Trends in Stunting, Underweight and Overweight Among Children Aged \u3c 5 Years in Kuwait: Findings From Kuwait Nutritional Surveillance System (2007-2019)

Background: There is a paucity of data on the secular trends of stunting and overweight among children aged \u3c 5 years in oil-rich countries in the Middle East. Aims: To examine the secular trends of stunting, underweight and overweight in children aged \u3c 5 years in Kuwait between 2007 and 2019. Methods: We used large individual data records (n=48 108) from the Kuwait Nutritional Surveillance System (KNSS) to calculate height/length-for-age z score (HAZ), weight-for-age z score and body mass index (BMI)-for-age z score using World Health Organization growth references. Stunting and underweight were defined as less than -2 standard deviation (SD) and overweight (including obesity) as ≥ 2 SD. Trends of stunting, underweight and overweight were investigated using logistic regression models. Results: The prevalence of stunting, underweight and overweight was 5.15%, 2.33% and 10.78%, respectively. Stunting increased during the study period, among children aged \u3c 2 years. There was no increasing trend in overweight during the study period. These findings were corroborated by the distribution of HAZ and BMI-for-age z scores. Current prevalence of combined stunting and overweight was 1.53% in boys and 1.98% in girls. Conclusion: Current prevalence of stunting and underweight is low in Kuwait indicating that undernutrition is no longer a major public health issue. There is a tendency for stunting to increase in children aged less than 2 years, highlighting the need to investigate early causes of stunting such as maternal and pregnancy-related factors

Impact of Treating Maternal Periodontal Disease on the Risk of Preterm Birth and Low Birth Weight: An Umbrella Review of Systematic Reviews

Pregnancy involves complex physical and hormonal changes that significantly impact almost every organ system, including the oral cavity. The presence of oral disease in women has consequences for both their child and their health. The two main oral conditions linked to pregnancy are gingivitis and periodontal disease. Several studies have demonstrated that there is a positive association between periodontal disease and adverse pregnancy outcomes such as preterm birth (PTB) and low birth weight (LBW). PTB and LBW are among the leading causes of perinatal mortality and morbidity. It has been hypothesized that periodontal disease may cause PTB and/or LBW either directly through the presence of gram-negative anaerobic bacteremia originating in the gingival biofilm or indirectly through the production of pro-inflammatory markers which enter the bloodstream from the gingival submucosa. The ultimate result of both pathogenic pathways is the same, the development of an immune inflammatory response and/or the local suppression of growth factors in the fetal–placental unit (including the myometrium, membranes, amniotic fluid, placenta, circulation, and fetal tissues), which in turn shortens gestational age and triggers labor. Overall, the impact of treating maternal periodontitis on the risk of PTB or LBW remains unclear despite numerous observational studies reporting that periodontal disease is positively associated with adverse birth outcomes. Despite that umbrella reviews of systematic reviews have been published on this topic, recent high-quality systematic reviews have been published and thus, there is a need for updated umbrella reviews that includes evidence from multiple sources. In the present umbrella review, we aim to review the evidence of the impact of treating maternal periodontitis on the risk of PTB and LBW, which is a prerequisite to formulating guidelines regarding this issue.https://digitalcommons.odu.edu/gradposters2023_healthsciences/1015/thumbnail.jp

Exposure to Household Secondhand Smoke Among Adolescents in Kuwait: Results From Two School-Based Cross-Sectional Studies

