Malnutrition affects over 30 million children annually and has profound immediate and enduring repercussions. Survivors often suffer lasting neurocognitive consequences that impact academic performance and socioeconomic outcomes. Mechanistic understanding of the emergence of these consequences is poorly understood. Using multi-system SHAP interpreted random forest models and network analysis, we show that Moderate Acute Malnutrition (MAM) associates with enrichment of faecal Rothia mucilaginosa, Streptococcus salivarius and depletion of Bacteroides fragilis in a cohort of one-year-old children in Dhaka, Bangladesh. These microbiome changes form interconnected pathways that involve reduced plasma odd-chain fatty acid levels, decreased gamma and beta electroencephalogram power in temporal and frontal brain regions, and reduced vocalization. These findings support the hypothesis that prolonged colonization by oral commensal species delay gut microbiome and brain development. While causal links require empirical validation, this study provides insights to improve interventions targeting MAM-associated neurodevelopmental deficits.

Background: Children’s screen time has substantially increased worldwide, including in Bangladesh, especially since the pandemic, which is raising concern about its potential adverse effects on their physical, mental, and social health. Parental supervision may play a crucial role in mitigating these negative impacts. However, there is a lack of empirical evidence assessing the relationship between parental screen time supervision and health outcomes among school children in Dhaka, Bangladesh. Objective: We aimed to explore the association between supervised and unsupervised screen time on the physical, mental, and social health of school-going children in Dhaka, Bangladesh. Methods: We conducted a cross-sectional descriptive study between July 2022 and June 2024. A total of 420 children, aged 6‐14 years, were enrolled via the stratified random sampling method across three English medium and three Bangla medium schools in Dhaka. Data were collected through a semistructured questionnaire; anthropometry measurements; and the Bangla-validated Strength and Difficulties Questionnaire (SDQ), Pittsburgh Sleep Quality Index (PSQI) Scale, and Spencer Children Anxiety Scale (SCAS). Results: A total of 234 out of 420 students (56%) used digital screen devices without parental supervision. We did not find a substantial difference in the duration of the daily mean use of digital devices among the supervised students (4.5 hours, SD 2.2 hours) and the unsupervised students (4.6 hours, SD 2.4 hours). According to the type of school, English medium school children had a mean higher screen time (5.46 hours, SD 2.32 hours) compared to Bangla medium school children (3.67 hours, SD 2.00 hours). Headache was significantly higher among the unsupervised digital screen users compared to those who used digital screens with parental supervision (175/336 students, 52.1% versus 161/336 students, 47.9%; P<.003). Moreover, students who used digital screens without parental supervision had poor quality of sleep. Behavioral problems such as conduct issues (119/420 students, 28.3%) and peer difficulties (121/420 students, 28.8%) were observed among the participants. However, when comparing supervised and unsupervised students, we found no statistically significant differences in the prevalence of these issues. Conclusions: The findings of the study showed that the lack of screen time supervision is associated with negative health effects in children. The roles of various stakeholders, including schools, parents, policy makers, and students themselves, are crucial in developing effective guidelines for managing screen use among students. Further research is needed to demonstrate causal mechanisms; identify the best interventions; and determine the role of mediators and moderators in households, surroundings, and schools.

Background: Faltered growth has been shown to affect 161 million children worldwide and derail cognitive development from early childhood. The neural pathways by which growth faltering in early childhood affects future cognitive outcomes remain unclear, which is partially due to the scarcity of research using both neuroimaging and sensitive behavioral techniques in low-income settings. We employed EEG to examine the association between growth faltering and brain functional connectivity and whether brain functional connectivity mediates the effect of early adversity on cognitive development. Methods: We recruited participants from an urban impoverished neighborhood in Dhaka, Bangladesh. One sample consisted of 85 children whose EEG and growth measures (height for age, weight for age, and weight to height) were collected at 6 months and cognitive outcomes were assessed at 27 months. Another sample consisted of 115 children whose EEG and growth measures were collected at 36 months and IQ scores were assessed at 48 months. Path analysis was used to test the effect of growth measures on cognitive outcomes through brain functional connectivity. Findings: Faltered growth was found to be accompanied by overall increased functional connectivity in the theta and low-beta frequency bands for the 36-month-old cohort. For both cohorts, brain functional connectivity was negatively predictive of later cognitive outcomes at 27 and 48 months, respectively. Faltered growth was found to have a negative impact on children’s IQ scores in the older cohort, and this effect was found to be mediated by brain functional connectivity in the low-beta band. Interpretation: The association found between growth measures and brain functional connectivity may reflect a broad deleterious effect of malnutrition on children’s brain development. The mediation effect of functional connectivity on the relation between physical growth and later IQ scores provides the first experimental evidence that brain functional connectivity may mediate the effect of biological adversity on cognitive development. Funding: Bill and Melinda Gates Foundation (OPP1111625)

About 40 million children under the age of 18 years are estimated to suffer from abuse and neglect around the world. Child abuse in developing countries, including South Asia, is yet to be recognized as a major social and public health problem with an enormous burden on the economy and society. The present study conducted to find out the level of knowledge and perception of child abuse among the adolescent girls in some selected high schools in Dhaka city.

