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Archives of Public Health
Published in: Archives of Public Health 1/2015

Open Access 01-12-2015 | Research

Prevalence and factors associated with stunting and thinness among adolescent students in Northern Ethiopia: a comparison to World Health Organization standards

Authors: Yohannes Adama Melaku, Gordon Alexander Zello, Tiffany K. Gill, Robert J. Adams, Zumin Shi

Published in: Archives of Public Health | Issue 1/2015

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Abstract

Background

Adolescence is last chance for curbing the consequences of malnutrition and breaking the intergenerational cycle of malnutrition and poor health. This study aimed to assess the prevalence and the factors associated with stunting and thinness among in-school adolescents in northern Ethiopia using the 2006 World Health Organization (WHO) standards.

Methods

In-school adolescents (n = 348, 10–19 years old) were randomly selected to participate in this cross-sectional study. Anthropometric measurements were carried out to determine the proportion of adolescents who were stunted (height-for-age < −2 Standard Deviation (SD)) and thin (body-mass-index-for-age < −2 SD). T-test was employed to evaluate mean weight and height differences between groups. Pearson chi-square, chi-square trend and Fisher’s exact tests were used to explore the crude association of categorical outcome variables and associated factors. Crude and adjusted associations between the outcome variables (stunting and thinness) and independent variables (socio-demographic, eating behavior and sanitation) were also determined using logistic regression. Stata version 11.1 was used to analyze the data.

Results

The height of the adolescents was 147.6 ± 11.2 cm (mean ± SD) and weight was37.2 ± 9.5 kg. The mean Z-scores of height-for-age and body-mass-index (BMI)-for-age of adolescents were −1.49 and −1.29, respectively. The prevalence of stunting and thinness among adolescents was 28.5 % (boys = 37.7 %; girls = 21.2 %; P = 0.001) and 26.1 % (boys = 32.4; girls = 21.6 %; p = 0.017), respectively. Adolescents in 13–15 year old age group (Adjusted Odds ratio (AOR) = 2.23; 95 % CI: 1.22, 4.08), boys (AOR = 2.53; 95 % CI: 1.52, 4.21) and rural residents (AOR = 2.15; 95 % CI: 1.20, 3.86) had significantly higher odds of being stunted compared to their counterparts. Furthermore, boys had higher (AOR = 1.97; 95 % CI: 1.19, 3.25) odds of being thin compared to girls. Compared to those 10 to 12 years of age, adolescents in 16 to 19 years of age were 53 % (AOR = 0.47; 95 % CI: 0.23, 0.95) less likely to be thin.

