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NUTRITIONAL STATUS OF UNDER CHILDREN by alicejenny

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									NNP Baseline Survey 2004                                                               Chapter 5


5.4 NUTRITIONAL STATUS OF UNDER-5 CHILDREN
The mean age, height, and weight of 4,826 children aged 24-59 months were 41.1 months, 89.7 cm,
and 11.8 kg respectively. The mean HAZ of under-5 children was -2.0, WAZ -2.1, and WHZ -1.1.
Children in the BINP areas had significantly better HAZ compared to those in the NNP areas. The
mean WHZ of under-5 children, however, was better in the NNP areas.

There was no difference between the areas regarding the proportion of children with stunting,
defined as HAZ <-2. The overall prevalence of stunting was 50%. Severe stunting (HAZ <-3) was
significantly more prevalent among children in the NNP areas compared to those in the BINP areas
(22% vs 17%). On the contrary, 53% of children in the BINP areas had mild or no stunting as
opposed to 47% in the NNP areas.

Under-weight, defined as WAZ <-2, was observed in 56% of under-5 children. The prevalence of
severe under-weight was 13.8%, without any difference between the areas. About 56% of children
were moderately under-weight (-3.0 SD to -2.01 SD).

The prevalence of wasting (WHZ <-2) was 12%, while severe wasting (WHZ <-3) was observed in
only 0.7% of children. Eleven percent of children had moderate wasting, and 47% were suffering
from mild wasting.




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Table 5.4.1. Distribution of age, height, weight, and anthropometric indices of 24-59 months old children, NNP Baseline Survey 2004
                                                                                                 Survey area
                                   NNP                                        BINP                                       Comparison                                     All
Indicator
                                           25%                                                                                        25%                                        25%
                  Mean    SD     Median            75%ile   Mean    SD     Median     25% ile    75%ile   Mean    SD     Median              75%ile   Mean    SD     Median             75%ile
                                            ile                                                                                        ile                                        ile

Age (months)       41.2   9.8     41.0     33.0     49.0    40.9    9.7     41.0       32.0       49.0    41.8    9.7     42.0        33.0    50.0    41.1    9.7     41.0       33.0      49.0


Height (cm)        89.4   7.3     89.2     84.2     94.7    89.8    7.2     89.7       84.6       95.0    90.0    7.0     90.2        85.5    95.0    89.7    7.2     89.6       84.4      94.8


Weight (kg)        11.8   1.9     11.6     10.4     13.0    11.8    1.9     11.7       10.4       13.0    11.8    1.8     11.8        10.6    13.0    11.8    1.9     11.7       10.4      13.0


MUAC (mm)         145.1   11.7   144.0     138.0   152.0    144.7   11.6   144.0      138.0      152.0    144.6   10.4   144.0    138.0      152.0    144.8   11.5   144.0      138.0   152.0


HAZ- score         -2.1   1.3     -2.1     -2.9     -1.3    -1.9    1.2     -1.9       -2.7       -1.2    -2.0    1.3     -2.0        -2.8    -1.3    -2.0    1.3     -2.0       -2.8      -1.2


WAZ-score          -2.1   0.9     -2.1     -2.7     -1.5    -2.1    0.9     -2.1       -2.7       -1.5    -2.1    0.9     -2.2        -2.7    -1.5    -2.1    0.9     -2.1       -2.7      -1.5


WHZ-score          -1.1   0.8     -1.1     -1.6     -0.6    -1.2    0.8     -1.2       -1.7       -0.7    -1.2    0.7     -1.2        -1.6    -0.8    -1.1    0.8     -1.2       -1.7      -0.7


HA% of median      91.8   5.1     91.7     88.6     95.0    92.3    4.9     92.3       89.2       95.3    92.0    5.2     92.0        88.8    94.9    92.0    5.0     91.9       88.9      95.1


WA% of median      77.8   9.7     77.4     71.4     84.1    77.8    9.5     77.1       71.2       83.5    77.6    9.7     77.0        71.1    83.5    77.8    9.6     77.2       71.3      83.8


WH% of median      90.2   7.2     89.9     85.7     94.6    89.5    7.4     89.1       84.5       93.8    89.7    6.9     89.5        85.0    93.0    89.8    7.3     89.4       85.1      94.1

Total                              2,108                                      1,990                                         728                                        4,826

One way analysis of variance, p<0.05
HAZ: BINP vs NNP
WHZ: NNP vs BINP
HA% of median: BINP vs NNP
WH% of median: NNP vs BINP




