exudates and Growth-Disorders

A randomised trial was carried out to determine the effect of supplementation of fish oil among 51 children with leukaemia aged 4 to 12 years on appetite level, caloric intake, body weight and lean body mass. They were randomly allocated into the trial group (TG) and the control group (CG). At baseline, 30.8% of TG subjects and 44.0% of CG subjects were malnourished and 7.7% of subject from TG and 28.0% from CG were classified as stunted. The majority of subjects from TG and CG were in the mild malnutrition category for mid upper arm muscle circumference (MUAMC)-for-age. The TG group showed significant increment in MUAMC (0.13 cm vs -0.09 cm) compared with CG at 8 weeks (p<0.001). There was a significant higher increase for appetite level (0.12±0.33) (p<0.05) and an increasing trend on energy and protein intake in the TG group (213±554 kcal; 3.64 ±26.8 g) than in the CG group. In conclusion, supplementation of fish oil has a positive effect on appetite level, caloric intake and MUAMC among children with leukaemia.

Topics: Academic Medical Centers; Appetite Regulation; Arm; Body Size; Body Weight; Child; Child Development; Child, Preschool; Dietary Proteins; Dietary Supplements; Energy Intake; Female; Fish Oils; Growth Disorders; Humans; Leukemia; Malaysia; Male; Malnutrition; Patient Dropouts

To access the effectiveness of the treatment of soil-transmitted helminthiasis (STH) on the growth of primary school children, 353 children were block stratified to receive either mebendazole plus pyrantel oxantel pamoate every three months or a placebo. The children were followed for two years with 89% completing the trial. Follow-up stools indicated that the treatment was efficacious for ascariasis and trichuriasis. There was virtually no hookworm infection. The children were malnourished as measured by the number below -2 SD of height and weight standards. There was no difference in height or weight between the treatment and control groups by sex initially or at the end of two years of follow-up. The treatment of Ascaris and Trichuris had no effect on growth parameters. The effect of STH on growth may be mediated through hookworm infections.

Topics: Ascariasis; Body Height; Body Weight; Child; Cohort Studies; Female; Growth Disorders; Humans; Malaysia; Male; Nutrition Disorders; Parasite Egg Count; Single-Blind Method; Trichuriasis

This study aims to assess social determinants of stunting among children aged <5 y within the Malay ethnicity in Malaysia.. This study used data from the National Health and Morbidity Survey 2016: Maternal and Child Health. It includes a sample of 10 686 children, ages 0 to 59 mo, of Malay ethnicity. Height-for-age z score was determined based on the World Health Organization Anthro software. A binary logistic regression model was used to examine the association between the selected social determinants and the occurrence of stunting.. About 22.5% of children aged <5 y of Malay ethnicity were stunted. For those ages 0 to 23 mo, stunting is more prevalent in boys, in rural areas, and in those who have screen exposure, whereas a reduction of stunting was observed for those children whose mothers work in the private sector and in those who consume formula milk and meat. As for those ages 24 to 59 mo, there was a higher prevalence of stunting for those with self-employed mothers and reduced prevalence in children with hygienic waste disposal practices as well as those who play with toys.. The prevalence of stunting among children of Malay ethnicity aged <5 in Malaysia necessitates immediate intervention. It is pertinent to facilitate early identification of those children at risk of stunting for additional care to promote healthy growth.

Topics: Child; Female; Growth Disorders; Humans; Infant; Malaysia; Male; Mothers; Prevalence; Social Determinants of Health

