Nutritional Status of Children after a Food-Supplementation Program Integrated with Routine Health Care through Mobile Clinics in Migrant Communities in the Dominican Republic

Kavita Parikh Pediatric Hospitalist Division, Children's National Medical Center, Washington, DC; Pediatrics Residency Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Divisions of GI, Hepatology, and Nutrition, Global Health, Infectious Diseases, and General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Departments of Pediatrics and Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania

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Gabriela Marein-Efron Pediatric Hospitalist Division, Children's National Medical Center, Washington, DC; Pediatrics Residency Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Divisions of GI, Hepatology, and Nutrition, Global Health, Infectious Diseases, and General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Departments of Pediatrics and Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania

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Shirley Huang Pediatric Hospitalist Division, Children's National Medical Center, Washington, DC; Pediatrics Residency Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Divisions of GI, Hepatology, and Nutrition, Global Health, Infectious Diseases, and General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Departments of Pediatrics and Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania

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Geraldine O'Hare Pediatric Hospitalist Division, Children's National Medical Center, Washington, DC; Pediatrics Residency Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Divisions of GI, Hepatology, and Nutrition, Global Health, Infectious Diseases, and General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Departments of Pediatrics and Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania

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Rodney Finalle Pediatric Hospitalist Division, Children's National Medical Center, Washington, DC; Pediatrics Residency Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Divisions of GI, Hepatology, and Nutrition, Global Health, Infectious Diseases, and General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Departments of Pediatrics and Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania

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Samir S. Shah Pediatric Hospitalist Division, Children's National Medical Center, Washington, DC; Pediatrics Residency Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Divisions of GI, Hepatology, and Nutrition, Global Health, Infectious Diseases, and General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Departments of Pediatrics and Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania

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The objective of this study was to compare acute and chronic undernutrition rates before and after the introduction of a food-supplementation program as an adjunct to routine health care for children of migrant workers in the Dominican Republic. The cross-sectional study was conducted in five rural communities in the Dominican Republic. Children 18 years and younger were eligible if they received routine health care from local mobile clinics. Data were obtained before (2005) and after (2006) initiation of a food-supplementation program. χ2 or Fisher exact tests were used for analysis. Among 175 children in 2005, 52% were female, and 59% were < 5 years of age (mean age = 5.3 years). Among 148 children in 2006, 48% were female, and 57% were < 5 years of age (mean age = 5.6 years). Acute undernutrition rates decreased from 40% to 23% (P = 0.001) after initiation of the food-supplementation program. Rates of chronic undernutrition decreased from 33% to 18% after the initiation of the food-supplementation program (P = 0.003). Food supplementation in the context of routine health-care visits improved the nutritional status of children, and it warrants further exploration as a way to reduce childhood undernutrition in resource-scarce areas.

Author Notes

*Address correspondence to Kavita Parikh, 111 Michigan Avenue NW, Main Building 4th Floor, Washington, DC 20010. E-mail: kparikh@cnmc.org

Authors' addresses: Kavita Parikh, Pediatric Hospitalist Division, Children's National Medical Center, Washington, DC, E-mail: kparikh@cnmc.org. Gabriela Marein-Efron, Pediatrics Residency Program, Children's Hospital of Philadelphia, Philadelphia, PA, E-mail: mareinefrong@email.chop.edu. Shirley Huang, Division of GI, Hepatology, and Nutrition, Children's Hospital of Philadelphia, Philadelphia, PA, E-mail: huangs@email.chop.edu. Geraldine O'Hare and Rodney Finalle, Division of Global Health, Children's Hospital of Philadelphia, Philadelphia, PA, E-mails: ohare@email.chop.edu and finalle@email.chop.edu. Samir Shah, Department of Global Health and the Divisions of Infectious Disease and General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA and Departments of Pediatrics and Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, PA, E-mail: shahs@email.chop.edu.

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