INTRODUCTION: Detrimental effects of secondhand smoke (SHS) exposure are well established; however, data on SHS exposure among adolescents in Kuwait are lacking. Hence, this study sought to estimate the prevalence of household SHS exposure among two samples of adolescents in Kuwait and assess its variation by socioeconomic status and parental education level. METHODS: Data from two large school-based cross-sectional studies were analyzed. Adolescents attending public middle (n=3864; aged 11-14 years) and high (n=1959; aged 14-19 years) schools throughout Kuwait were enrolled in 2016-2017, and parental self-reported household SHS exposure was ascertained. Associations were assessed using Poisson regression with robust variance estimation, and adjusted prevalence ratios (APRs) and 95% confidence intervals (CIs) were estimated. RESULTS: Overall, 45.8% (1755/3836; 95% CI: 44.2-47.3%) of the enrolled middle school students and 51.6% (998/1936; 95% CI: 49.3-53.8%) of the enrolled high school students were exposed to household SHS. Among middle and high school students, the prevalence of household SHS exposure increased as maternal/paternal education level and family income decreased. Among middle school students, paternal educational attainment of middle school or less compared to bachelor\u27s degree or higher was associated with 1.60 times (95% CI: 1.44-1.79) higher household SHS exposure. Similarly, in the sample of middle school students, the prevalence of household SHS exposure significantly increased from 35.8% among children from families reporting the highest household income to 50.5% among children from families with the lowest reported household income (p-trend\u3c0.001). CONCLUSIONS: Household SHS exposure is substantially high among adolescents in Kuwait. Enrolled adolescents from families with low socioeconomic status or with low parental education level have the highest household SHS exposure. These findings highlight the need for national comprehensive tobacco control policies and increasing parental awareness of the impact of SHS exposure on children

Anemia And It\u27s Associated Factors Among Adolescents in Kuwait

We estimated the prevalence of anemia among school children and investigated factors associated with this problem in Kuwait. A cross-sectional study was conducted on 1415 adolescents randomly selected from middle schools in Kuwait. Hemoglobin, iron, ferritin, folate and vitamin B-12, in addition to many other laboratory indicators, were measured in a venous blood sample. Data on risk factors for anemia were collected from parents and adolescents. Multiple logistic regression was used to investigate factors associated with anemia. The prevalence of anemia was 8.06% (95% CI: 6.69-9.60%), which was significantly higher among females compared to males (10.96% vs. 5.04%; p \u3c 0.001). Mean (SD) Hb level was 133.7 (9.89) g/L and 130.00 (10.48) g/L among males and females, respectively (p \u3c 0.001). The prevalence of mild, moderate and severe anemia was 5.94%, 1.91% and 0.21%, respectively. Gender, age, iron concentration and ferritin were associated with anemia in multivariable analysis. These data indicate that anemia among school children in Kuwait is of mild public health significance. Further reduction in anemia in school girls should focus on correcting iron deficiency. Surveillance systems for anemia may consider using a cut-off point that is specific for the method of blood sampling and the method of Hb measurement

Predictors of Acne Vulgaris Among Adolescents in Kuwait

Objectives: The prevalence of acne vulgaris (AV) among adolescents in Kuwait has remained mostly unknown. This study aimed to estimate the prevalence of AV and its predictors among adolescents in Kuwait. Subjects and Methods: A cross-sectional study was conducted on 714 participants who were randomly selected from public schools using multistage cluster random sampling. The presence or absence of AV, as well as severity of AV, were assessed using the Global Acne Grading Scale. Data on risk factors and potential confounders were collected from the parents through a self-administered questionnaire, and from the adolescents by face-to-face interview. Weight and height were measured in a standardized manner. Results: Of 714 participants, 320 (44.8%; 95% CI 41.1–48.6%) self-reported AV. By clinical examination, AV was found among 479 (67.1%; 95% CI 63.5–70.5%) participants. Factors that were found to be significantly associated with AV in multivariable analysis were age, gender, nationality, and BMI categories. Females compared to males (adjusted prevalence ratio [APR] 1.16 [95% CI 1.05–1.25]; p = 0.006) and overweight or obese adolescents compared to normal weight (APR 1.15 [95% CI 1.02–1.26] and 1.14 [95% CI 1.02–1.23], respectively; p = 0.026) were more likely to have AV. None of the food items studied showed an association with AV in multivariable analysis. Conclusion: The prevalence of self-reported AV seems to be lower than that reported in other settings, while the prevalence of AV by clinical examination resembles that reported in many other countries. BMI was the only modifiable risk factor associated with AV in multivariable analysis, and none of the food items studied was related to the presence or absence of AV in multivariable analysis