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Table 5.4.2. Distribution of age, height, weight, and anthropometric indices of 24-59 months old boys, NNP Baseline Survey 2004
                                                                                               Survey area
                                 NNP                                        BINP                                     Comparison                                     All
Indicator
                                         25%                                                                                      25%                                        25%
                Mean    SD     Median            75%ile   Mean    SD     Median     25% ile   75%ile   Mean    SD    Median              75%ile   Mean    SD     Median             75%ile
                                          ile                                                                                      ile                                        ile
                                                                                                                                                                                       49.0
Age (months)    41.0    9.7     41.0     32.0     48.1    41.3    9.6     41.0       33.0      49.0    42.3    9.7    43.0        34.0    51.0    41.3    9.7     41.0       33.0

                                                                                                                                                                                       95.5
Height (cm)     90.2    7.2     89.6     84.8     95.4    90.8    7.1     90.8       85.7      95.6    90.8    6.7    91.0        86.8    95.7    90.6    7.1     90.5       85.5

                                                                                                                                                                                       13.4
Weight (kg)     12.1    1.9     12.0     10.6     13.4    12.2    1.9     12.1       10.8      13.4    12.2    1.8    12.2        11.0    13.4    12.1    1.9     12.0       10.7

                                                                                                                                                                                    152.0
MUAC (mm)       145.8   11.7   146.0     138.0   152.0    145.8   11.0   146.0      138.0     152.0    145.7   9.8   144.0    140.0      152.0    145.8   11.1   146.0      138.0

                                                                                                                                                                                       -1.1
HAZ-score       -2.0    1.2     -2.0     -2.8     -1.1    -1.8    1.2     -1.8       -2.6      -1.1     -2.0   1.2    -2.0        -2.6    -1.2    -1.9    1.2     -1.9       -2.7

                                                                                                                                                                                       -1.4
WAZ-score       -2.0    0.9     -2.0     -2.6     -1.4    -2.0    0.9     -2.0       -2.6      -1.4     -2.0   0.8    -2.0        -2.6    -1.5    -2.0    0.9     -2.0       -2.6

                                                                                                                                                                                       -0.7
WHZ-score       -1.1    0.8     -1.2     -1.6     -0.6    -1.2    0.8     -1.2       -1.7      -0.7     -1.1   0.7    -1.2        -1.6    -0.8    -1.1    0.8     -1.2       -1.7

                                                                                                                                                                                       95.5
HA% of median   92.1    5.0     92.0     88.8     95.5    92.6    5.0     92.5       89.5      95.6    91.9    4.7    92.0        89.3    95.1    92.3    5.0     92.3       89.2

                                                                                                                                                                                       84.2
WA% of median   78.2    9.7     78.0     72.0     84.3    78.5    9.6     77.9       71.7      84.3    77.8    9.3    77.6        71.9    83.5    78.3    9.6     77.8       71.9

                                                                                                                                                                                       94.2
WH% of median   90.2    7.2     89.8     85.2     94.6    89.8    7.4     89.2       84.8      93.8    89.9    6.7    89.5        85.0    93.0    90.0    7.2     89.4       85.0

Total                            1,026                                      1,011                                       384                                        2,421
One way analysis of variance, p<0.05
Height-for-age z-score: BINP vs comparison
Height-for-age % of median: BINP vs comparison




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Table 5.4.3. Distribution of age, height, weight, and anthropometric indices of 24-59 months old girls, NNP Baseline Survey 2004
                                                                                              Survey area
                                 NNP                                        BINP                                     Comparison                                     All
Indicator
                                         25%                                                                                      25%                                        25%
                Mean    SD     Median            75%ile   Mean    SD     Median    25% ile   75%ile   Mean    SD     Median              75%ile   Mean    SD     Median             75%ile
                                          ile                                                                                      ile                                        ile

Age (months)    41.4    9.8     41.0     33.0     50.0    40.5    9.8     40.0      32.0      49.0    41.2    9.7     41.7        33.0    49.0    41.0    9.8     40.0       33.0      49.0


Height (cm)     88.7    7.3     88.4     83.3     93.7    88.7    7.1     88.6      83.6      93.7    89.1    7.3     88.7        83.5    94.2    88.8    7.2     88.5       83.5      93.8


Weight (kg)     11.5    1.9     11.4     10.2     12.7    11.3    1.8     11.3      10.0      12.5    11.5    1.8     11.4        10.2    12.5    11.4    1.8     11.3       10.1      12.6


