A Systematic Review and Meta‑Analysis of the Prevalence of Malnutrition Among 6‑14‑Year‑Old Children in Iran

Mohammad Mohseni, Shiler Ahmadi, Heshmatollah Asadi, Elham Dehghanpour Mohammadian, Zoleykha Asgarlou, Fatemeh Ghazanfari, Ahmad Moosavi

Abstract


Background: Malnutrition is a major public health issue worldwide. It has significant consequences, including weakened immune systems, which may lead to increased incidences of infectious disease and higher mortality, particularly in children. A systematic review and meta‑analysis were conducted to estimate the overall prevalence of malnutrition (wasting, underweight, and stunting) among children of 6–14 years of age in Iran.

Methods: Data were collected in 2018 based on searches of the PubMed, Science Direct, Scopus, Google Scholar, Science Information Database (SID), Magiran, Irandoc, and Iranmedex databases using the following keywords: childhood, childhood malnutrition, children, nutrition, malnutrition, wasting, underweight, stunting, child, student, boy, girl, cause, prevalence, and Iran, in order to identify studies eligible for inclusion in the review. Comprehensive Meta‑Analysis, version 2 (CMA: 2) was used to estimate the overall prevalence of malnutrition.

Results: Nine out of 328 articles were included in our analyses. The overall of wasting among children of 6–14 years of age in Iran based on the random‑effects model (according to nine studies and 18,296 participants) was 12.5% (95% Confidence Interval, 7.1‑21.2). The overall prevalence of underweight based on the random‑effects model (according to 10 studies and 19,185 participants) was 19% (95% CI, 8.1‑38.6). Also, the overall prevalence of stunting based on the random‑effects model (according to 10 studies and 19,185 participants) was 20% (95% CI, 9.4‑37.8).

Conclusions: The results of this study show that the prevalence of malnutrition among 6–14‑year‑old children in Iran is similar to the global average. We need solutions that can be used for both prevention and reduction of malnutrition, especially in areas with middle or low socioeconomic status. It is necessary to identify factors associated with malnutrition in various geographic regions in order to implement appropriate programs based on factors with the highest impact in each region.


Keywords


Child; malnutrition; meta‑analysis; prevalence

Full Text:

PDF

References


Mohseni M, Aryankhesal A, Kalantari N. Prevention of

malnutrition among children under 5 years old in Iran: A policy

analysis. PLoS One 2019;14:e0213136.

Hajhir MS. Diseases Induced by Malnutrition. 1st ed. Tehran:

Andisheh Farda; 2004.

Baratta R, Degano C, Leonardi D, Vigneri R, Frittitta L. High

prevalence of overweight and obesity in 11–15-year-old children

from Sicily. Nutr Metab Cardiovasc Dis 2006;16:249-55.

Mohseni M, Aryankhesal A, Kalantari N. Prevalence of

malnutrition among Iran’s under five-year-old children and the

related factors: A systematic review and meta-analysis. Iran J

Pediatr 2018;28:e9189.

Ramazanpour M, Akaberi A, Khoshnoudostad E, Shoraka H.

Investigation into malnutrition Prevalence rate and

effective factors on under – five – year – old children in

Maneh -Semelghan city (2012-2013). J North Khorasan Univ

Med Sci 2013;5:365-73.

Ibrahim SA, Abd el-Maksoud A, Nassar MF. Nutritional stunting

in Egypt: Which nutrient is responsible? East Mediterr Health J

;8:272-80.

Kliegman RM, Stanton B, Geme JS, Schor NF, Behrman RE.

Nelson Textbook of Pediatrics. Elsevier Health Sciences; 2015.

Emamian MH, Gorgani N, Fateh M. Malnutrition status in

children of Shahroud, Iran. Knowl Health 2011;6:7-14.

Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P,

De Onis M, et al. Maternal and child undernutrition and

overweight in low-income and middle-income countries. Lancet

;382:427-51.

Grantham-McGregor S, Cheung YB, Cueto S, Glewwe P, Richter L,

Strupp B, et al. Developmental potential in the first 5 years for

children in developing countries. Lancet 2007;369:60-70.