Conclusions

Undernutrition is widely prevalent among adolescents in northern Ethiopia. Sex, age and area of residence significantly associated with adolescent undernutrition. The study underlines the need for nutrition interventions targeting rural and boy adolescents.
Literature
1.
UNDO/UNFPA/WHO/World Bank. Special program of Research, Development and Research Training in Human Reproductive Health (HRP), Progress in Reproductive Health Research. WHO production services, Geneva, Switzerland. ISBN 92 4 159191 9; p144; 2003.
2.
Ghai OP, Gupta P, Paul VK. Ghai Essential Pediatrics, Adolescent Health and Development. Pediatrics. 2006;6:66.
3.
UNICEF: progress for children: a report card on adolescents: UNICEF publications, New York, USA; Number 10, April 2012.
4.
Campagna VN, Souza ASL. Corpoeimagem corporal no início da adolescênciafeminina. Bol Psic. 2006;56(124):9–35.
5.
Nutrition for the school-aged child. UNL/Cooperative Extension Service. NebGuide Series No.G92-1086-A 2002, 1.
6.
WHO. The Management of Nutrition in Major Emergencies. 2nd ed. Geneva: World Health Organization; 2000. p. 236.
7.
Shahid A, Siddiqui FR, Bhatti MA, Ahmed M, Khan MW. Assessment of Nutritional Status of Adolescent College Girls at Rawalpindi. Department of Islamic International Medical College, Rawalpindi, Pakistan: HOD Community Medicine; 2010.
8.
9.
10.
Central Statistical Agency [Ethiopia]. Ethiopia Mini Demographic and Health Survey, Addis Ababa, Ethiopia. 2014.
11.
Ethiopian Health and Nutrition Research Institute: Nutrition baseline survey report for the national nutrition program of Ethiopia, Ethiopian Health and Nutrition Research Institute, Addis Ababa, Ethiopia, 2009/2010.
12.
Mulugeta A, Hagos F, Stoecker B, Kruseman G, Linderhof V, Zenebe A, et al. Nutritional status of adolescent girls from rural communities of Tigray, Northern Ethiopia. Ethiop J Health Dev. 2009;23(1):5–11.CrossRef
13.
Prentice AM. The emerging epidemic of obesity in developing countries. Int J Epidemiol. 2006;35(1):93–9.PubMedCrossRef
14.
15.
16.
Mustanski BS, Viken RJ, Kaprio J, Pulkkinen L, Rose RJ. Genetic and environmental influences on pubertal development: longitudinal data from Finnish twins at ages 11 and 14. Dev Psychol. 2004;40(6):1188–98.PubMedCrossRef
17.
Berkey CS, Colditz GA, Rockett HR, Frazier AL, Willett WC. Dairy consumption and female height growth: prospective cohort study. Cancer Epidemiol Biomarkers Prev. 2009;18(6):1881–7.PubMedPubMedCentralCrossRef
18.
Biro FM, Lucky AW, Simbartl LA, Barton BA, Daniels SR, Striegel-Moore R, et al. Pubertal maturation in girls and the relationship to anthropometric changes: pathways through puberty. J Pediatr. 2003;142(6):643–6.PubMedCrossRef
19.
Cheng G, Gerlach S, Libuda L, Kranz S, Günther ALB, Karaolis-Danckert N, et al. Diet quality in childhood is prospectively associated with the timing of puberty but not with body composition at puberty onset. J Nutr. 2010;140(1):95–102.PubMedCrossRef
20.
Rogol AD, Clark PA, Roemmich JN. Growth and pubertal development in children and adolescents: effects of diet and physical activity. Am J Clin Nutr. 2000;72(2 Suppl):521S–8.PubMed
21.
Hadley C, Lindstrom D, Tessema F, Belachew T. Gender bias in food insecurity experiences of adolescents in Jimma zone. Soc Sci Med. 2008;66(2):427–38.PubMedCrossRef
22.
Belachew T, Hadley C, Lindstrom D, Gebremariam A, Lachat C, Kolsteren P. Food insecurity, school absenteeism and educational attainment of adolescents in Jimma Zone Southwest Ethiopia: a longitudinal study. Nutr J. 2011;10:29.PubMedPubMedCentralCrossRef
23.
Harrison KA, Fleming AF, Briggs ND, Rossiter CE. Growth during pregnancy in Nigerian primigravidae. Br J Obstet Gynaecol. 1985;92 Suppl 5:32–9.
24.
Naeya RL. Teenaged and pre-teenaged pregnancies: consequences of the fetal maternal competition for nutrients. Paediatrics. 1981;67:146–50.
25.
Brabin L, Brabin BJ. The cost of successful adolescent growth and development in girls in relation to in relation to iron and vitamin A status. Am J Clin Nutr. 1992;55:955–8.PubMed
26.
Deshmukh P, Gupta S, Bharambe M, Dongre M, Kaur S, Garg B. Nutritional Status of Adolescents in Rural Wardha Indian. J Pediatrics. 2006;73(2):139–41.
27.
Mesert Y, Jemal H, Hailu K, Fleming L. Socioeconomic and demographic factors affecting body mass index of adolescents students aged 10–19 in Ambo, Ethiopia. Int J Biol Sci. 2010;6(4):321–6.
28.
Carvalho IH, Francescantonio M, Neutzling M, Taddei A. Risk factors for overweight and obesity in adolescents of a Brazilian university: a case–control study. Nutr Hosp. 2009;24:17–24.
29.
WHO. Anthroplus for personal computers manual: Software for assessing growth of the world’s children and adolescents. Department of Nutrition for Health and Development. Geneva: WHO; 2009. (Available from: http://​www.​who.​int/​growthref/​en/​) [Accessed on August 25, 2014].
30.
Gomes Fda S, Anjos LA, Vasconcellos MT. Influence of different body mass index cut-off values in assessing the nutritional status of adolescents in a household survey. Cad Saude Publica. 2009;25:1850–7.PubMed
