title: Trends in the prevalence of undernutrition, nutrient and food intake and predictors of undernutrition among under five year tribal children in India.
abstract: Undernutrition among children under five year is a significant public health problem in India. The present study was carried out to assess trends in nutritional status, nutrient and food intake among children under five year over two time periods. It was a community-based cross-sectional study, carried out in tribal areas of India. A total of 14,587 children, 0-5 years old were covered for nutritional assessment in terms of underweight, stunting and wasting. A 24 hour diet survey was carried out in a sub-sample of households surveyed. Wealth index was constructed using principle component analysis. The prevalence of underweight and stunting had declined significantly over the periods (49% vs 57%, 51% vs 58%, respectively), while the prevalence of wasting remained similar (22% vs 23%). There was marginal decrease in the intake of foods and nutrients over the periods, and was below recommended levels. Stepwise regression showed that the risk of underweight and stunting was significantly (p<0.01) higher among children of illiterate mothers and children from lowest and middle households wealth index. Morbidities during preceding fortnight had 1.3 times higher risk of underweight and wasting. In conclusion, undernutrition is a significant health problem among tribal children and is associated with literacy status of mothers, household wealth index and morbidities. Therefore implementation of appropriate nutritional intervention strategies and improvement in households food security through public distribution systems, food intakes, socioeconomic condition, literacy of parents and personal hygiene may help in improving the nutritional status of tribal children.
authors.affiliation: Division of Community Studies, National Institute of Nutrition, Indian Council of Medical Research, Jamai-Osmania (PO), Tarnaka, Hyderabad-500007, India. indrapal.m@rediffmail.com
authors.forename: Indrapal Ishwarji
authors.initials: II
authors.lastname: Meshram
authors.forename: Nimmathota
authors.initials: N
authors.lastname: Arlappa
authors.forename: Nagalla
authors.initials: N
authors.lastname: Balakrishna
authors.forename: Kodavanti
authors.initials: K
authors.lastname: Mallikharjuna Rao
authors.forename: Avula
authors.initials: A
authors.lastname: Laxmaiah
authors.forename: Ginnela Nag Veera
authors.initials: GN
authors.lastname: Brahmam
mesh_terms: D044466:Asian People; D002657:Child Development; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004032:Diet / Q000009:adverse effects* / Q000191:economics / Q000208:ethnology; D004522:Educational Status; D005504:Food Analysis; D006130:Growth Disorders / Q000191:economics / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology*; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D008297:Male; D044342:Malnutrition / Q000191:economics / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology*; D009035:Mothers / Q000193:education; D011204:Poverty Areas; D015995:Prevalence; D012423:Rural Health / Q000191:economics / Q000208:ethnology; D012959:Socioeconomic Factors; D019282:Wasting Syndrome / Q000191:economics / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology