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E-book The Biology of the First 1,000 Days

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Penilaian

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According to current estimates, 23% of the world’s children under 5 years of age are stunted, a condition that is measured using short height-for-age (see Box 1.1) [1]. Although this represents a decline from 33% in 2000, the fact that 156 million chil-dren globally still suffer from chronic undernutrition underscores the continued need for renewed efforts and innovative approaches for growth promotion. Progress has been particularly slow in Africa, where one out of every three children is stunted (Figure 1.1) [1]. In fact, despite a decline in stunting prevalence, the absolute number of stunted children in Africa increased from 50.4 million in 2000 to 58.5 million in 2015 [1]. Although Asia has seen an average annual decline in the prevalence of child stunting of about 1.5%, from 38% in 2000 to 24% in 2015, countries in East Asia have accounted for most of this progress [1]. Reductions have been much slower among countries in South Asia where more than one out of every three children under age 5 is stunted. At a subregional level, more than 30% of children under 5 in Western Africa, Middle Africa, Eastern Africa, Southern Asia, and Oceania are stunted [1]. In addition to these geographical differences, there are also dras-tic sociodemographic disparities in the prevalence of chronic undernutrition. An nalysis of 79 population-based surveys has illustrated that the prevalence of stunt-ing is, on average, 2.5 times higher among children living in the poorest quintile of households than the richest quintile [1]. Similarly, the child stunting prevalence is 1.45 times higher in rural versus urban areas [2]. Globally, an estimated 50 million children are wasted, an indicator of thin-ness that is strongly associated with mortality [1]. Moderately and severely wasted children are, respectively, 3.0 and 9.4 times more likely to die than children with a weight-for-height z-score >–1 [3]. Although the global burden of child wasting is considerably smaller than that of stunting, efforts to enhance the coverage of inter-ventions to prevent and treat acute malnutrition are urgently needed, particularly given the increased risk of mortality faced by wasted children. Approximately two-thirds of the world’s wasted children live in Asia and one-quarter live in Africa. At 14%, the prevalence of child wasting in South Asia is near the 15% threshold used to define a critical public health emergency [1,4].Of equal concern is the growing burden of overweight children. Worldwide, there are now 42 million overweight children under 5 years of age [1]. Since 2000, the number of overweight children under 5 has increased by more than 50% in Africa, with gains being particularly pronounced in low- and middle-income countries [1]. At a subregional level, the prevalence of overweight among children under 5 now exceeds 10% in Central Asia, Northern Africa, and Southern Africa [1].Intrauterine growth restriction is a key risk factor for stunting, wasting, and under-weight in childhood. Recent estimates indicate that 15% to 20% of all births globally are low birth weight (LBW), which translates to more than 20 million LBW births per year [5]. Half of these births occur in only three countries: India, Pakistan, and Nigeria. India alone makes up 38% of the global total [5]. The prevalence of small-for-gestational-age (SGA) births is approximately twice the prevalence of LBW in all regions of the world [6]. In 2010, more than 32 million infants were born SGA, which represents more than one-quarter of all births in low- and middle-income countries [6]. The highest prevalence of SGA is found in South Asia and the Sahelian countries of Africa. As with LBW, the burden of SGA is particularly high in India; in 2010, 12.8 million infants, representing ~47% of all births, were SGA [6].In addition to anthropometric indicators that reflect physical growth during the first 1,000 days, indicators of the micronutrient status of pregnant women and young children provide useful insight into the dietary quality of vulnerable subgroups, as they influence the risk of mortality, morbidity, and adverse developmental outcomes. Iron, vitamin A, iodine, zinc, and folate are the micronutrient deficiencies that have received the greatest attention in terms of their public health burden, and are esti-mated to account for approximately 7% of the global burden of disease every year [7]. Globally, an estimated 2 billion people are affected by deficiencies in at least one essential micronutrient. Figure 1.2 summarizes the global prevalence of vitamin A deficiency and iron deficiency anemia among pregnant women and children under 5.The estimated global prevalence of iodine deficiency and zinc deficiency is 29% and 17%, respectively [2]. Unfortunately, limited data are available on the global prevalence of folate deficiency. Not surprisingly, there is a great deal of overlap in the regional distribution of these micronutrient deficiencies and the anthropometric deficits previously described. Africa exhibits the highest levels of iron deficiency anemia among pregnant women and children under 5, vitamin A deficiency among children under 5, iodine deficiency and zinc deficiency, while Asia exhibits the high-est prevalence of vitamin A deficiency among pregnant women [2]. Just as various forms of an anthropometric deficit can coexist, it is also common for women and children to suffer from multiple micronutrient deficits simultaneously, although the extent of overlap is often uncertain.

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Ketersediaan

Informasi Detail

Judul Seri

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No. Panggil

618.2 ALL t

Penerbit

USA : Taylor & Francis., 2018

Deskripsi Fisik

519 hlm

Bahasa

English

ISBN/ISSN

9781315152950

Klasifikasi

618.2

Tipe Isi

text

Tipe Media

computer

Tipe Pembawa

online resource

Edisi

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Subjek

Obstetric, Midwifery

Info Detail Spesifik

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Pernyataan Tanggungjawab

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Versi lain/terkait

Lampiran Berkas

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