Kashfi S, Khani Jeihooni A. The prevalence of protein-energy

malnutrition (PEM) in children under 5 years in Abadeh city.

J Fasa Univ Med Sci/Majallah-i Danishgah-i Ulum-i Pizishki-i

Fasa 2014;3:363-70.

WHO. Physical status: The use of and interpretation of

anthropometry, Report of a WHO Expert Committee. World

Health Organization; 1995.

De Onis M, Blössner M, Borghi E, Frongillo EA, Morris R.

Estimates of global prevalence of childhood underweight in 1990

and 2015. JAMA 2004;291:2600-6.

Hamel C, Enne J, Omer K, Ayara N, Yarima Y, Cockcroft A,

et al. Childhood malnutrition is associated with maternal care

during pregnancy and childbirth: A cross-sectional study in

Bauchi and Cross River States, Nigeria. J Publ Health Res

;4:408.

UNICEF, WHO, WorldBankGroup. Levels and trends in child

malnutrition; September 2015.

Bener A, Kamal A. Growth patterns of Qatari school children and

adolescents aged 6-18 years. J Health Popul Nutr 2005;23:250-8.

Jacobs B, Roberts E. Baseline assessment for addressing acute

malnutrition by public-health staff in Cambodia. J Health Popul

Nutr 2004;22:212-9.

Zimmermann M, Gubeli C, Puntener C, Molinari L. Overweight

and obesity in 6-12 year old children in Switzerland. Swiss Med

Wkly 2004;134:523-8.

Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC,

Ioannidis JP, et al. The PRISMA statement for reporting

systematic reviews and meta-analyses of studies that evaluate

health care interventions: explanation and elaboration. Journal of

clinical epidemiology 2009;62:e1-e34.

Vandenbroucke JP, Von Elm E, Altman DG, Gøtzsche PC,

Mulrow CD, Pocock SJ, et al. Strengthening the reporting of

observational studies in epidemiology (STROBE): Explanation

and elaboration. Ann Intern Med 2007;147:W163-94.

Karimi B, Ghorbani R, Niaki MA. Malnutrition and some related

factors in primary school children, Semnan, Iran. J Egypt Public

Health Assoc 2016;91:174-8.

Gholami M, Dehghan A, Kargar N, Mohammadi P,

Moosazadeh M, Hadizadeh H. Prevalence of malnutrition in

children 7-12 years old in Kerman, 2013. J Community Health

Res 2014;2:261-6.

Veghari G. The relationship of ethnicity, socio-economic factors

and malnutrition in primary school children in north of Iran:

A cross-sectional study. J Res Health Sci 2013;13:58-62.

Namakin K, Sharifzade G, Majnone H, Firouzi F, Latifi M.

Prevalence of malnutrition in students of deprived areas in South

Khorasan. Knowl Health 2011;6:38-42.

Dehghan A, Ershad Langroudi M, Kamali Sarvestani M,

Shahoseini S. Prevalence of malnutrition in students of

elementary schools in Larestan city in 2010. 2011;2:25-8.

Darvishi S, Hazhir MS, Reshadmanesh N, Shahsavari S.

Evaluation of malnutrition prevalence and its related factors in

primary school students in Kurdistan Province. Sci J Kurdistan

Univ Med Sci 2009;14:78-87.

Delvarianzadeh M, Sadeghian F. Malnutrition prevalence among

rural school students. Payesh 2006;5:263-9.

Delavarianzadeh Zadeh M, Hossein-Zadeh S. Surveying the

nutritional status of school students of Shahrood city and some

related factors in 2004. Koomesh 2006;7:41-8.

Taheri F, Khazaee T, Foadoddini M, Eghbal A, Abdolahi A.

Epidemiology of malnutrition in 11-14 year old boy teenagers of

Birgand. Mod Care J 2009;6:48-53.

Ghorbani J. A study of malnutrition at the primary school students

in Zanjan. J Zanjan Univ Med Sci Health Serv 1998;23:24-31.