Mothers\u27 Perceptions of Their Children\u27s Weight: Opportunity for Health Promotion in Kuwait

Background: Mothers’ perceptions of their children’s weight remain mostly unknown in oil-rich countries of the Middle East. Aims: To compare maternal perceptions of their children’s weight with actual body weight. Methods: We used the Kuwait nutritional surveillance data for 5 consecutive years (2015-2019) (N = 5119), which were collected through face-to-face interviews with mothers of children aged 2-5 years attending vaccination centres. Results: Of the 5119 mothers in the study, 163 (3.18%) and 332 (6.48%) had obese or overweight children, respectively. Among 4624 mothers who had normal weight children, 1350 (29.20%) perceived their children’s weight as below normal. Seventy-nine (48.47%) and 16 (9.82%) mothers of children with obesity thought their children had normal weight or were underweight, respectively. Conclusion: Mothers in Kuwait often underestimate the weight of their children, including those children who have normal weight. This highlights the importance of addressing maternal misperceptions during visits to the primary healthcare centre

Season of Birth and Sugary Beverages Are Predictors of Raven\u27s Standard Progressive Matrices Scores in Adolescents

To investigate factors associated with cognitive functioning in healthy adolescents, a school-based cross-sectional study was conducted on 1370 adolescents aged 11-16 years that were randomly selected from all governorates of Kuwait. Raven\u27s Standard Progressive Matrices (SPM), a non-verbal test of intelligence, was used to measure cognitive functioning of the study participants. Data on predictors of cognitive functioning were collected from parents and adolescents. Weight and height of the participants were measured in a standardized manner and blood samples were tested in an accredited laboratory under strict measures of quality control. In multivariable linear regression analysis, factors that showed significant association with the SPM score were gender (p=0.002), season of birth (p=0.009), place of residence (p\u3c0.001), father\u27s (p\u3c0.001) and mother\u27s (p=0.025) educational level, type of housing (p\u3c0.001), passive smoking at home (p=0.031), sleeping hours during weekends (p=0.017), students\u27 educational level (p\u3c0.001) and the frequency of consumption of sugary drinks (p\u3c0.001). The link between cognitive functioning and season of birth seems to be robust in various geographical locations including the Middle East. The association between sugary drinks and cognitive functioning highlights the importance of diet independently of obesity and support efforts to reduce consumption of sugary drinks among children

Sex Differences in the Association of Sibship Size and Position in Sibship with Lipid Profile During Adolescence: A Cross-Sectional Study

Background. Epidemiologic studies have reported associations of sibship size and position of the child in the sibship with multiple health outcomes, including adiposity and diabetes. However, little is known about sibling effects on lipids. Hence, this study sought to evaluate associations of the number of total, older, and younger siblings with lipid profile among adolescents. Methods. In a cross-sectional study among high school students aged 14 to 19 years, lipid levels were measured in capillary blood. Parents reported the number of siblings (total, older, and younger). Geometric means of lipids were calculated, and linear regression was used to estimate the ratio of geometric means (RoGM) and 95% confidence intervals (CI). Analyses were sex stratified. Results. Of the total study sample (n = 1,584), 758 (47.9%) were boys and 826 (52.1%) were girls, with median age of 16.0 years. Total cholesterol (TC) was lower by 8% (adjusted-RoGM = 0.92, 95% CI: 0.88–0.96) among boys with ≥3 older siblings compared to those with no older siblings. Similarly, boys with ≥3 younger sibling compared to those with no younger siblings had reduced TC by 7% (adjusted-RoGM = 0.93, 0.87–0.99). Moreover, an increased number of total siblings (≥4 vs. 0/1: adjusted-RoGM = 0.80, 0.67–97) and older siblings (≥3 vs. 0: adjusted-RoGM = 0.90, 0.82–0.98) were associated with reduced low-density lipoprotein cholesterol (LDL-C) among boys. Similarly, lower levels of triglycerides (TG) were seen among boys with ≥3 older siblings compared to those with no older siblings (adjusted-RoGM = 0.87, 0.78–0.96). A higher number of younger siblings was associated with increased high-density lipoprotein cholesterol (HDL-C) among boys (≥3 vs. 0: adjusted-RoGM = 1.08, 1.01–1.17). Sibship characteristics were not associated with lipids among girls. Conclusions. Increased number of total, older, and younger siblings were associated with favorable lipid profiles among adolescent boys, but not girls. Mechanisms underlying these associations need further investigations