Malnutrition, particularly undernutrition, is a critical global health challenge, contributing to nearly half of all deaths among children under 5 and severely impacting physical and mental health, along with neural and cognitive development. Prior research by Xie et al. (2019a) linked growth faltering to altered EEG functional connectivity (FC) at 36 months and poorer cognitive outcomes at 48 months; however, no associations were found at 6 months for EEG measures or at 27 months for cognitive outcomes. Our study investigates these relationships in a sample of 12-month-old infants in Dhaka, Bangladesh, using various growth measurements (height/length-for-age, weight-for-age, weight-for-height/length, head-circumference-for-age, and mid-upper-arm-circumference-for-age z-scores) as indicators of nutritional status. Brain development was assessed through EEG, focusing on power spectral density (PSD) and FC, while cognitive development was evaluated with the Bayley Scales of Infant and Toddler Development, Fourth Edition. Our findings reveal that, at 12 months, growth faltering, indicative of undernutrition, was associated with reduced PSD, while initial correlations with increased FC did not remain significant after false discovery rate (FDR) correction. PSD was further positively linked to cognitive development, but associations with FC were not significant post-correction. Notably, EEG PSD in the theta and alpha bands mediated the relationship between malnutrition and behavioral outcomes. These results underscore the early impact of malnutrition on brain development, highlighting the importance of PSD in understanding neural development in this context. Our study emphasizes the need for early intervention and continuous monitoring to mitigate the adverse effects of malnutrition on infant brain and cognitive development. RESEARCH HIGHLIGHTS: - EEG power spectral density (PSD) in the theta and alpha frequency bands at 12 months sheds light on undernutrition’s impact on cognitive development. - Better nutritional health, indicated by higher height/length-for-age (HAZ), leads to increased theta and alpha PSD, contributing to better cognitive outcomes. - Initial correlations between undernutrition, increased EEG functional connectivity (FC), and poorer cognitive outcomes did not remain significant after FDR correction. - Findings highlight the critical role of nutritional interventions in early childhood to support optimal neural and cognitive development.

BACKGROUND In Bangladesh as well as throughout the world, children's screen time has significantly increased. Children spent a lot of time on the internet and digital screens for entertainment, education, and communication which have increased their daily screen time. However, the potential detrimental impacts of excessive screen time on children's mental, physical, and social health have drawn attention. OBJECTIVE This study aimed to explore the effect of high exposure to screen on health and mental well-being of school-going children in Dhaka, Bangladesh. METHODS From July 2022 to June 2024, this cross-sectional descriptive study was carried out. 420 kids between the ages of 6 and 14 were enrolled in three English-medium and three Bangla-medium schools in Dhaka city using a stratified random sample technique. Anthropometric measurements, a semi-structured questionnaire, the Pittsburgh Sleep Quality Index Scale (PSQI), the Development and Wellbeing Assessment Scale (DAWBA), and the Strength and Difficulties Questionnaire (SDQ), which was validated in Bangla, were used to gather data. We considered the students who were exposed to screen for less than 2 hours as the low-exposed group and those who were exposed for more than 2 hours as high-exposed group. RESULTS We found 83% of the students were high exposed group and their average screen time was 4.6 ± 2.3 hours. Compared to the low exposed group, the high exposed group had a significantly higher rate of eye problems (96% vs 4%, P< 0.001). Headache was also common in high exposed group (83%). Moreover, students of high exposed group had a short duration and poor quality of sleep which was statistically significant. Furthermore, obesity was more predominant in the high-exposure group (p < 0.001). Our study revealed overall 40% of children suffered from mental health problems by using DAWBA scale which was increased in high exposed group compared to low exposed group. Behavioral problems, such as conduct issues (28.3%) and peer difficulties (28.8%), were observed among the participants. However, there was no statistically significant difference was found between two groups. CONCLUSIONS A collaborative and coordinated multistage approach will be required to create effective and acceptable guidelines and policies for the optimum and positive use of digital screens for the children of Bangladesh. Further prospective studies on larger scales can be conducted to determine the impacts on health aspects meticulously.