MUAC (mm)       144.4   11.6   144.0     136.0   152.0    143.5   12.2   142.0     136.0     150.0    143.4   10.9   142.0    136.0      150.0    143.9   11.8   144.0      136.0      152.0


HAZ-score       -2.2    1.3     -2.2     -3.0     -1.4    -2.0    1.2     -2.0      -2.8      -1.3     -2.0   1.4     -2.0        -2.9    -1.3    -2.1    1.3     -2.1       -2.9      -1.3


WAZ-score       -2.1    0.9     -2.2     -2.8     -1.5    -2.2    0.9     -2.3      -2.8      -1.7     -2.2   1.0     -2.2        -2.8    -1.6    -2.2    0.9     -2.2       -2.8      -1.6


WHZ-score       -1.1    0.8     -1.1     -1.6     -0.6    -1.2    0.8     -1.2      -1.7      -0.7     -1.2   0.8     -1.2        -1.6    -0.8    -1.1    0.8     -1.2       -1.6      -0.7


HA% of median   91.5    5.2     91.3     88.3     94.5    92.0    4.8     92.0      89.0      94.9    92.0    5.6     91.9        88.7    94.8    91.8    5.1     91.7       88.6      94.7


WA% of median   77.5    9.7     76.9     70.9     84.0    77.1    9.4     76.4      70.9      82.8    77.4    10.3    76.5        70.8    83.3    77.3    9.7     76.7       70.9      83.3


WH% of median   90.3    7.2     90.0     86.0     94.4    89.1    7.4     88.9      84.3      93.8    89.4    7.1     89.5        85.1    92.9    89.7    7.3     89.5       85.1      94.0

Total                            1,082                                       979                                        344                                        2,373

One way analysis of variance, p<0.05
Weight-for-height z-score: NNP vs BINP
Weight-for-height % of median: NNP vs BINP




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Table 5.4.4. Frequency distribution of malnutrition based on z-score among 24-59 months old children, NNP Baseline Survey 2004
                                                                              Survey area
Indicator                           NNP                         BINP                     Comparison                All
                             No.            %             No.           %              No.          %     No.             %
HAZ
<-3.00 SD                    465           22.1           344          17.3            137        18.9    947            19.6

-3.000 SD to -2.01 SD        646           30.6           590          29.6            234        32.2   1470            30.5

-2.00 SD to -1.01 SD         590            28            656          33              224        30.8   1470             30.5

-1.00 SD and above           407           19.3           400          20.1            132        18.2    939            19.5
WAZ
<-3.00 SD                    299           14.2           257          12.9            109        14.9    664            13.8

-3.000 SD to -2.01 SD        862           40.9           862          43.3            302        41.5   2026             42

-2.00 SD to -1.01 SD         708           33.6           645          32.4            239        32.9   1593             33

-1.00 SD and above           239           11.3           226          11.4            77         10.6    543            11.2
WHZ
<-3.00 SD                    15             0.7           16           0.8              3          0.5    35              0.7

-3.000 SD to -2.01 SD        203            9.6           247          12.4            89         12.3    539            11.2

-2.00 SD to -1.01 SD         967           45.9           958          48.1            366        50.2   2291            47.5

-1.00 SD and above           923           43.8           769          38.6            270        37.1   1962            40.7
Total                        2,108                       1,990                         728               4,826
HAZ <-3.00: NNP vs BINP, p<0.001
HAZ -2.00 SD and above: BINP vs NNP, p<0.001
WHZ -3.00 to -2.01: NNP vs BINP, p <0.004; NNP vs comparison, p<0.05
WHZ -2.00 SD and above: NNP vs BINP, p<0.004
WHZ -1.00 SD and above: NNP vs BINP and comparison, p<0.05




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Table 5.4.5. Frequency distribution of malnutrition based on z-score among 24-59 months old boys, NNP Baseline Survey 2004
                                                                            Survey area
Indicator
                                    NNP                          BINP                    Comparison                      All
                                   No.            %     No.             %            No.            %            No.              %
HAZ
<-3.00 SD                          203           19.8   153            15.1          67            17.5          423             17.5

-3.000 SD to -2.01 SD              305           29.8   286            28.3          122           31.9          714             29.5

-2.00 SD to -1.01 SD               296           28.9   342            33.8          125           32.7          763             31.5

-1.00 SD and above                 222           21.6   230            22.7          69            17.9          521             21.5
WAZ
<-3.00 SD                          118           11.5   105            10.4          46            12.1          270             11.1

