1. % Malnutrition (less than -2Z)
Socioeconomic Factors Associated With Children’s Oral Health and Malnutrition in Nepal
Chloe Tsang, Karen Sokal-Gutierrez, Howard Barkan, Kristine Ronsin, Ashmita Baral
BACKGROUND
RESULTS
RESULTS
Childhood Malnutrition
Nepal has 41% of its children under 5 stunted
Early Childhood Caries
Tooth decay is one of the most prevalent chronic conditions, affecting 60-90% of children worldwide
Limited Health Care
There is only 1 dentist for every 100,000 people
Rural and Urban Development
Rapid urbanization is shifting traditional nutritional practices towards increased junk food consumption
I. Demographics
IV. Child Oral Health and Nutrition Status
Maternal
Total
Urban Mothers
Rural Mothers
Mean age
29.7 years
29.5 years
29.9 years
Mean education level*
4.9 years
6.1 years
2.5 years
Mean number of children*
2 children
3 children
Mean household size*
5 members
6 members
Child Oral Health Status
Children
Total
Urban Children
Rural Children
Mean age*
4.4 years
4.3 years
5.1 years
Females
52.2%
44.9%
51.1%
Males
46.9%
53.5%
48.9%
% Malnutrition (less than -2Z)
Total
Urban Children
Rural Children
HAZ*
34.2%
29.5%
42.7%
WAZ
14.8%
13.2%
17.6%
BMI
2.1%
2.0%
ABSTRACT & HYPOTHESIS
Despite greater knowledge about oral health and nutrition, greater access to and consumption of junk food drives poor nutritional practices and increased early childhood caries
II. Maternal Oral Health and Nutrition Knowledge
KNOWLEDGE
Dental Caries
Oral Health Practices
Nutritional Value
ACCESS
Dental Care
Oral Hygiene Products
Junk Food
Knowledge
Total
Urban
Rural
Sweets cause caries
85.5%
84.7%
87.0%
Juice/soda causes caries*
5.0%
6.4%
2.3%
Not brushing causes caries*
26.1%
29.5%
20.0%
Don’t know how caries affect children*
8.0%
6.0%
11.2%
Think caries causes pain
74.9%
73.4%
79.5%
Think caries affects eating
47.5%
44.9%
52.6%
Think caries affects sleep*
17.6%
21.1%
11.6%
Think caries harms health*
8.9%
12.4%
0.9%
PRACTICES
Oral Care
Nutrition
Bottle feeding
OUTCOMES
Level of Decay
 Weight and Height
poor oral health outcomes
better oral health outcomes
URBAN
RURAL
RISK FACTORS*
-- Knowledge
-- Access to dental care
-- Access to dental hygiene products
-- Access to junk food
-- Daily consumption of junk food
VI. Summary
OBJECTIVES
Explore key socioeconomic factors contributing to poor oral health and nutrition through baseline analysis
Determine effective interventions to improve children’s oral health and nutrition
III. Child Oral Health and Nutrition Practices
METHODS
CONCLUSION
Data Collection: Sampled participants in 10 community health camps, 5 from urban and 5 from rural areas Study Population: 632 mothers interviewed; 836 children aged 0-8 years measured: 532 (63.6%) urban children; 304 (36.4%) rural children Maternal Interviews: Assessed knowledge of oral health and nutrition Oral Health Examinations: De decay=surface enamel decay, Dd=dentin decay, Dp=pulp decay; decayed missing and filled teeth; recurrent caries Nutritional Status Examinations: HAZ=height for age, WAZ=weight for age; BAZ=BMI for age Analysis: SPSS version 22, tested for statistical significance between urban with rural responses and correlations for association analysis
Junk food consumption is adversely reshaping traditional practices and reinforcing malnutrition and childhood caries
Key interventions include reducing the consumption of junk food and improving overall health knowledge and practices in the household and at school, starting from birth
Further analysis will explore the results of our intervention program
ACKNOWLEDGEMENTS
Many thanks to: the Hasilo Nepal team, volunteer dentists, UC Berkeley, UCSF, UCB Health Research for Action Center; hundreds of participating families and children; supported funding from Global Healing, UC Berkeley Undergraduate Research Apprenticeship Program
*statistically significant difference between urban and rural (p<.05) by chi-sq test