Feasible Means to Address Moderately Malnourished Children Within BINP Communities
Mild and Moderate Malnourished Children
Behavioral: Prospective Longitudinal Interventional Stury
|Study Design:||Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Prevention
- Mothers understanding and ability to identify moderate malnutrition in children.
- Mothers understanding on consequence of moderate malnutrition.
- Change in knowledge of mothers in feeding practices.
- Frequency of home feeding (Breast-feeding and supplementary feeding).
- Frequency of seeking medical care during illness, referral, incidence, duration of illness.
- Adequacy of child feeding, frequency & type of feeding.
- Weight gain, weight for age and weight for height at the end of intervention.
- Proportion of complementary feeds in 6-9 months age group.
- Nutritional status of children at various phases of intervention and observation.
- Adaptation level of nutrition education program by CNP, CNO.
- Constant of not practicing education knowledge.
- Incidence and prevalence of diarrhoea and ALRI
- Referral success and failure
- Resistance to education
- Food insecurity for child
- Mothers time constraint for CF preparation
- CNP time constraints for INE
|Study Start Date:||December 2000|
|Estimated Study Completion Date:||September 2002|
Bangladesh has the highest proportion of malnourished children in the world. The infant and child mortality are also among the highest in south Asia. In Bangladesh, `. The Government of Bangladesh has been trying different ways for reducing childhood malnutrition. Such programs include the Vulnerable Group Development (VGD) Project, vitamin A distribution project, iodine deficiency disorder control program, iron supplementation program and improving food availability for the underprivileged sections of the society. Despite these, not enough improvement has been observed in the field of nutrition. In review of the past fifty-year’s information of dietary intake and growth, it has been observed that food intake has substantially decreased and growth faltering in children has worsened (Roy et al 1988). Materal malnutrition is evidenced by low weight, short stature and anemia in pregnant and lactating women. Micronutrient deficiencies are evidenced by prevalence of xerophthalmia, iron deficiency anemia and iodine deficiency disorders. The effects of childhood under nutrition, begin with a low birth weight (estimated to occur among 35-50% of births in Bangladesh) (Hasan et al 1995) and continue into adulthood.
The prevalence of PEM among children is very high, and has remained almost the same for the last decade. Thirty percent of all children under six years of age are severely stunted and another 31.2% are moderately stunted (BBS 1995). As many as 68.3% of the total children are under -weight and 16.7% are wasted, the highest rates are in Asia (BBS 1995). Given the greatly disadvantaged start by the way of a low birth-weight followed by inadequate breast-feeding by their undernourished mothers, average Bangladeshi infants are already below the lower end of the range of anthropometric values found among western babies during the first three to six months. The late and insufficient introduction of complementary feeding further retards the infant's growth; usually the child do not pick up its pace of growth before two years of age. By then, it is too late to reverse the early growth lag, which persists throughout the life, and similarly some of the damages done to mental development are irreparable. The weight for age curve of Bangladeshi children continues to lie below the third percentile of the NCHS Standard, though it runs roughly parallel to the standard from around the second year of life onward; the older children cope better with the adverse milieu of food-insecure and unhealthy household, while being unable to regain lost ground.
Please refer to this study by its ClinicalTrials.gov identifier: NCT00372242
|Principal Investigator:||Swapan K Roy, MBBS, PhD||International Centre for Diarrhoeal Disease Research, Bangladesh|