SF Hasnain, SK Hashmi


Background: Malnutrition is a common problem, especially in developing countries. Of the 11 million
children under 5 who die each year in the developing countries mainly from preventable causes, the
death of about 54% are either directly or indirectly attributable to malnutrition. The objectives of this
study were to assess the prevalence and associated factors for underweight in rural Sindh. Methods: A
cross-sectional survey was conducted in Jhangara Town, located in District Dadu, Sindh. Eight hundred
children under 5 years of age were enrolled. A questionnaire was used to elicit required information and
anthropometric measurements were made. Results: The overall prevalence for underweight was 54.3%
in the study population, which was higher than the prevalence reported by PDHS 1990–91. In
multivariate analysis, various factors for underweight were consanguinity (OR=1.5, 95% CI=1.08–
2.07), low birth weight (parents’ perspective) (OR=1.6, 95% CI=1.08–2.16) and lack of breast-feeding
(OR=2.7, 95% CI=1.19–6.17). Conclusion: Effective strategies to discourage consanguineous
marriages between first cousins are required. Promoting breast feeding is another factor that should be
incorporated while designing control strategies to reduce morbidity and mortality due to malnutrition in
children (<5 years).
Keywords: Underweight, Consanguinity, Children, under 5 years

Full Text:



Bender D.A. Introduction to Nutrition and Metabolism. 2nd ed.

London: Taylor and Francis; 1997.

Schaible UE, Kaufmann SH. Malnutrition and Infection:

Complex Mechanisms and Global Impacts PLoS Med


Ambrus JL Sr, Ambrus JL Jr. Nutrition and infectious diseases in

developing countries and problems of acquired

immunodeficiency syndrome. Exp Biol Med (Maywood)


Woodward B. Protein, calories, and immune defenses. Nutr Rev


World Health Organization. Nutrition: Challenges. 2005.

Available at [Accessed

March 2007]

State of the world’s children 2007. Available: [Accessed 29 March 2007].

UNICEF. Analysis of the number of underweight children in the

developing world. UNICEF Progress for Children. A report card

on nutrition. Last updated May 2006.

Mendez MA, Adair LS. Severity and timing of stunting in the

first two years of life affect performance on cognitive tests in late

childhood. J Nutr 1999;129:1555–62.

World Health Organization. A Critical Link. Interventions for

Physical Growth and psychological development. a review. Doc

WHO/CHS/CAH/99.3. Geneva: WHO, 1999.

de Onis M. Child growth and development. In: Semba RD,

Bloem MW (eds). Nutrition and Health in Developing Countries.

Totowa, NJ: Humana Press; 2001. p.71–91.

de Onis M, Blössner M, The World Health Organization Global

Database on Child Growth and Malnutrition: methodology and

applications. Int J Epidemiol 2003;32:518–26.

UNICEF. The State of world Children. New York: Oxford

University Press; 1998. p.10.

WHO Working Group. Use and interpretation of anthropometric

indicators of nutritional status. Bull World Health Organ


National Institute of Population Studies. Pakistan Demographic

and Health Survey 1990/91. NIPS Islamabad Pakistan 1992, p.


National Institute of Health. Pakistan National Nutrition Survey

–87. NIH Islamabad, Pakistan 1988.p.19–36.

Kumar D, Goel NK, Mittal PC, Misra P. Influence of Infantfeeding Practices on Nutritional Status of Under-five Children.

Indian J Pediatr 2006;73(5):417–21.

Siddique B, Memon I, Jamal A, Aslam R. Assessment of risk

factors and case fatality rate of malnourished admitted children.

Med Channel 2006;12(4):47–51.

Salim F, Rehman S, Niazi HU, Hussain J, Malik AF. Growth of

children; effect of family size. Professional Med J


Rayhan MI, Khan MSH. Factors Causing Malnutrition among

under five Children in Bangladesh. Pak J Nutr 2006;5(6):558–62.

