Nutritional status, infant and young child feeding among children aged 6-59 months in Windhoek and surrounding areas, Namibia
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Date
2022
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Publisher
University of Namibia
Abstract
Malnutrition is a global health concern in children under five years, and often presents as stunting, underweight, overweight and wasting. Measurement errors in taking anthropometry limits their validity in defining childhood malnutrition, resulting in need for alternative techniques. This study aimed to determine the nutritional status of Namibian children under five years, and to correlate these findings with their dietary practices, as well as test new digital technologies in child anthropometric measurements. A cross-sectional, descriptive study was conducted on Namibian children between the age of 6 to 59 months, using anthropometric measurements of weight, height and mid-upper arm circumference. Height was collected using three different instruments, an analog height board, a digi-board and a 3D scanning mobile phone app called Child Growth Monitor (CGM). The reliability of the digi-board was assessed using technical error of measurement (TEM), percentage technical error of measurement (%TEM), intra class correlation (ICC) and statistical tests on absolute differences. Accuracy of the CGM 3D imaging to diagnose stunting was assessed by sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). In all these assessments, the analog height board was considered as the gold standard and used for comparison. A dietary survey was conducted using a 24-hour food recall questionnaire. The study recruited 612 children, of which 425 children yielded data using the digital board and analog height board and 187 children yielded data using the CGM 3D imaging and analog height board. The prevalence of malnutrition was determined to be 29.6% stunting, 4.5% wasting, 16.7% underweight and 2.4% overweight, based on the traditional analog height board. The digi-board indicated superiority to the analog height board in terms of reliability (analog TEM = 0.22, digi-board TEM=0.16), while the CGM 3D imaging underestimated children for wasting (analog and CGM 3D imaging = 7% and 1.1%). Underweight and stunting estimated similarly (analog and CGM 3D imaging = 15% and 13.3% for underweight, and 26.9% and 27% for stunting, respectively). There was a low positive correlation between malnutrition and dietary diversity of children, and food diversity was found to improve child health. In this study, the prevalence of stunting is moderate according to the World Health Organisation cut-offs, confirming that stunted growth is still a health problem in Namibian children under five years, and proper interventions such as food donations and educational programmes to mothers on breast- and young child feeding practices are required to address these issues.
Description
A thesis submitted in full fulfilment of the requirements for the Degree of Master of Science in Physiology (Nutrition)
Keywords
Anthropometry, Malnutrition, Children, 3D imaging, Reliability, Dietary, Diversity