This study compared the current nutritional status, hemoglobin levels and their associations with soil-transmitted helminth (STH) infections between two categories of Negritos (indigenous): (i) Inland Jungle Villages (IJV) (ii) and Resettlement Plan Scheme (RPS) near town peripheries, decades after redevelopment and demarginalization. A total of 416 Negritos (IJV: 149; RPS: 267) was included for nutritional profiling based on anthropometric analysis. However, only 196 (IJV: 64; RPS: 132) individuals consented to blood taking for the hemoglobin (Hb) measurements. Subsequently, the association of undernutrition and anemia with STH infections were determined based on univariate and multivariate logistic regression analyses. The overall prevalence of stunting, wasting, and underweight amongst children and adolescents (n = 343) were 45.8%, 42.3% and 59.1%, respectively. In adults (n = 73), the prevalence of underweight was low (6.8%) but overweight and obese was prominent (26.0%). For anemia (n = 196), an overall prevalence rate of 68.4% were observed with 80% and 70.4% of children aged 2-6 y/o and aged 7-12 y/o, respectively being anemic. Comparatively, the prevalence of underweight (WAZ) was significantly higher in the RPS versus the IJV (P = 0.03) In the IJV, children aged ≤ 6 y/o and having STH poly-parasitism were associated with underweight (P = 0.01) and moderate-severe T. trichiura infection was associated with anemia. Whilst in the RPS, underweight was highly associated with only T. trichiura infection (P = 0.04). Wasting was significantly associated with young children aged ≤10 in both IJV (P = 0.004) and RPS (P = 0.02). Despite efforts in improving provision of facilities and amenities among the indigenous, this study highlighted a high magnitude of nutritional issues among the Negritos especially those in the RPS and their likely association with STH infections and decades of demarginalization. Joint nutritional intervention strategies with mass anti-helminthic treatment are imperative and urgently needed to reduce the undernutrition problems especially among indigenous children.

Topics: Adolescent; Adult; Anemia; Animals; Child; Child, Preschool; Female; Growth Disorders; Helminthiasis; Helminths; Hemoglobins; Humans; Malaysia; Male; Malnutrition; Nutritional Status; Prevalence; Soil; Thinness; Young Adult

Multiple factors affect growth in children with atopic dermatitis (AD). We investigated food restriction practice, nutrition, and growth in children with AD. Food restriction is defined as restriction ≥3 types of food due to AD or food allergy.. A cross-sectional study was performed in 150 children aged 12-36 months.. recurrent infections, moderate to severe asthma, recent systemic steroid, other diseases affecting growth/nutrition. Growth parameters, SCORing Atopic Dermatitis (SCORAD), hemoglobin, hematocrit, sodium, potassium, albumin, protein, calcium, phosphate, B12, iron, and folate values were determined. Parents completed a 3-day food diary.. The prevalence of food restriction was 60.7%. Commonly restricted foods were shellfish 62.7%, nuts 53.3%, egg 50%, dairy 29.3%, and cow's milk 28.7%. Food-restricted children have significantly lower calorie, protein, fat, riboflavin, vitamin B12, calcium, phosphorus and iron intakes and lower serum iron, protein and albumin values. Z scores of weight-for-age (-1.38 ± 1.02 vs -0.59 ± 0.96, P = .00), height-for-age (-1.34 ± 1.36 vs -0.51 ± 1.22, P = .00), head circumference-for-age (-1.37 ± 0.90 vs -0.90 ± 0.81, P = .00), mid-upper arm circumference (MUAC)-for-age (-0.71 ± 0.90 vs -0.22 ± 0.88, P = .00), and BMI-for-age (-0.79 ± 1.15 vs -0.42 ± 0.99, P = .04) were significantly lower in food-restricted compared to non-food-restricted children. More food-restricted children were stunted, underweight with lower head circumference and MUAC. Severe disease was an independent risk factor for food restriction with OR 5.352; 95% CI, 2.26-12.68.. Food restriction is common in children with AD. It is associated with lower Z scores for weight, height, head circumference, MUAC, and BMI. Severe disease is an independent risk factor for food restriction.

Topics: Anthropometry; Caloric Restriction; Child, Preschool; Cross-Sectional Studies; Dermatitis, Atopic; Female; Food Hypersensitivity; Growth Disorders; Humans; Infant; Malaysia; Male; Nutritional Status

Endocrine dysfunction due to iron overload secondary to frequent blood transfusions is a common complication in children with transfusion-dependent thalassaemia (TDT). We ascertained the prevalence of endocrine dysfunction in children with TDT seen in a hospital setting in Malaysia.. We reviewed all patients with TDT who had ≥ 8 blood transfusions per year. Patients who had a history of stem cell transplantation, concurrent autoimmune diseases or were newly diagnosed to have TDT were excluded. Standard diagnostic criteria were used in the diagnosis of various endocrine dysfunctions.. Of the 82 patients with TDT, 65% had at least one endocrine dysfunction. Short stature was the commonest (40.2%), followed by pubertal disorders (14.6%), hypoparathyroidism (12.3%), vitamin D deficiency (10.1%), hypocortisolism (7.3%), diabetes mellitus (5.2%) and overt hypothyroidism (4.9%). Subclinical hypothyroidism and pre-diabetes mellitus were seen in 13.4% and 8.6% of the patients, respectively. For children aged < 10 years, the prevalence of both thyroid dysfunction and hypoparathyroidism was 9.1%.. Two-thirds of children with TDT experienced at least one endocrine dysfunction. Thyroid dysfunction and hypoparathyroidism may be missed if endocrine screening is only performed in children with TDT > 10 years of age. Close monitoring for endocrine dysfunction and hormonal therapy is essential to prevent long-term adverse outcomes.