-3.000 SD to -2.01 SD              400           39     410            40.6          151           39.4          961             39.7

-2.00 SD to -1.01 SD               381           37.1   359            35.5          145           37.8          885             36.6

-1.00 SD and above                 126           12.3   137            13.6          41            10.7          304             12.6
WHZ
<-3.00 SD                           6            0.6     5             0.5            2            0.6            13              0.6

-3.000 SD to -2.01 SD              101           9.9    119            11.8          40            10.5          261             10.8

-2.00 SD to -1.01 SD               488           47.6   494            48.9          197           51.3          1179            48.7

-1.00 SD and above                 431           42     393            38.9          144           37.6          968              40
Total                                    1,026                1,011                         384                         2,421
HAZ <-3.00: NNP vs BINP, p=0.006




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Table 5.4.6. Frequency distribution of malnutrition based on z-score among 24-59 months old girls, NNP Baseline Survey 2004
                                                                           Survey area
                                   NNP                          BINP                    Comparison                        All
Indicator
                           Number           Percent         Number             Percent      Number          Percent        Number           Percent
HAZ
<-3.00 SD                    262             24.2            191                19.5           70            20.4            524             21.8

-3.000 SD to -2.01 SD        340             31.5            304                31.1          112            32.5            756             31.4

-2.00 SD to -1.01 SD         294             27.2            314                32.1           99            28.7            707             29.4

-1.00 SD and above           185             17.1            170                17.4           63            18.4            419             17.4
WAZ
<-3.00 SD                    180             16.7            152                15.5           62            18.1            395             16.4

-3.000 SD to -2.01 SD        462             42.7            452                46.2          151             44            1065             44.3

-2.00 SD to -1.01 SD         327             30.2            286                29.2           94            27.4            707             29.4

-1.00 SD and above           113             10.5             89                 9.1           36            10.5            238              9.9
WHZ
<-3.00 SD                     9               0.8             11                 1.1           1              0.3            21               0.9

-3.000 SD to -2.01 SD        101              9.4            128                13.1           49            14.2            278             11.6

-2.00 SD to -1.01 SD         479             44.3            464                47.4          169            49.1           1112             46.2

-1.00 SD and above           492             45.5            376                38.4          125            36.4            994             41.3
Total                               1,082                              979                            344                           2,405
HAZ <-3.00 SD: BINP vs NNP, p=0.01                                 WHZ -3.00 to -2.01 NNP vs BINP, p= 0.008, NNP vs comparison, p=0.012
HAZ -2.00 SD and above: BINP vs NNP, p<0.01                        WHZ -2.00 SD and above NNP vs BINP and comparison
WHZ -1.00 SD and above NNP vs BINP and comparison, p<0.01




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                              Fig 5.4.1: Percent distribution of stunting, underweight and wasting of 24-59 months old children by
                                                               division, NNP Baseline survey 2004
                  80
                                                                       HAZ <-2.00 SD                                          WAZ <-2.00 SD                                         WHZ <-2.00 SD
                             66.4                                                                                                                                                                                                                          73.4
                  70
                                                          68
                             62.7                                      63.7 60.3                        59.6                                                                                                               54.3                            62.4
                  60                                                                                                 54.4 53                                           54.4
                                                          61.5                                                                                    51.1                                                            57                             58.2          50.2
                                                                                                        56                                                                                  55.5
                                       52.1                       60.4                                                                                         43
                  50                                                                55.1                                                                                                                                            51                                50
                                                                                                                     49                                                                                                                          49.2
  % of children




                                                                                                                                  47.6                                                               47.5
                                                                                                                                                               44.4                         43.7
                                       42.6                                                                                                       41.6                                                            41.7
                  40                                                                                                                                                                                 40.9
                                                                                                                                                                            38.5

                  30


                  20                                                                                                                                                                        19.2
                             16.3                         16.5                                                                                                              16.8                                                                 16.7      15.6
                                                                                    14.5                13.1                                                                                                      14.5              14.1
                                                                                                                                  11.7
                  10                                                   9.4                                           9.9                          8.4                                                9.3                                                           9.9
                                       7.7                                                                                                                     7.6

