Displaying publications 1 - 20 of 60 in total

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  1. Chooi KF, Chulan U
    Vet Rec, 1985 Mar 30;116(13):354.
    PMID: 4002545
    Matched MeSH terms: Growth Disorders/pathology; Growth Disorders/veterinary*
  2. Lye CW, Sivasampu S, Mahmudiono T, Majid HA
    J Public Health (Oxf), 2023 Nov 29;45(4):e677-e691.
    PMID: 37291061 DOI: 10.1093/pubmed/fdad070
    BACKGROUND: This systematic review aims to investigate the association between household food insecurity (HFIS) and undernutrition in children under 5 years old, thereby informing policymakers on the vital factors needed to be considered in tailoring an effective strategy to tackle childhood undernutrition and ultimately HFIS.

    METHODS: We performed a systematic review that examined household food insecurity among the undernourished under-five children. PubMed, Cochrane, EBSCO Host, Web of Science and Cumulative Index to Nursing and Allied Health Literature were searched from 1 January 2012 to 1 April 2022, for relevant articles. Outcome measures were stunting, underweight or wasting. Of the 2779 abstracts screened, 36 studies that fulfilled the inclusion and exclusion criteria were included. A range of tools had been used to measure HFIS, the most common being Household Food Insecurity Access Scale. HFIS has been found to be significantly associated with undernutrition, particularly stunting and underweight. This is observed proportionately across all national income levels.

    CONCLUSIONS: Sustainable and inclusive economic growth, which aims to reduce income, education and gender inequality, should be a key policy goal in the minimizing food insecurity and childhood undernutrition. Multisectoral interventions are needed to address these issues.

    Matched MeSH terms: Growth Disorders/etiology; Growth Disorders/epidemiology
  3. Dimitri P, Fernandez-Luque L, Banerjee I, Bergadá I, Calliari LE, Dahlgren J, et al.
    J Med Internet Res, 2021 05 20;23(5):e27446.
    PMID: 34014174 DOI: 10.2196/27446
    BACKGROUND: The use of technology to support health and health care has grown rapidly in the last decade across all ages and medical specialties. Newly developed eHealth tools are being implemented in long-term management of growth failure in children, a low prevalence pediatric endocrine disorder.

    OBJECTIVE: Our objective was to create a framework that can guide future implementation and research on the use of eHealth tools to support patients with growth disorders who require growth hormone therapy.

    METHODS: A total of 12 pediatric endocrinologists with experience in eHealth, from a wide geographical distribution, participated in a series of online discussions. We summarized the discussions of 3 workshops, conducted during 2020, on the use of eHealth in the management of growth disorders, which were structured to provide insights on existing challenges, opportunities, and solutions for the implementation of eHealth tools across the patient journey, from referral to the end of pediatric therapy.

    RESULTS: A total of 815 responses were collected from 2 questionnaire-based activities covering referral and diagnosis of growth disorders, and subsequent growth hormone therapy stages of the patient pathway, relating to physicians, nurses, and patients, parents, or caregivers. We mapped the feedback from those discussions into a framework that we developed as a guide to integration of eHealth tools across the patient journey. Responses focused on improved clinical management, such as growth monitoring and automation of referral for early detection of growth disorders, which could trigger rapid evaluation and diagnosis. Patient support included the use of eHealth for enhanced patient and caregiver communication, better access to educational opportunities, and enhanced medical and psychological support during growth hormone therapy management. Given the potential availability of patient data from connected devices, artificial intelligence can be used to predict adherence and personalize patient support. Providing evidence to demonstrate the value and utility of eHealth tools will ensure that these tools are widely accepted, trusted, and used in clinical practice, but implementation issues (eg, adaptation to specific clinical settings) must be addressed.

    CONCLUSIONS: The use of eHealth in growth hormone therapy has major potential to improve the management of growth disorders along the patient journey. Combining objective clinical information and patient adherence data is vital in supporting decision-making and the development of new eHealth tools. Involvement of clinicians and patients in the process of integrating such technologies into clinical practice is essential for implementation and developing evidence that eHealth tools can provide value across the patient pathway.