Topics: Adolescent; Adult; Blood Transfusion; Child; Child, Preschool; Cross-Sectional Studies; Endocrine System Diseases; Female; Growth Disorders; Humans; Hypoparathyroidism; Malaysia; Male; Prevalence; Thalassemia; Thyroid Diseases; Young Adult

Despite emerging evidence regarding the reversibility of stunting at older ages, most stunting research continues to focus on children below 5 years of age. We aimed to assess stunting prevalence and examine the sociodemographic distribution of stunting risk among older children and adolescents in a Malaysian population.. We used cross-sectional data on 6759 children and adolescents aged 6-19 years living in Segamat, Malaysia. We compared prevalence estimates for stunting defined using the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) references, using Cohen's. The classification of children and adolescents as stunted or normal height differed considerably between the two references (CDC. Our findings justify a framework for strategies addressing stunting across childhood, and highlight the need for consensus on a single definition of stunting in older children and adolescents to streamline monitoring efforts.

Topics: Adolescent; Child; Cost of Illness; Cross-Sectional Studies; Female; Growth Disorders; Humans; Malaysia; Male; Odds Ratio; Prevalence; Risk Assessment; Sanitation; Thinness; Young Adult

The prevalence of stunting, thinness, overweight, and obesity among children differs by ethnicity. It is not known whether differences in body build across the ethnic groups influence the interpretation of nutritional parameters.. To explore the differences in body build across the 5 main ethnic groups in Malaysia and to determine whether differences in body build have an impact on the interpretation of nutrition indicators.. A total of 3227 children aged 2.0 to 12.9 years who participated in the South East Asian Nutrition Surveys (SEANUTS) in Malaysia were included in this analysis. Body weight, height, sitting height, wrist and knee breadths, and biceps and subscapular skinfolds were measured, and relative leg length, slenderness index, and sum of skinfolds were calculated. Z scores for height-for-age (HAZ) and body mass index-for-age (BAZ) were calculated using the World Health Organization (WHO) 2007 growth standards.. Differences in relative leg length and slenderness across the ethnic groups were correlated with HAZ and BAZ. Correction for differences in body build did, in some ethnic groups, have significant impact on the prevalence of stunting, thinness, overweight, and obesity, and the pattern of prevalence across ethnic groups changed.. At the population level, corrections for body build had only minor and mostly nonsignificant effects on prevalence, but at an individual level, corrections for body build placed a substantial number of children in different height or weight categories. Whether these misclassifications warrant additional assessment of body build in clinical practice will need further investigation.

Topics: Anthropometry; Body Height; Body Mass Index; Body Weight; Child; Child, Preschool; Ethnicity; Female; Growth Disorders; Humans; Infant; Malaysia; Male; Nutritional Status; Obesity; Overweight; Somatotypes; Thinness; World Health Organization

Nutrition is an important factor in mental development and, as a consequence, in cognitive performance. Malnutrition is reflected in children's weight, height and BMI curves. The present cross-sectional study aimed to evaluate the association between anthropometric indices and cognitive performance in 6746 school-aged children (aged 6-12 years) of four Southeast Asian countries: Indonesia; Malaysia; Thailand; Vietnam. Cognitive performance (non-verbal intelligence quotient (IQ)) was measured using Raven's Progressive Matrices test or Test of Non-Verbal Intelligence, third edition (TONI-3). Height-for-age z-scores (HAZ), weight-for-age z-scores (WAZ) and BMI-for-age z-scores (BAZ) were used as anthropometric nutritional status indices. Data were weighted using age, sex and urban/rural weight factors to resemble the total primary school-aged population per country. Overall, 21% of the children in the four countries were underweight and 19% were stunted. Children with low WAZ were 3·5 times more likely to have a non-verbal IQ < 89 (OR 3·53 and 95% CI 3·52, 3·54). The chance of having a non-verbal IQ < 89 was also doubled with low BAZ and HAZ. In contrast, except for severe obesity, the relationship between high BAZ and IQ was less clear and differed per country. The odds of having non-verbal IQ levels < 89 also increased with severe obesity. In conclusion, undernourishment and non-verbal IQ are significantly associated in 6-12-year-old children. Effective strategies to improve nutrition in preschoolers and school-aged children can have a pronounced effect on cognition and, in the longer term, help in positively contributing to individual and national development.