                   0
                                             Comparison




                                                                                           Comparison




                                                                                                                                     Comparison




                                                                                                                                                                               Comparison




                                                                                                                                                                                                                       Comparison




                                                                                                                                                                                                                                                               Comparison
                       NNP




                                                                 NNP




                                                                                                               NNP




                                                                                                                                                         NNP




                                                                                                                                                                                               NNP




                                                                                                                                                                                                                                           NNP
                                BINP




                                                                             BINP




                                                                                                                           BINP




                                                                                                                                                                     BINP




                                                                                                                                                                                                           BINP




                                                                                                                                                                                                                                                    BINP
                              Barisal                                  Chittagong                                     Dhaka                                     Khulna                               Rajshahi                                     Sylhet




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                               Fig 5.4.2: Comparison of median body weight of 24-59 months old boys with NCHS median


                   20               MedainWeight                          NCHS Median                           -2SD

                   18

                   16

                   14
 Medain Wt. (kg)




                   12

                   10

                   8

                   6

                   4

                   2

                   0
                        24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59
                                                                      Age in month




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                                 Fig 5.4.3: Comparison of median body weight of 24-59 months old girls with NCHS median
               20
                                     MedainWeight                          NCHS Median                           -2SD
               18

               16

               14
 Meadian Wt (kg.)




               12

               10

                    8

                    6

                    4

                    2

                    0
                        24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59
                                                                      Age in month




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                                 Fig 5.4.4: Comparison of median height of 24-59 months old boys with NCHS median

               120
                                Median Height                NCHS Median                   -2SD

               100


                   80
 Median Ht. (cm)




                   60


                   40


                   20


                   0
                        24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59
                                                                      Age in month




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                                      Fig 5.4.5: Comparison of median height of 24-59 months old girls with NCHS median
                 120
                                      Median Height                    NCHS Median                     -2SD

                 100
 Medain height (cm)




                      80


                      60


                      40


                      20


                      0
                           24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59
                                                                         Age in month




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  NNP Baseline Survey 2004                                                                                                                                         Chapter 5




Table 5.4.7. Distribution of age, height, weight, MUAC, and BMI of mothers of 24-59 months old children, NNP Baseline Survey 2004
                                                                                                 Survey area
                                NNP                                     BINP                                          Comparison                                 All
Indicator
                                       25%     75%                              25%           75%                               25%     75%                             25%     75%
              Mean    SD     Median                    Mean    SD     Median                          Mean     SD     Median                    Mean    SD     Median
                                        ile     ile                              ile           ile                               ile     ile                             ile     ile

Age (years)   26.4    6.1     25.0     22.0    30.0    26.3    6.0     25.0     22.0          30.0    26.5     5.8     26.0     22.0    30.0    26.4    6.0     25.0    22.0    30.0


Height (cm)   150.4   18.8   150.2     146.6   153.6   150.2   19.8   149.8     146.4         153.3   150.9    29.1   149.9     146.8   153.8   150.4   21.1   150.0    146.6   153.5


Weight kg)    44.6    7.3     43.5     40.0    47.7    45.1    7.5     43.9     40.0          49.0    45.5     7.9     44.3     39.8    50.1    45.0    7.4     43.8    40.0    48.5


MUAC (mm)     239.6   25.8   236.0     222.0   252.0   241.7   27.6   238.0     222.0         256.0   240.2    26.3   236.0     222.0   258.0   240.6   26.6   238.0    222.0   256.0


BMI           19.8    3.0     19.3     17.9    21.0    20.1    3.1     19.5     18.0          21.6    20.2     3.2     19.5     18.0    21.8    20.0    3.1     19.4    18.0    21.3

Total                          2,108                                    1,990                                             728                                   4,826
One way analysis of variance, p<0.05
Weight: NNP vs comparison , p=0.04




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       Table 5.4.8. Percentage distribution of BMI classification of mothers of 24-59 months old children, NNP Baseline Survey
       2004
                                                                            Survey area
        BMI clasification-1          NNP                      BINP                      Comparison                All
                               No.            %         No.             %             No.         %       No.             %
       ≤15.99                  80            3.8        90             4.5            27          3.7     197            4.1

       16.00-16.99             180           8.6        128            6.5            49          6.8     357            7.4

       17.00-18.49             452           21.5       412            20.8           161         22.3    1025           21.4

       18.50-19.99             580           27.6       505            25.5           166         23.0    1251           26.1

       20.00 +                 807           38.5       844            42.6           318         44.1    1970           41.0
       BMI clasification-2
       ≤18.49                  714           33.9       635            32.0           239         32.9    1587           33.0

       18.50 +                1392           66.1      1351            68.0           486         67.1    3230           67.0
       Total                         2,106                    1,986                         725                  4,817




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