    Matched MeSH terms: Growth Disorders/diagnosis; Growth Disorders/drug therapy
  4. Nadhiroh SR, Micheala F, Tung SEH, Kustiawan TC
    Nutrition, 2023 Nov;115:112094.
    PMID: 37572547 DOI: 10.1016/j.nut.2023.112094
    OBJECTIVES: Maternal anemia is a worldwide health issue and a common pregnancy complication. It leads to consequences including infant mortality, low birth weight, preterm birth, unrecoverable or partially reversible neurobehavioral and cognitive deficits, and short birth length. However, the relationship between maternal anemia and stunting in children is not well defined. This systematic literature review sought to determine whether maternal anemia was associated with height or length and stunting conditions in infants and children ages 0-60 mo in cohort, case-control, and cross-sectional studies carried out in several countries.

    METHODS: A systematic review was performed on articles published from 2014-2021 related to maternal anemia and stunting. The electronic databases used were ScienceDirect, PubMed, Scopus, ProQuest, Google Search, and AJOG (American Journal of Obstetrics and Gynecology). The literature search was performed up to December 7, 2021.

    RESULTS: Twelve studies were included. Nine studies examined the correlation between maternal anemia and length or weight in children. Seven of the nine studies showed an association between maternal anemia and stunting in children; the others showed an association between maternal anemia and birth length. Three studies found no association between maternal anemia and stunting in children under age 5 y.

    CONCLUSIONS: The current review emphasizes that stunting in children may be associated with maternal anemia, specifically in developing countries. This implies that it is crucial to prevent anemia in adolescent girls and women before and during pregnancy as a part of programs to eliminate stunting in children.

    Matched MeSH terms: Growth Disorders/complications; Growth Disorders/epidemiology
  5. Chee HL
    Med J Malaysia, 1992 Sep;47(3):170-81.
    PMID: 1491642
    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.
    Matched MeSH terms: Growth Disorders/etiology; Growth Disorders/epidemiology
  6. Partap U, Young EH, Allotey P, Sandhu MS, Reidpath DD
    PMID: 30891249 DOI: 10.1017/gheg.2019.1
    Background: 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.

    Methods: 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 κ coefficient. Associations between sociodemographic indices and stunting risk were examined using mixed-effects Poisson regression with robust standard errors.

    Results: The classification of children and adolescents as stunted or normal height differed considerably between the two references (CDC v. WHO; κ for agreement: 0.73), but prevalence of stunting was high regardless of reference (crude prevalence: CDC 29.2%; WHO: 19.1%). Stunting risk was approximately 19% higher among underweight v. normal weight children and adolescents (p = 0.030) and 21% lower among overweight children and adolescents (p = 0.001), and decreased strongly with improved household drinking water sources [risk ratio (RR) for water piped into house: 0.35, 95% confidence interval (95% CI) 0.30-0.41, p < 0.001). Protective effects were also observed for improved sanitation facilities (RR for flush toilet: 0.41, 95% CI 0.19-0.88, p = 0.023). Associations were not materially affected in multiple sensitivity analyses.

    Conclusions: 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.

    Matched MeSH terms: Growth Disorders/epidemiology*; Growth Disorders/pathology
  7. Ngim CF, Lai NM, Hong JY, Tan SL, Ramadas A, Muthukumarasamy P, et al.
    Cochrane Database Syst Rev, 2017 09 18;9:CD012284.
    PMID: 28921500 DOI: 10.1002/14651858.CD012284.pub2
    BACKGROUND: Thalassaemia is a recessively-inherited blood disorder that leads to anaemia of varying severity. In those affected by the more severe forms, regular blood transfusions are required which may lead to iron overload. Accumulated iron from blood transfusions may be deposited in vital organs including the heart, liver and endocrine organs such as the pituitary glands which can affect growth hormone production. Growth hormone deficiency is one of the factors that can lead to short stature, a common complication in people with thalassaemia. Growth hormone replacement therapy has been used in children with thalassaemia who have short stature and growth hormone deficiency.

    OBJECTIVES: To assess the benefits and safety of growth hormone therapy in people with thalassaemia.

    SEARCH METHODS: We searched the Cochrane Haemoglobinopathies Trials Register, compiled from electronic database searches and handsearching of journals and conference abstract books. We also searched the reference lists of relevant articles, reviews and clinical trial registries. Our database and trial registry searches are current to 10 August 2017 and 08 August 2017, respectively.

    SELECTION CRITERIA: Randomised and quasi-randomised controlled trials comparing the use of growth hormone therapy to placebo or standard care in people with thalassaemia of any type or severity.

    DATA COLLECTION AND ANALYSIS: Two authors independently selected trials for inclusion. Data extraction and assessment of risk of bias were also conducted independently by two authors. The quality of the evidence was assessed using GRADE criteria.