Topics: Anthropometry; Body Mass Index; Child; Child Development; Cognition; Cross-Sectional Studies; Female; Growth Disorders; Humans; Indonesia; Intelligence Tests; Malaysia; Male; Malnutrition; Nutritional Status; Rural Population; Students; Thailand; Thinness; Urban Population; Vietnam

It is known that dietary diversity improves diet quality and nutritional status of young children. This study aimed to determine the relationship between dietary diversity and nutritional status of Orang Asli children in Krau Wildlife Reserve.. A total of 216 children from three Orang Asli sub-tribes (Jah Hut, Temuan and Che Wong) aged 1 to 6 years from 162 households in 16 villages participated in this cross-sectional study. Children and mothers were measured for body weight and height. Mothers were interviewed for household socio-demographic information and diet diversity of children in the last 7 days. Diet diversity score (DDS) was calculated based on 15 food groups.. There was a high prevalence of underweight (50.9%) and stunting (61.6%) in Orang Asli children. For mothers, 11.1%, 27.8% and 7.4% were underweight, overweight and obese, respectively. Mean DDS of children was 6.38 [95% CI-6.10, 6.65] of the possible 15. Higher DDS of children was significantly related to older age (p < 0.05), the non Jahut sub-tribe (p < 0.01) and longer maternal years of schooling (p < 0.05). DDS was also positively related to weight-for-age z-scores (p < 0.001) and height-for-age z-scores (p < 0.05).. Undernutrition remains a major nutrition problem among Orang Asli children living within the forest reserve. Efforts to promote dietary diversity should emphasise traditional and nutritious foods that could improve health and nutritional status of the Orang Asli children.

Topics: Adult; Child, Preschool; Cross-Sectional Studies; Developing Countries; Diet; Educational Status; Female; Growth Disorders; Humans; Infant; Malaysia; Male; Mothers; Nutritional Requirements; Nutritional Status; Obesity; Overweight; Sex Factors; Socioeconomic Factors; Surveys and Questionnaires; Thinness

Feeding difficulties in cleft lip and palate (CLP) infants is commonly observed and is the most traumatic experience the family has to face. These infants are undernourished and have compromised growth. The purpose of this study was to 1) assess general health and growth parameters in children with CLP and in normal children; and 2) investigate the feeding methods of CLP infants and normal infants. A total of 221 children from birth to six years of both sexes, with CLP (60 children) and normal (161 children) were selected. The CLP and normal children were divided into three subgroups by age. The practice of feeding the infants in subgroup I was assessed using standard piloted questionnaires. The assessment of growth was done at baseline and at six months in all the subgroups.The general well being of the children was assessed by noting the number of common infections. Results showed that a significantly higher percentage of mothers with normal babies (p < 0.01) had a positive attitude towards breast feeding. When compared to normal children, CLP children were more susceptible to infections (p < 0.05) and measured significantly lower on the height growth curve(p < 0.05). Hence, height can be used to monitor growth in CLP children.

