Accommodation and disability-specific differences in nutritional status of children with disabilities in Kathmandu,
Krishna Prasad Sapkota1, Akira Shibanuma2, Ken Ing Cherng Ong1
1Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Insights
Children with disabilities face malnutrition risks, with specific disability types linked to distinct nutritional issues. Tailored interventions are crucial for improving their health outcomes in Nepal.
Area of Science:
- Pediatric Nutrition
- Disability Studies
- Public Health in Developing Nations
Background:
- Children with disabilities are disproportionately vulnerable to malnutrition globally.
- Limited data exists on malnutrition prevalence and associated factors among children with disabilities in Nepal.
- Institutionalized children with disabilities require targeted nutritional assessments.
Purpose of the Study:
- To investigate the prevalence of malnutrition (stunting, underweight, overweight/obesity) among children with disabilities in Nepal.
- To identify factors associated with different types of malnutrition based on disability type and accommodation.
- To inform the development of specific interventions for this vulnerable population.
Main Methods:
- A cross-sectional study involving 345 children with disabilities across 22 institutions in Kathmandu Valley, Nepal.
- Data collected via structured interviews with parents/guardians covering demographics, disability characteristics, feeding practices, and dietary patterns.
- Nutritional status assessed using standardized height-for-age, weight-for-age, and BMI-for-age indices; statistical models included generalized linear and multinomial logistic regression.
Main Results:
- High rates of malnutrition observed: 45% stunting, 33% underweight, 19% thinness, and 12% overweight/obesity.
- Physical disabilities were associated with a higher risk of stunting compared to sensory disabilities (RR=1.88).
- Autism and intellectual disabilities showed increased odds of overweight/obesity compared to sensory disabilities (aOR=5.56 and aOR=5.84, respectively).
Conclusions:
- Malnutrition presents diversely among children with disabilities, with specific disability types correlating with different nutritional outcomes.
- Accommodation type did not show a significant association with malnutrition status in this study.
- Developing tailored, disability-specific approaches is essential to effectively address and improve malnutrition in children with disabilities.
Background:
Worldwide, more than 150 million children < 18 years live with disabilities. These children are more vulnerable to malnutrition regardless of institutional care that they receive, such as daycare or residential care. In Nepal, little is known about the status of malnutrition and factors associated with malnutrition among children with disabilities. This study was conducted to investigate the factors associated with malnutrition based on the types of disability and accommodation.
Methods:
This institution-based, cross-sectional study was conducted in 22 institutions in the Kathmandu Valley, Nepal. From these institutions, parents/guardians of all children with disabilities were recruited who were present there on the day of data collection. They were interviewed using a structured questionnaire. The questionnaire included questions on demographic characteristics, disability type and severity, accommodation place, feeding practices, and dietary patterns. The outcome variables, stunting, underweight, and obesity were measured using height-for-age, weight-for-age, and body mass index-for-age, respectively. A generalized linear model was used to investigate the factors associated with stunting and underweight, and multinomial logistic regression was used to identify the factors associated with overweight and obesity.
Results:
Among the 345 children with disabilities, 45% were stunted, 33% were underweight, 19% were thin, and 12% were overweight. Children with physical disabilities (relative risk ratio = 1.88, 95% confidence interval [CI] = 1.26-2.81) were more likely to be stunted than those with sensory disabilities. Children with autism (adjusted odds ratio [aOR] = 5.56, 95% CI: 1.23-25.23) and intellectual disabilities (aOR = 5.84, 95% CI: 1.59-21.51) were more likely to be overweight and obese than those with sensory disabilities. No evidence was found regarding an association between accommodation type and malnutrition.
Conclusion:
Children with disabilities are vulnerable to malnutrition in several ways. Different types of disabilities are associated with different forms of malnutrition. Considering the types of disabilities, tailor-made approaches should be adopted to improve malnutrition status.
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