    MAIN RESULTS: One parallel trial conducted in Turkey was included. The trial recruited 20 children with homozygous beta thalassaemia who had short stature; 10 children received growth hormone therapy administered subcutaneously on a daily basis at a dose of 0.7 IU/kg per week and 10 children received standard care. The overall risk of bias in this trial was low except for the selection criteria and attrition bias which were unclear. The quality of the evidence for all major outcomes was moderate, the main concern was imprecision of the estimates due to the small sample size leading to wide confidence intervals. Final height (cm) (the review's pre-specified primary outcome) and change in height were not assessed in the included trial. The trial reported no clear difference between groups in height standard deviation (SD) score after one year, mean difference (MD) -0.09 (95% confidence interval (CI) -0.33 to 0.15 (moderate quality evidence). However, modest improvements appeared to be observed in the following key outcomes in children receiving growth hormone therapy compared to control (moderate quality evidence): change between baseline and final visit in height SD score, MD 0.26 (95% CI 0.13 to 0.39); height velocity, MD 2.28 cm/year (95% CI 1.76 to 2.80); height velocity SD score, MD 3.31 (95% CI 2.43 to 4.19); and change in height velocity SD score between baseline and final visit, MD 3.41 (95% CI 2.45 to 4.37). No adverse effects of treatment were reported in either group; however, while there was no clear difference between groups in the oral glucose tolerance test at one year, fasting blood glucose was significantly higher in the growth hormone therapy group compared to control, although both results were still within the normal range, MD 6.67 mg/dL (95% CI 2.66 to 10.68). There were no data beyond the one-year trial period.

    AUTHORS' CONCLUSIONS: A small single trial contributed evidence of moderate quality that the use of growth hormone for a year may improve height velocity of children with thalassaemia although height SD score in the treatment group was similar to the control group. There are no randomised controlled trials in adults or trials that address the use of growth hormone therapy over a longer period and assess its effect on final height and quality of life. The optimal dosage of growth hormone and the ideal time to start this therapy remain uncertain. Large well-designed randomised controlled trials over a longer period with sufficient duration of follow up are needed.

    Matched MeSH terms: Growth Disorders/drug therapy*; Growth Disorders/etiology
  8. Logarajan RD, Nor NM, Ibrahim S, Said R
    Nutrition, 2023 Jul;111:112030.
    PMID: 37172456 DOI: 10.1016/j.nut.2023.112030
    OBJECTIVE: This study aims to assess social determinants of stunting among children aged <5 y within the Malay ethnicity in Malaysia.

    METHODS: 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.

    RESULTS: 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.

    CONCLUSIONS: 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.

    Matched MeSH terms: Growth Disorders/etiology; Growth Disorders/epidemiology
  9. Abu Zaid Z, Shahar S, Jamal AR, Mohd Yusof NA
    Asia Pac J Clin Nutr, 2012;21(4):502-10.
    PMID: 23017308
    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.
    Matched MeSH terms: Growth Disorders/complications; Growth Disorders/diet therapy; Growth Disorders/ethnology; Growth Disorders/pathology
  10. Poh BK, Wong JE, Norimah AK, Deurenberg P
    Food Nutr Bull, 2016 Mar;37(1):3-13.
    PMID: 26769039 DOI: 10.1177/0379572115626025
    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.
    Matched MeSH terms: Growth Disorders/ethnology; Growth Disorders/epidemiology*
  11. Salemi S, Besson A, Eblé A, Gallati S, Pfäffle RW, Mullis PE
    Growth Horm. IGF Res., 2003 Oct;13(5):264-8.
    PMID: 12932747
    OBJECTIVE: 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.

    PATIENTS AND METHODS: 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.

    RESULTS: 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.

    CONCLUSION: 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.