UNICEF. The State Of The World’s Children 2014. 2014. Available

from: https://www.unicef.org/publications/files/SOWC2014_In_

Numbers_28_Jan.pdf. [Last accessed on 2021 Jan 12].

Demissie S, Worku A. Magnitude and factors associated with malnutrition in children 6-59 months of age in pastoral

community of Dollo Ado district, Somali region, Ethiopia. Sci J

Public Health 2013;1:175-83.

Masibo PK, Makoka D. Trends and determinants of undernutrition

among young Kenyan children: Kenya Demographic and Health

Survey; 1993, 1998, 2003 and 2008–2009. Public Health Nutr

;15:1715-27.

Mohseni M, Aryankhesal A. A national document for child

nutrition in Iran: A vital need. Ann Nutr Metab 2018;73:250-1.

Shivaprakash N, Joseph RB. Nutritional status of rural schoolgoing children (6-12 years) of Mandya District, Karnataka. Int J

Sci Stud 2014;2:39-43.

Sheikholeslam R, Naghavi M, Abdollahi Z, Zarati M, Vaseghi S,

Sadeghi Ghotbabadi F, et al. Current status and the 10 years

trend in the malnutrition indexes of children under 5 years in

Iran. Iran J Epidemiol 2008;4:21-8.

Fesharakinia A, Sharifzadeh G. Prevalence of malnutrition in

under 5-year old children in Birjand city in 2011. J Birjand Univ

Med Sci 2013;20:77-84.

Asgary R, Liu M, Naderi R, Grigoryan Z, Malachovsky M.

Malnutrition prevalence and nutrition barriers in children under

years: A mixed methods study in Madagascar. Int Health

;7:426-32.

Farrokh-Eslamlou HR, Oshnouei S, Ahmadi N, Babaei F.

Geographical distribution of nutrition deficiency among children

under five years old in the West Azerbaijan Province, Iran.

Urmia Med J 2013;24:201-9.

Naderi Beni M, Lak R, Jazaeri S, Eftekhar Ardebili H.

Prevalence of malnutrition under five years in Chadegan (area

district city) Iran 2011. Iran J Epidemiol 2013;9:22-8.

O’Donnell OA, Wagstaff A. Analyzing Health Equity using

Household Survey Data: A Guide to Techniques and their

Implementation. World Bank Publications; Philadelphia, USA:

Saunders 2008.

Martorell R, Horta BL, Adair LS, Stein AD, Richter L, Fall CH,

et al. Weight gain in the first two years of life is an important

predictor of schooling outcomes in pooled analyses from five

birth cohorts from low-and middle-income countries. J Nutr

;140:348-54.

Laquatra I. Nutrition for weight management. In: Mahan LK,

Escott-Stump S, editors. Krause’s Food, Nutrition, and Diet

Therapy. 2004. p. 562-3.

Abidoye R, Eze D. Comparative school performance through

better health and nutrition in Nsukka, Enugu, Nigeria. Nutr Res

;20:609-20.

Kabir M, Keshtkar A, Lashkar Bolouki F. Prevalence of

malnutrition in children under 2 years old and its relationship

with mothers background variables in Golestan province.

J Gorgan Univ Med Sci 2006;8:32-9.

Mohammadinia N, Sharifi H, Rezaei M, Heydari N. The

prevalence of malnutrition among children under 5 years old

referred to health centers in Iranshahr during 2010-2011. J Occup

Health Epidemiol 2012;1:139-49.

Bhanderi D, Choudhary S. An epidemiological study of health

and nutritional status of under five children in semi-urban

community of Gujarat. Indian J Public Health 2005;50:213-9.

Odunayo SI, Oyewole AO. Risk factors for malnutrition among

rural Nigerian children. Asia Pac J Clin Nutr 2006;15:491-5.

Mohseni M, Aryankhesal A, Kalantari N. Factors associated

with malnutrition among under five-year-old children in Iran:

A systematic review. Ann Trop Med Public Health 2017;10:1147-58.

Aheto JMK, Keegan TJ, Taylor BM, Diggle PJ. Childhood

malnutrition and its determinants among under‐five children in

Ghana. Paediatr Perinat Epidemiol 2015;29:552-61.