Mozumder AB, Barkat-E-Khuda, Kane TT, Levin A, Ahmed S.

The Effect Of Birth Interval On Malnutrition In Bangladeshi

Infants And Young Children. J Biosoc Sci 2000;32:289–300.

Schesselman JJ. Case-Control Studies: Design Conduct,

Analysis. New York: Oxford University Press; 1982.

Gupaldas T. Seshadri S. (eds). Nutrition: monitoring and

Assessment. New Delhi India: Oxford University Press; 1987.

International Institute for Population Sciences (IIPS) and ORC

Macro. 2000. National Family Health Survey (NFHS-2), 1998–

: India. Mumbai: IIPS. Available at:


Sheikholeslam R, Kimiagar M, Siasi F, Abdollahi Z, Jazayeri

A, Keyghobadi K, et al. Multidisciplinary intervention for

reducing malnutrition among children in the Islamic Republic of

Iran. East Meditter Health J 2004;10:844–52.

J Ayub Med Coll Abbottabad 2009;21(3)

Victora CG, Smith PG, Vaughan JP, Nobre LC, Lombardi

C, Teixeira AM, et al . Evidence for protection by breast feeding

against infant death from infectious diseases in Brazil. Lancet


Government of Pakistan. National Nutrition Survey, 2001–02.

Islamabad, Pakistan: Planning Commission and UNICEF;2002.

Hussain R. Community perceptions of reasons for preference for

consanguineous marriages in Pakistan. J Biosoc Sci


Hussain R, Bittles AH. The prevalence and demographic

characteristics of consanguineous marriages in Pakistan. J Biosoc

Sci 1998;30(2):261–75.

Hussain R. The effect of religious, cultural and social identity on

population genetic structure among Muslims in Pakistan. Ann

Hum Biol 2005;32(2):145–53.

Hussain R. The impact of consanguinity and inbreeding on

perinatal mortality in Karachi, Pakistan; Paediatr Perinat

Epidemiol 1998;12:370–82.

Abdulrazzaq YM, Bener A, al-Gazali LI, al-Khayat

AI, Micallef R, Gaber T. A study of possible deleterious effects

of consanguinity. Clin Genet 1997;51(3):167–73.

Yaqoob M, Gustarsom, KH, Jalil F, Kalberg J and Iselius L.

Early Child Health is Lahore Pakistan: II Inbreeding, Acta

Paediatr 1993;82(390):17–26.

Gul S . Consanguinity and the impact of hereditary factors upon

disabilities in children. Pak Pediatric J 1992;16(3):145–50.

Hussain R, Bittles AH and Sullivan S. Consanguinity and early

mortality in the Muslim populations of India and Pakistan. Am J

Human Biol 2001;13:777–87.

Gustaven KH. Prevalence and aetiology of congenital birth

defects, infant mortality and mental retardation in Lahore,

Pakistan: A prospective cohort study. Acta Paediatrica


al-Eissa YA, Ba’Aqeel HS, Haque KN, AboBakr AM, al-Kharfy

TM, Khashoggi TY, et al. Determinants of term intrauterine

growth retardation: the Saudi experience. Am J Perinatol


WHO Working Group. Use and interpretation of anthropometric

indicators of nutritional status. Bull World Health Organ


Adair L. Low birth weight and intrauterine growth retardation in

Filipino infants, Pediatrics 1989;84:613–22.

Vella V, Tomkins A. Nviku J, Marshal T. Determinants of

nutritional status in south west Uganda. J Trop Paediatr


Smith LC, Ramakrishnan U, Ndiaye A, Haddad, LJ, Martorell,

R. The Importance of Women’s Status for Child Nutrition in

Developing Countries, Research Report 131, International Food

Policy Research Institute, Washington DC, 2003. p. 126–31.


  • There are currently no refbacks.

Contact Number: +92-992-382571

email: [jamc] [@] []