    Matched MeSH terms: Growth Disorders/genetics*; Growth Disorders/pathology
  12. Lai KP, Kaur H, Mathias RG, Ow-Yang CK
    PMID: 8629068
    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.
    Matched MeSH terms: Growth Disorders/epidemiology; Growth Disorders/parasitology*
  13. Ngim CF, Lai NM, Hong JY, Tan SL, Ramadas A, Muthukumarasamy P, et al.
    Cochrane Database Syst Rev, 2020 05 28;5:CD012284.
    PMID: 32463488 DOI: 10.1002/14651858.CD012284.pub3
    BACKGROUND: Thalassaemia is a recessively-inherited blood disorder that leads to anaemia of varying severity. In those affected by the more severe forms, regular blood transfusions are required which may lead to iron overload. Accumulated iron from blood transfusions may be deposited in vital organs including the heart, liver and endocrine organs such as the pituitary glands which can affect growth hormone production. Growth hormone deficiency is one of the factors that can lead to short stature, a common complication in people with thalassaemia. Growth hormone replacement therapy has been used in children with thalassaemia who have short stature and growth hormone deficiency. This review on the role of growth hormone was originally published in September 2017 and updated in April 2020.

    OBJECTIVES: To assess the benefits and safety of growth hormone therapy in people with thalassaemia.

    SEARCH METHODS: We searched the Cochrane Haemoglobinopathies Trials Register, compiled from electronic database searches and handsearching of journals and conference abstract books. Date of latest search: 14 November 2019. We also searched the reference lists of relevant articles, reviews and clinical trial registries. Date of latest search: 06 January 2020.

    SELECTION CRITERIA: Randomised and quasi-randomised controlled trials comparing the use of growth hormone therapy to placebo or standard care in people with thalassaemia of any type or severity.

    DATA COLLECTION AND ANALYSIS: Two authors independently selected trials for inclusion. Data extraction and assessment of risk of bias were also conducted independently by two authors. The certainty of the evidence was assessed using GRADE criteria.

    MAIN RESULTS: We included one parallel trial conducted in Turkey. The trial recruited 20 children with homozygous beta thalassaemia who had short stature; 10 children received growth hormone therapy administered subcutaneously on a daily basis at a dose of 0.7 IU/kg per week and 10 children received standard care. The overall risk of bias in this trial was low except for the selection criteria and attrition bias which were unclear. The certainty of the evidence for all major outcomes was moderate, the main concern was imprecision of the estimates due to the small sample size leading to wide confidence intervals. Final height (cm) (the review's pre-specified primary outcome) and change in height were not assessed in the included trial. The trial reported no clear difference between groups in height standard deviation (SD) score after one year, mean difference (MD) -0.09 (95% confidence interval (CI) -0.33 to 0.15 (moderate-certainty evidence). However, modest improvements appeared to be observed in the following key outcomes in children receiving growth hormone therapy compared to control (moderate-certainty evidence): change between baseline and final visit in height SD score, MD 0.26 (95% CI 0.13 to 0.39); height velocity, MD 2.28 cm/year (95% CI 1.76 to 2.80); height velocity SD score, MD 3.31 (95% CI 2.43 to 4.19); and change in height velocity SD score between baseline and final visit, MD 3.41 (95% CI 2.45 to 4.37). No adverse effects of treatment were reported in either group; however, while there was no clear difference between groups in the oral glucose tolerance test at one year, fasting blood glucose was significantly higher in the growth hormone therapy group compared to control, although both results were still within the normal range, MD 6.67 mg/dL (95% CI 2.66 to 10.68). There were no data beyond the one-year trial period.

    AUTHORS' CONCLUSIONS: A small single trial contributed evidence of moderate certainty that the use of growth hormone for a year may improve height velocity of children with thalassaemia although height SD score in the treatment group was similar to the control group. There are no randomised controlled trials in adults or trials that address the use of growth hormone therapy over a longer period and assess its effect on final height and quality of life. The optimal dosage of growth hormone and the ideal time to start this therapy remain uncertain. Large well-designed randomised controlled trials over a longer period with sufficient duration of follow up are needed.

    Matched MeSH terms: Growth Disorders/drug therapy*; Growth Disorders/etiology
  14. Tan KA, Lum SH, Yahya A, Krishnan S, Jalaludin MY, Lee WS
    Singapore Med J, 2019 Jun;60(6):303-308.
    PMID: 30556093 DOI: 10.11622/smedj.2018155
    INTRODUCTION: 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.

    METHODS: 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.

    RESULTS: 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%.

    CONCLUSION: 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.

    Matched MeSH terms: Growth Disorders/etiology*; Growth Disorders/epidemiology
  15. Zulkifley MA, Mohamed NA, Abdani SR, Kamari NAM, Moubark AM, Ibrahim AA
    Diagnostics (Basel), 2021 Apr 24;11(5).
    PMID: 33923215 DOI: 10.3390/diagnostics11050765
    Skeletal bone age assessment using X-ray images is a standard clinical procedure to detect any anomaly in bone growth among kids and babies. The assessed bone age indicates the actual level of growth, whereby a large discrepancy between the assessed and chronological age might point to a growth disorder. Hence, skeletal bone age assessment is used to screen the possibility of growth abnormalities, genetic problems, and endocrine disorders. Usually, the manual screening is assessed through X-ray images of the non-dominant hand using the Greulich-Pyle (GP) or Tanner-Whitehouse (TW) approach. The GP uses a standard hand atlas, which will be the reference point to predict the bone age of a patient, while the TW uses a scoring mechanism to assess the bone age using several regions of interest information. However, both approaches are heavily dependent on individual domain knowledge and expertise, which is prone to high bias in inter and intra-observer results. Hence, an automated bone age assessment system, which is referred to as Attention-Xception Network (AXNet) is proposed to automatically predict the bone age accurately. The proposed AXNet consists of two parts, which are image normalization and bone age regression modules. The image normalization module will transform each X-ray image into a standardized form so that the regressor network can be trained using better input images. This module will first extract the hand region from the background, which is then rotated to an upright position using the angle calculated from the four key-points of interest. Then, the masked and rotated hand image will be aligned such that it will be positioned in the middle of the image. Both of the masked and rotated images will be obtained through existing state-of-the-art deep learning methods. The last module will then predict the bone age through the Attention-Xception network that incorporates multiple layers of spatial-attention mechanism to emphasize the important features for more accurate bone age prediction. From the experimental results, the proposed AXNet achieves the lowest mean absolute error and mean squared error of 7.699 months and 108.869 months2, respectively. Therefore, the proposed AXNet has demonstrated its potential for practical clinical use with an error of less than one year to assist the experts or radiologists in evaluating the bone age objectively.
    Matched MeSH terms: Growth Disorders
  16. Lee WS, Tee CW, Tan AG, Wong SY, Chew KS, Cheang HK, et al.
    Pediatr Neonatol, 2019 12;60(6):676-683.
    PMID: 31056340 DOI: 10.1016/j.pedneo.2019.04.004
    BACKGROUND: Parents often express concerns about feeding difficulties in their child. We hypothesized that these parental concerns were associated with adverse growth status in early childhood. We aimed to determine the prevalence of such concerns and whether these concerns were associated with adverse growth status in early childhood.

    METHODS: We performed a cross-sectional study among healthy children aged 12-36 months attending three well-baby clinics in three urban areas in Malaysia and Singapore between December 2016 and February 2017. Parents were interviewed for concerns about their child's feeding and presence of behavioral and organic red flags for feeding difficulties. We defined growth faltering as weight-for-age < 3rd centile and short stature as height-for-age < 3rd centile according to World Health Organization Growth Standards.

    RESULTS: Of the 303 children studied (boys = 160, 52.8%; mean [± SD] chronological age at interview 21.3 [± 4.0] months), 13% (n = 38/292) had growth faltering and 19.5% (n = 50/256) had short stature. Overall, 36.3% (n = 110) of parents expressed concerns about their child's feeding behavior. Sixty-eight percent (n = 206) of parents reported presence of at least one behavioral and 18.5% (n = 56) had at least one organic red flag for feeding difficulties, respectively. 9.9% (n = 30) had both behavioral and organic red flags for feeding difficulties. Growth faltering was significantly associated with parental concern about feeding (odds ratio [OR] 3.049, p growth faltering in early childhood.

    Matched MeSH terms: Growth Disorders/etiology*
  17. Bunupuradah T, Kariminia A, Aurpibul L, Chokephaibulkit K, Hansudewechakul R, Lumbiganon P, et al.
    Pediatr Infect Dis J, 2016 Feb;35(2):201-4.
    PMID: 26484429 DOI: 10.1097/INF.0000000000000961
    We analyzed final height of 273 perinatally HIV-infected Asian adolescents older than 18 years at their last clinic visit. By the World Health Organization child growth reference, 30% were stunted, but by the Thai child growth reference, 19% were stunted. Half of those who were stunted at antiretroviral therapy initiation remained stunted over time. Being male and having a low baseline height-for-age Z score of less than -1.0 were associated with low final height Z score.
    Matched MeSH terms: Growth Disorders/epidemiology*
  18. Yen WC, Shariff ZM, Adznam SN, Sulaiman N, Siew CY
    Asia Pac J Clin Nutr, 2018 7 27;27(4):886-892.
    PMID: 30045435 DOI: 10.6133/apjcn.072017.02
    BACKGROUND AND OBJECTIVES: Information on the growth status of indigenous children is useful for developing intervention strategies, but the data are limited. This study determined the prevalence of undernutrition among under-five indigenous children (Orang Asli) and tracked the growth status of Orang Asli children aged 0-3 years.