Topics: Body Height; Body Weight; Child Care; Child Nutritional Physiological Phenomena; Child, Preschool; Cleft Lip; Cleft Palate; Feeding Methods; Female; Growth Disorders; Humans; Infant; Infant Care; Infant Nutritional Physiological Phenomena; Infant, Newborn; Malaysia; Male; Parents

Growth is an inherent property of life. About 10% of the congenital forms of growth retardation and short stature are genetically caused. Beside the gene involved in direct GH-production, there are different candidate genes important for appropriate pituitary development causing combined pituitary hormone deficiency (CPHD). However, severe growth retardation and failure to thrive remain the leading reason for medical assessment in these patients.. We report two siblings of a healthy but consanguineous Malaysian family presenting with severe short stature caused by CPHD with a variable phenotype. Importantly, at the beginning the girl presented with isolated GHD, whereas the boy was hypothyroid. As the most common gene alterations responsible for CPHD are within either the PROP-1- or the POU1F1- (PIT-1)-gene these two genes were further studied.. Subsequent sequencing of the six exons of the POU1F1-gene allowed the identification of a new N-terminal mutation (Q4ter) in these two children. A substitution of C to T induced a change from a glutamine (CAA) to a stop codon (TAA) in exon 1 of the PIT-1 protein. Both affected children were homozygous for the mutation, whereas the mother and father were heterozygous.. We describe two children with autosomal recessive inherited CPHD caused by a new N-terminal located mutation within the PUO1F1-gene. The clinical history of these two children underline the phenotypic variability and support the fact that children with any isolated and/or combined PHD need to be closely followed as at an any time other hormonal deficiencies may occur. In addition, molecular analysis of the possible genes involved might be most helpful for the future follow-up.

Topics: Adolescent; Amino Acid Sequence; Child; Child, Preschool; Consanguinity; DNA-Binding Proteins; Female; Growth Disorders; Human Growth Hormone; Humans; Malaysia; Male; Molecular Sequence Data; Phenotype; Pituitary Hormones; Point Mutation; Transcription Factor Pit-1; Transcription Factors

Stool examination, height and weight measurements were undertaken on 249 early primary school children at two schools in North-eastern Peninsular Malaysia. Helminth infected children were treated and follow-up anthropometric measurements and stool examination undertaken on all (n = 100) children at one of the schools 16 months later; to observe the relationship between acquisition of infection and growth. Baseline Ascaris prevalence rates at the two schools were 16.0% (23/144) and 47.6% (50/105) respectively whilst Trichuris rates were 33.3% (48/144) and 52.4% (55/105). Hookworm infection was uncommon. There was no difference in weight or height for age between infected and uninfected children at any time. Acquisition of worm infection over the initial 16 month follow-up period was not associated with significant decreases in growth rates. However the small subsets of children with heavy Ascaris infection were consistently lighter and shorter at all evaluation times. They also gained significantly less weight and tended to have reduced linear growth rates between measurements. Further interventional studies are required to determine if this association is one of cause and effect or largely incidental.

Topics: Anthropometry; Ascariasis; Body Height; Body Weight; Child; Female; Follow-Up Studies; Growth Disorders; Humans; Intestinal Diseases, Parasitic; Malaysia; Male; Regression Analysis; Statistics, Nonparametric; Trichuriasis

In a study of mild to significant malnutrition in an urban squatter settlement, the weights for age of 297 children between birth and ten years, and the heights for age and weights for height of 197 children between two to ten years were analysed. Using NCHS standards, the overall prevalence of underweight was found to be 18.9%, stunting 15.2%, and wasting 11.2%. Age and ethnicity were significantly associated with the prevalence of underweight and stunting. The growth achievement of children below the age of two years were significantly better off than the older children, and Chinese children significantly better off than Malay and Indian children.. Industrialization and urbanization attract in-migrant. Unable to afford conventional housing, many newcomers settle as squatters. These squatter settlements are generally polluted, overcrowded, and ridden with infectious diseases. Child malnutrition is widespread in urban and rural areas of Malaysia. This study explores the extent of mild to significant malnutrition in the squatter settlement of Kampung Baiduri located adjacent to an industrial area in Petaling Jaya. Weights for age of 297 children between birth and ten years, and heights for age and weights for height of 197 children between 2-10 years were collected over a 3-month period in 1988, and subsequently analyzed. On the basis of US National Center for Health Statistics standards, the overall prevalence of underweight was 18.9%, stunting 15.2%, and wasting 11.2%. Age and ethnicity were significantly associated with the prevalence of underweight and stunting. Moreover, the growth achievement of children under age 2 years was significantly better than that of older children, and Chinese children fared significantly better than Malay and Indian children. These findings indicate a need to make these children primary targets of nutrition intervention programs.

Topics: Child; Child Nutrition Disorders; Child, Preschool; Growth Disorders; Humans; Malaysia; Poverty; Prevalence; Urban Health