Prevalence and associated factors of undernutrition among under-five children from model and non-model households in east Gojjam zone, Northwest Ethiopia: a comparative cross-sectional study.
Developing countries, undernutrition remains significant public health attention, as it was a combined consequence of poor dietary consumption and recurrent infectious illness especially in countries same Ethiopia. Undernutrition is associated with morbidity and mortality among children. This study, therefore, was conducted to assess the prevalence and associated factors of undernutrition among under-five children from the model and non-model households at Eastern Gojjam administrative Zone, northwest Ethiopia.
A community-based comparative cross-sectional study was conducted from 1st July 2015 to 30th August 2015 in East Gojjam Zone among 507 households (170 from model-household and 337 from non-model household) selected using a multistage sampling technique. Data were collected using questionnaire and nutritional anthropometric measurement. The Emergency Nutrition Assessment for Standardized Monitoring and Assessment of Relief and Transition was used to convert raw anthropometric data into Z-scores. The collected data were entered into EpiData, and analysis was conducted using Statistical Package for Social Sciences (SPSS) version 22. The Emergency Nutrition Assessment for Standardized Monitoring and Assessment of Relief and Transition was used to convert raw anthropometric data into Z scores. Descriptive statistics were used to report the prevalence of outcome variable, undernutrition (intermesh of underweight, stunting, and wasting). In addition, results were presented using narration, tables, and figures including frequency and percentage. Adjusted Odds Ratio (AOR) with its 95% Confidence Interval (CI) was computed. Univariate and multivariate logistic regression analyses were done. A p-value less than 0.05 of was considered to declare a result as statistically significant.
This study found that the prevalence of undernutrition explained by stunting (height-for-age Z-score (HAZ) < - 2), underweight (weight-for-age Z-score (WAZ) < - 2) and wasting (weight-for-height Z-score (WHZ) < - 2) were 44.7% [95%CI 41.11, 48.29%]c, 15.3% [95%CI: 12.17, 18.43%] and 10% [95% CI 8.0, 12.0%], and 52.5% [95% CI: 48.62, 56.98%], 24.3% [95% CI: 20.22, 28.38%] and 11.3% [95% CI: 8.45, 14.15%] in under-five children among model household and non-model respectively. Protected water (AOR = 0.08, 95% CI: 0.03, 0.18) and less than three times daily intake of food (AOR = 4.06, 95% CI: 1.53, 10.82) were predictors for undernutrition among under-five model household. Protected source of drinking water (AOR = 0.07, 95% CI: 0.03, 0.13), households that ever-had education on complementary feeding (AOR = 0.19, 95% CI: 0.09, 0.25) and starting complementary feeding on 6 month after birth (AOR = 0.19, 95% CI: 0.09, 0.25) were significant predictors for under-five undernutrition among non-model households.
The prevalence of undernutrition explained by stunting, underweight and wasting among under-five children in both model and non-model households were high. The prevalence of all the three parameters (stunting, underweight and wasting) was higher among the non-model households compared to the models, even if the differences were not statistically significant. Use of an unprotected source of drinking water and less than three times daily intake of food were found to be associated with undernutrition among under-five children in the model households. On the other hand, having educational exposure on complementary feeding, using drinking water from protected sources and initiation of complementary feedings at age of 6 months were found to be associated with undernutrition among children in the non-model households. Therefore, the concerned bodies must access safe and adequate water supply, works on information dissemination using mass media on timely initiation of complementary feeding, save water and on meal frequency should be strengthened.
Zeray A
，Kibret GD
，Leshargie CT
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The effect of maternal and child factors on stunting, wasting and underweight among preschool children in Northern Ghana.
Undernutrition among preschool children in Northern region is the highest in Ghana. However, there is scarcity of data on the factors that determine undernutrition in these children. This study investigated the effect of maternal and child factors on undernutrition among preschool children in Northern Ghana.
This study was a community based analytical cross-sectional survey on a sample of 425 mother- child pairs drawn from 25 clusters. A semi- structured questionnaire was used to collect data on maternal and child socio-demographic characteristics, feeding practices and anthropometry. Anthropometric indices of Height-for-age Z-scores (HAZ), Weight-for-height Z-scores (WHZ) and Weight-for - age Z-scores (WAZ) were used to classify child stunting, wasting and underweight respectively. Bivariate and multivariate analyses were performed to determine associations between explanatory variables and undernutrition.
The prevalence of stunting, wasting and underweight were 28.2, 9.9 and 19.3% respectively. Multiple logistic regression analysis showed that, the odds of stunting was higher among male children [AOR = 1.99; 95% CI (1.26-3.13); p = 0.003], children of mothers less than 150 cm in height [AOR = 3.87; 95% CI (1.34-11.20); p = 0.01], mothers 155-159 cm tall [AOR = 2.21; 95% CI (1.34-3.66); p = 0.002], and older children aged 12-23 months [AOR 9.81; 95% CI (2.85-33.76); p < 0.001]. Wasting was significantly higher among male children [AOR = 2.40; 95% CI (1.189-4.844); p = 0.015], consumption of less than four food groups [AOR = 3.733; 95% CI (1.889-7.376); p < 0.001] and among children of underweight mothers [AOR = 3.897; 95% CI (1.404-10.820); p = 0.009]. Male children [AOR = 2.685; 95% CI (1.205-5.98); p = 0.016] and having low birth weight [AOR = 3.778; 95% CI (1.440-9.911); p < 0.001] were associated with higher odds of underweight in children.
Maternal height associated negatively with stunting but not wasting. Factors that affect low height -for-age z-score (HAZ) may not necessarily be the same as stunting. Infant and child feeding practices as measured by dietary diversity score associated positively with weight-for-height Z-scores than length-for-age Z-scores of young children. Surprisingly, consumption of some specific food groups including, animal source foods, legumes, staples and eggs were associated with lower HAZ but with increased likelihood of higher WHZ among children 6-59 months.
Ali Z
，Saaka M
，Adams AG
，Kamwininaang SK
，Abizari AR
... -
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Assessment of undernutrition using the composite index of anthropometric failure (CIAF) and its determinants: A cross-sectional study in the rural area of the Bogor District in Indonesia.
The Composite Index of Anthropometric Failure (CIAF) can comprehensively identify undernutrition by combining several indicators of nutritional status - namely, weight-for-age, length/height-for-age and weight-for-length/height - to determine the nutritional status of children under five years of age. This study aims to assess undernutrition using the CIAF and its determinants on children under five years of age in the Bogor District, Indonesia.
A cross-sectional study was conducted during February-May 2019 among 330 mother-children pairs (with children under five), selected by systematic random sampling from four villages as undernutrition pockets in the rural area of Bogor District, Indonesia. The nutritional status of the children was assessed by measuring weight and length/height. Z-score was calculated using WHO Anthro software and was categorized based on conventional indices, including weight-for-age (WAZ), length/height-for-age (HAZ) and weight-for-length/height (WHZ). The CIAF is measured based on a combination of conventional index measurements. In addition, mothers' and childrens' characteristics and clean living behaviour are assessed via structured questionnaires. Environmental sanitation is assessed using the environment meter. Binary logistic regression analysis with SPSS version 22.0 is used to analyse the dominant factors associated with undernutrition.
Among children under five, 42.1% experienced anthropometric failure (overall prevalence of undernutrition based on the CIAF), 2.4% experienced wasting only, 5.8% were classified as both wasting and underweight, 2.1% as wasting, underweight and stunting, 16.4% as underweight and stunting, 11.5% as stunting only, and 3.9% as underweight only. Assessment of nutritional status using a conventional anthropometric index shows that respective prevalences of underweight, stunted and wasted were 27.8, 29.7, and 10.6%. The mother's height is the most dominant factor associated with anthropometric failure [p = 0.008; AOR = 1.95; 95% CI: 2.19-3.19]. The most dominant factors associated with the conventional undernutrition indices of underweight, stunted and wasted are, respectively, family income [p = 0.018; AOR = 5.44; 95% CI: 1.34-22.11], mother's height [p = < 0.001; AOR = 3.29; 95% CI:1.83-5.91] and child's age [p = 0.013; AOR = 2.59; 95% CI: 1.22-5.47].
Nearly half of children under five experience anthropometric failure. Specific nutrition improvement interventions and specific nutrition interventions during pregnancy and lactation are needed, especially for malnourished mothers, to prevent malnutrition in infant.
Permatasari TAE
，Chadirin Y
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ResearchGate
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