    METHODS AND STUDY DESIGN: This study had two phases: a cross-sectional growth study of under-five Orang Asli children (N=304; Phase 1) and a 2-year prospective cohort growth study of Orang Asli children aged 0-3 years (N=214; Phase 2) in the Temerloh district of Pahang, Malaysia. Weight-for-age, length/height-for-age, weight-for-length/height, and body mass index-for-age were determined.

    RESULTS: The prevalence rates of stunting, underweight, wasting, and thinness in under-five Orang Asli children (Phase 1) were 64%, 49%, 14%, and 12%, respectively. In the cohort of 214 children (Phase 2), weight-for-age was initially documented and maintained closely at -1.50 standard deviations (SD) in the first 6 months, but it declined to approximately -2.00 SD at 15 months and remained close to -2.00 SD thereafter. Length/height-for-age declined rapidly to approximately -2.50 SD at 18 months and fluctuated between -2.30 and -2.50 SD thereafter. Weight-for-length/height increased sharply to -0.40 SD at 2-3 months, declined gradually to less than -1.00 SD at 12 months, and plateaued between -1.00 and -1.30 SD thereafter.

    CONCLUSIONS: Undernutrition is prevalent among Orang Asli children, with length rather than weight faltering being more pronounced in the first 2 years of life. Identifying the causes of early growth retardation in this population is required to inform future preventive strategies.

    Matched MeSH terms: Growth Disorders/epidemiology*
  19. Low DW, Jamil A, Md Nor N, Kader Ibrahim SB, Poh BK
    Pediatr Dermatol, 2020 Jan;37(1):69-77.
    PMID: 31667896 DOI: 10.1111/pde.14004
    BACKGROUND: 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.

    METHODS: A cross-sectional study was performed in 150 children aged 12-36 months.

    EXCLUSION CRITERIA: 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.

    RESULTS: 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.

    CONCLUSION: 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.

    Matched MeSH terms: Growth Disorders/epidemiology*
  20. El Kishawi RR, Soo KL, Abed YA, Muda WAMW
    BMC Pediatr, 2017 12 21;17(1):210.
    PMID: 29268788 DOI: 10.1186/s12887-017-0957-y
    BACKGROUND: Stunting continues to be a major public health problem in developing countries. It is one of the most important risk factors for morbidity and mortality during childhood. In Palestine, it is another health problem, which adds to the catastrophic issues in the region. This study aimed to determine the prevalence of stunting and its associated factors among preschool children in the Gaza Strip.

    METHODS: A cross-sectional study design was conducted in the Gaza Strip. A total of 357 children aged 2-5 years and their mothers aged 18-50 years were recruited. A multistage cluster sampling was used in the selection of the study participants from three geographical areas in the Gaza Strip: Jabalia refugee camp, El Remal urban area, and Al Qarara rural area. A structured questionnaire was used for face- to -face interviews with the respective child's mother to collect sociodemographic information and feeding practice. Anthropometric measurements for children were taken to classify height-for-age (HAZ), while maternal height was measured as well. Descriptive and binary logistic regression analyses were applied to determine the prevalence and associated factors with stunting.

    RESULTS: The total prevalence of stunting in this study was 19.6%, with the highest prevalence being (22.6%) in Jabalia refugee camp. It turns out that shorter mothers had increased the odds of stunting in preschool children in the Gaza Strip. Children born to mothers whose height was 1.55-1.60 m or <1.55 m were more likely to be stunted (p = 0. 008), or (p 1.60 m. Moreover, parental consanguinity increased the risk of stunted children (p = 0. 015).

    CONCLUSIONS: This study showed the prevalence of stunting was of alarming magnitude in the Gaza Strip. Our results also demonstrated that parental consanguinity and short maternal stature were associated with stunting. Culturally appropriate interventions and appropriate strategies should be implemented to discourage these types of marriages. Policy makers must also raise awareness of the importance of the prevention and control of nutritional problems to combat stunting among children in the Gaza Strip.

    Matched MeSH terms: Growth Disorders/epidemiology*
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