Exposure to household secondhand smoke among adolescents in Kuwait: Results from two school-based cross-sectional studies

INTRODUCTION: Detrimental effects of secondhand smoke (SHS) exposure are well established; however, data on SHS exposure among adolescents in Kuwait are lacking. Hence, this study sought to estimate the prevalence of household SHS exposure among two samples of adolescents in Kuwait and assess its variation by socioeconomic status and parental education level. METHODS: Data from two large school-based cross-sectional studies were analyzed. Adolescents attending public middle (n=3864; aged 11-14 years) and high (n=1959; aged 14-19 years) schools throughout Kuwait were enrolled in 2016-2017, and parental self-reported household SHS exposure was ascertained. Associations were assessed using Poisson regression with robust variance estimation, and adjusted prevalence ratios (APRs) and 95% confidence intervals (CIs) were estimated. RESULTS: Overall, 45.8% (1755/3836; 95% CI: 44.2-47.3%) of the enrolled middle school students and 51.6% (998/1936; 95% CI: 49.3-53.8%) of the enrolled high school students were exposed to household SHS. Among middle and high school students, the prevalence of household SHS exposure increased as maternal/paternal education level and family income decreased. Among middle school students, paternal educational attainment of middle school or less compared to bachelor's degree or higher was associated with 1.60 times (95% CI: 1.44-1.79) higher household SHS exposure. Similarly, in the sample of middle school students, the prevalence of household SHS exposure significantly increased from 35.8% among children from families reporting the highest household income to 50.5% among children from families with the lowest reported household income (p-trend<0.001). CONCLUSIONS: Household SHS exposure is substantially high among adolescents in Kuwait. Enrolled adolescents from families with low socioeconomic status or with low parental education level have the highest household SHS exposure. These findings highlight the need for national comprehensive tobacco control policies and increasing parental awareness of the impact of SHS exposure on children

Dysmenorrhea Among High-School Students and It\u27s Associated Factors in Kuwait

Background Although dysmenorrhea is not a life-threatening condition, it can cause a substantial burden on individuals and communities. There is no data on the prevalence of dysmenorrhea in Kuwait. This study aimed to estimate the prevalence of dysmenorrhea among female public high-school students in Kuwait and investigate factors associated with dysmenorrhea. Methods A cross-sectional study using multistage cluster sampling with probability proportional to size method was conducted on 763 twelfth grade female public high-school students (aged 16–21 years). We used face-to-face interview with a structured questionnaire to collect data on dysmenorrhea and presumed risk factors. Weight and height of the students were measured using appropriate weight and height scales in a standardized manner. The association between dysmenorrhea and potential risk factors was assessed using multiple logistic regression. Results The one-year prevalence of dysmenorrhea was found to be 85.6% (95%CI: 83.1–88.1%). Of the participants with dysmenorrhea, 26% visited a public or a private clinic for their pain and 4.1% were hospitalized for their menstrual pain. Furthermore, 58.2% of students with dysmenorrhea missed at least one school day and 13.9% missed at least one exam. Age of menarche (p-value = 0.005), regularity and flow of the menstrual period (p-value = 0.025, p-value = 0.009; respectively), and drinking coffee (p-value = 0.004) were significantly associated with dysmenorrhea in multivariable analysis. Conclusion Dysmenorrhea seems to be highly prevalent among female high-school students in Kuwait, resembling that of high-income countries. Because of the scale of the problem, utilizing school nurses to reassure and manage students with primary dysmenorrhea and referring suspected cases of secondary dysmenorrhea is recommended