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Table 6 Clinical signs of nutritional deficiencies and malnutrition among study children before and during the COVID-19 pandemic

From: Water, sanitation, hygiene practices, health and nutritional status among children before and during the COVID-19 pandemic: longitudinal evidence from remote areas of Dailekh and Achham districts in Nepal

Clinical signs of nutritional deficiency and malnutrition

[N(%)]

P-value*

Dailekh [n (%)]

P-value*

Achham [n (%)]

P-value*

Persistencea of child health problems (95% CI) (OR)c or (B)d

P-value

Incidenceb of child health problems (95% CI) (OR)c or (B)d

P-value

 

Baseline [n (%)]

Endline [n (%)]

Baseline [n (%)]

Endline [n (%)]

Baseline [n (%)]

Endline [n (%)]

Bitot’s spot

191 (26.7)

197 (40.2)

0.01

89 (25.0)

98 (40.3)

0.01

102 (28.4)

90 (38.5)

0.005

0.80 (0.23–2.83)

0.73

1.16 (0.59–2.25)

0.67

Loss of hair pigment

95 (13.3)

203 (41.4)

0.01

56 (15.7)

113 (46.5)

0.01

39 (10.9)

83 (35.5)

0.01

1.18 (0.15–9.22)

0.88

0.69 (0.33–1.46)

0.34

Dry and infected cornea

139 (19.4)

180 (36.7)

0.01

49 (13.8)

93 (38.3)

0.01

90 (25.1)

76 (32.5)

0.001

0.47 (0.12–1.83)

0.28

1.39 (0.62–3.14)

0.42

Oedema

29 (4.1)

49(10.0)

0.01

9 (2.5)

21 (8.6)

0.003

20 (5.6)

27 (11.5)

0.004

n/a

n/a

0.10 (0.04–0.28)

0.01

Pale conjunctiva

336 (47.0)

310 (63.3)

0.01

154 (43.3)

157 (64.6)

0.01

182 (50.7)

144 (61.5)

0.004

13.6 (2.42–76.46)

0.00

5.37 (1.70–16.90)

0.01

Bowed legs

27 (3.8)

28 (5.7)

0.12

9 (2.5)

8 (3.3)

0.56

18 (5.0)

18 (7.7)

0.09

n/a

n/a

n/a

n/a

Spongy bleeding gums

127 (17.8)

327 (66.7)

0.01

70 (19.7)

140 (57.6)

0.01

57 (15.9)

178 (76.1)

0.01

3.14 (0.69–14.17)

0.14

3.16 (1.12–8.89)

0.03

Dermatitis

463 (64.8)

399 (81.4)

0.01

235 (66.0)

188 (77.4)

0.002

228 (63.5)

201 (85.9)

0.01

22.14 (5.35–91.56)

0.01

12.39 (3.04–50.57)

0.01

Red inflamed tongue

175 (24.5)

120 (24.5)

0.63

80 (22.5)

53 (21.8)

1.00

95 (26.5)

65 (27.8)

0.42

0.76 (0.24–2.45)

0.65

0.62 (0.28–1.37)

0.24

Sub-dermal hemorrhage

42 (5.9)

107 (21.8)

0.01

19 (5.3)

43 (17.7)

0.01

23 (6.4)

61 (26.1)

0.01

n/a

n/a

0.82 (0.43–1.55)

0.54

Goiter

5 (0.7)

18 (3.7)

0.01

1 (0.3)

12 (4.9)

0.001

4 (1.1)

5 (2.1)

0.03

n/a

n/a

n/a

n/a

Stunting (height for age, HAZ)d

             

 Low

323 (45.2)

115 (33.6)

0.01

161 (45.2)

63 (31.3)

0.01

162 (45.1)

52 (36.9)

0.01

1.41 (0.51–3.92)

0.50

1.91 (0.73–5.01)

0.19

 Medium

202 (28.3)

61 (17.8)

98 (27.5)

37 (18.4)

104 (29.0)

24 (17.0)

 Severe

190 (26.6)

166 (48.5)

97 (27.3)

101 (50.3)

93 (25.9)

65 (46.1)

Underweight (weight for age, WAZ)

136 (19.0)

269 (54.9)

0.01

66 (18.5)

156 (64.2)

0.33

70 (19.5)

101 (43.2)

0.78

3.92 (1.11–13.87)

0.03

3.38 (1.36–8.41)

0.01

Thinness (wasting, body mass index for age, BAZ)

66 (9.2)

37 (7.7)

0.65

35 (9.8)

17 (8.5)

0.24

31 (8.6)

11 (7.8)

0.72

n/a

 

0.90 (0.03–0.32)

0.01

  1. a Persistence was analyzed in the sample of children who had the outcome at baseline
  2. b Incidence among the children who were free of outcome at baseline
  3. c Odds ratios (OR) were calculated using mixed logistic regression models of the outcome at endline as a function of the outcome at baseline, with the random intercept of the study ward and further adjustments for the district, age, sex and educational level of the child, and socioeconomic status of the caregivers
  4. d B were calculated by mixed linear regression model for the outcome at endline, including the random intercepts of the study wards and further adjustments for the district, sex and age, sex and education level of the child and socioeconomic status of the caregivers
  5. *P values were calculated using the McNemar test and Wilcoxon-signed rank test
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BMC Public Health

ISSN: 1471-2458

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