uu.seUppsala University Publications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Effects of psychosocial stimulation on growth and development of severely malnourished children in a nutrition unit in Bangladesh
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. (Internationell barnhälsa och nutrition/Persson)
International Centre for Diarrhoeal Disease Research, (ICDDR,B) Dhaka, Bangladesh.
Show others and affiliations
2009 (English)In: European Journal of Clinical Nutrition, ISSN 0954-3007, E-ISSN 1476-5640, Vol. 63, no 6, 725-731 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND/OBJECTIVES: Young children with severe malnutrition usually have poor mental development. Psychosocial stimulation may reduce their cognitive deficit, but it is not usually provided. The aim of the study was to incorporate stimulation into the routine treatment of severely malnourished children in a nutrition unit and evaluate the impact on their growth and development. DESIGN: Time-lagged controlled study. SETTING: Nutritional Rehabilitation Unit (NRU) in ICDDR,B Dhaka Hospital. METHODS: Severely malnourished children, aged 6-24 months, admitted to the NRU were enrolled. All received standard nutritional care. A control group of 43 children was studied initially, followed by an intervention group of 54 children. The intervened mothers and children participated in daily group meetings and individual play sessions for 2 weeks in hospital and were visited at home for 6 months. Children's growth was measured and development assessed using the Bayley Scales of Infant Development. RESULTS: Twenty-seven children were lost to the study. In the remaining children, both groups had similar developmental scores and anthropometry initially. After 6 months, the intervention group had improved more than the controls did by a mean of 6.9 (P<0.001; 95% CI: 3.9, 10.0) mental and 3.1 (P=0.024; 95% CI: 0.4, 5.7) motor raw scores and a mean of 0.4 (P=0.029; 95% CI: 0.1, 0.8) weight-for-age z scores, controlling for background variables. CONCLUSION: Psychosocial stimulation integrated into treatment of severely malnourished children in hospital, followed by home visits for 6 months, was effective in improving children's growth and development and should be an integral part of their treatment.

Place, publisher, year, edition, pages
2009. Vol. 63, no 6, 725-731 p.
Keyword [en]
severe malnutrition, psychosocial stimulation, Bangladesh
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-106766DOI: 10.1038/ejcn.2008.44ISI: 000266572000003PubMedID: 18772893OAI: oai:DiVA.org:uu-106766DiVA: diva2:226571
Available from: 2009-07-02 Created: 2009-07-02 Last updated: 2017-12-13Bibliographically approved
In thesis
1. Effects of Food Supplementation and Psychosocial Stimulation on Growth and Development of Severely Malnourished Children: Intervention Studies in Bangladesh
Open this publication in new window or tab >>Effects of Food Supplementation and Psychosocial Stimulation on Growth and Development of Severely Malnourished Children: Intervention Studies in Bangladesh
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Early childhood malnutrition is a global public health problem with serious short- and long-term consequences. The aim of this thesis is to evaluate the effects of psychosocial stimulation (PS) with or without food supplementation (FS) on growth and development of severely malnourished children, quality of home environment, mother’s child-rearing practices and depressive symptoms. The study setting was Dhaka, Bangladesh, and the participants were severely malnourished children, aged 6-24 months, admitted at Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B). A hospital-based study was conducted in Nutrition Rehabilitation Unit of ICDDR,B hospital, where a control group (n=43) was studied initially, followed by an intervention group (n=54). All received standard nutrition rehabilitation care. The intervention group received daily group meetings and play sessions in the hospital, and was thereafter visited at home for 6 months. A community-based randomised trial was conducted including children (n=507) admitted at hospital for initial treatment of an acute infection, and thereafter assigned to PS, FS, PS+FS, clinic control or hospital control groups. PS was delivered at follow-up visits, fortnightly for 6 months at community clinics. FS included distribution of cereal-based food packets (150–300 kcal/day depending on age) for 3 months. All groups received standard medical care and micronutrient supplementation. In the hospital-based study, the intervention group had significantly higher scores in mental (p<0.001, effect size 0.52 SD) and motor development (p=0.047, effect size 0.37 SD), and weight (p=0.03, effect size 0.39 SD), after 6- months intervention. In the community-based trial, there was a significant effect of stimulation after six months of intervention on children’s mental development (group*session interaction p=0.037, effect size=0.37 SD) and weight (group*session interaction p=0.02, effect size=0.26 SD) but no effect on motor development or linear growth. The PS+FS and PS groups differed in total HOME score, two HOME subscales (maternal involvement and play materials), and in mother’s child- rearing practices scores but not in depressive symptoms. PS with or without FS had small improvement on children’s growth and development, quality of home environment and mother’s rearing-practices of severely malnourished children. More intensive interventions with longer duration are therefore recommended.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2012. 59 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 786
Keyword
Psychosocial stimulation, food supplementation, HOME, child-rearing practices, maternal depressive symptoms, severe malnutrition, Bangladesh
National Category
Medical and Health Sciences
Research subject
International Health
Identifiers
urn:nbn:se:uu:diva-174833 (URN)978-91-554-8398-2 (ISBN)
Public defence
2012-09-05, Rosensalen, Akademiska sjukhuset, entrance 95/96 lower ground, Uppsala, 09:15 (English)
Opponent
Supervisors
Available from: 2012-06-14 Created: 2012-05-29 Last updated: 2013-01-10

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed
By organisation
Department of Women's and Children's Health
In the same journal
European Journal of Clinical Nutrition
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 477 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf