Chronic undernutrition in Latin America and the Caribbean can vary widely between neighboring countries: In one country less than 1 in 8 are affected, while more than 2 in 5 of their peers in the country next door are at a disadvantage due to the irreversible physical and cognitive damage that can accompany stunted growth.

The UNICEF-WHO-World Bank JME Working Group was established in 2011 to address the call for harmonized child malnutrition estimates that would be instrumental in benchmarking progress on child malnutrition. The first edition of the JME was released in 2012 and provided estimates for stunting, wasting, severe wasting, underweight and overweight, as well as a detailed description of the methodology (UNICEF & WHO, 2012). Since its inception, the JME outputs have comprised a harmonized country-level dataset of primary data (e.g., national estimates based on household surveys), as well as regional and global model-based estimates.

The lack of incidence data for wasting and severe wasting is a main reason why the JME does not present annual trends for these forms of malnutrition. Since the prevalence data are collected infrequently (every 3 to 5 years) in most countries and measure wasting at one point in time, it is not possible to capture the rapid fluctuations in wasting over the course of a given year or to adequately account for variations in seasons across survey years. In contrast, stunting and overweight are relatively stable over the course of a calendar year, making it possible to track changes in these two conditions over time with prevalence data.

McLain AC, Frongillo EA, Feng J, Borghi E. Prediction intervals for penalized longitudinal models with multisource summary measures: an application to childhood malnutrition. Statistics in Medicine 38:1002-1012, 2019. 153554b96e


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