31.
Silva HG, Chiara VL, Barros ME, Rego AL, Ferreira A, Pitasi BA, et al. Diagnosing the nutritional status of schoolchildren: a comparison between Brazilian and international criteria. J Pediatr (Rio J). 2008;84:550–5.CrossRef
32.
BayaBotti A, Perez-Cueto FJ, Vasquez Monllor PA, Kolsteren PW. International BMI-for-age references underestimate thinness and overestimate overweight and obesity in Bolivian adolescents. Nutr Hosp. 2010;25:428–36.
33.
Khasnutdinova SL, Grjibovski AM. Prevalence of stunting, underweight, overweight and obesity in adolescents in Velsk district, north-west Russia: a cross-sectional study using both international and Russian growth references. Public Health. 2010;124:392–7.PubMedCrossRef
34.
Belachew T, Lindstrom D, Hadley C, Gebremariam A, Kasahun W, Kolsteren P. Food insecurity and linear growth of adolescents in Jimma Zone, Southwest Ethiopia. Nutr J. 2013;12:55.PubMedPubMedCentralCrossRef
35.
Assefa H, Belachew T, Negash L. Socioeconomic Factors Associated with Underweight and Stunting among Adolescents of Jimma Zone, South West Ethiopia: A Cross-Sectional Study. ISRN Public Health 2013: 7. Hindawi Publishing Corporation. http://​dx.​doi.​org/​10.​1155/​2013/​238546.​
36.
de Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J. Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ. 2007;85:660–7.PubMedPubMedCentralCrossRef
37.
Hosmer DW, Lemeshow S. Applied Logistic Regression. 2nd ed. New York: J Wiley and Sons; 2000.CrossRef
38.
Daboné C, Delisle HF, Receveur O. Poor nutritional status of schoolchildren in urban and peri-urban areas of Ouagadougou (Burkina Faso). Nutr J. 2011;10:34.PubMedPubMedCentralCrossRef
39.
MEBA: Enquête de base du projet de santé et nutrition scoliare- Rapport présenté par Helen Keller International (HKI). Ministère de l’Enseignement de Base et de l’Alphabétisation-Burkina Faso, 2007, 31.
40.
Beasley M, Brooker S, Ndinaromtan M, Madjiouroum EM, Baboguel M, Djenguinabe E, et al. First nationwide survey of the health of schoolchildren in Chad. Trop Med Int Health. 2002;7(7):625–30.PubMedCrossRef
41.
Alam N, Roy SK, Ahmed T, Ahmed AMS. Nutritional Status, Dietary Intake, and Relevant Knowledge of Adolescent Girls in Rural Bangladesh. J Health Popul Nutr. 2010;28(1):86–94.PubMedPubMedCentralCrossRef
42.
Bovet P, Kizirian N, Madeleine G, Blössner M, Chiolero A. Prevalence of thinness in children and adolescents in the Seychelles: comparison of two international growth references. Nutr J. 2011;10:65.PubMedPubMedCentralCrossRef
43.
44.
45.
Central Statistical Agency [Ethiopia] and ICF International. Ethiopia Demographic and Health Survey 2011. Addis Ababa, Ethiopia and Calverton, Maryland, USA: Central Statistical Agency and ICF International; 2012.
46.
Central Statistical Agency [Ethiopia] and ICF International. Ethiopia Demographic and Health Survey 2005. Addis Ababa, Ethiopia and Calverton, Maryland, USA: Central Statistical Agency and ICF International; 2006.
47.
Coly AN, Milet J, Diallo A, Ndiaye T, Bénéfice E, Simondon F, et al. Preschool stunting, adolescent migration, catch-up growth, and adult height in young Senegalese men and women of rural origin. J Nutr. 2006;136(9):2412–20.PubMed
48.
Golden MHN. Is complete catch-up possible for stunted malnourished children? Eur J Clin Nutr. 1994;48(Supplement):S58–S71.1.PubMed
49.
50.
Oner N, Vatansever U, Sari A, Ekuklu E, Güzel A, Karasalihoğlu S, et al. Prevalence of underweight, overweight and obesity in Turkish adolescents. Swiss Med Wkly. 2004;134:529–33.PubMed
51.
Bener A. Prevalence of obesity, overweight, and underweight in Qatari adolescents. Food Nutr Bull. 2006;27:39–45.PubMedCrossRef
52.
Elena R, Luminit OC. Adolescent Malnutrition from Anthropological Perspective, “Francisc I. Rainer” Institute of Anthropology. Proc. Rom. Acad., Series B, 2007, 2, p. 155–158. Romanian Academy, 2007.
53.
Cabrera JF, Medina EA, Ramos MGC, León AH, Bernabé JAR, Pérez-Nevado F. Evaluación del estadonutricional de estudiantes adolescents de Extremadura basadoenmedidasantropométricas. Nutr Hosp. 2014;29(3):665–73.
54.
PCD. The anthropometric status of schoolchildren in five countries in the partnership for child development. Proc Nutr Soc. 1998;57(1):149–58.CrossRef
55.
Oninla SO, Owa JA, Onayade AA, Taiwo O. Comparative study of nutritional status of urban and rural Nigerian school children. J Trop Pediatr. 2007;53(1):39–43.PubMedCrossRef
56.
Teller H, Yimar G. Levels and determinants of malnutrition in adolescent and adult women in Southern Ethiopia. Ethio J Health Dev. 2000;14(1):57–66.
57.
Woldemariam G, Genebo T. Determinants of Nutritional Status of Women and Children in Ethiopia, Ethiopia. Addis Ababa, Ethiopia; Calverton, Md, USA: Health and Nutrition Research Institute; ORC Macro; 2002.
58.
Zerihun T, Larson CP, Hanley JA. Anthropometric status of Oromo women of child bearing age in rural southwestern Ethiopia. Ethio J Health Dev. 1997;11(3):1–7.
59.
Federal Minister of Health of Ethiopia (FMoH), National Nutritional Program (NNP) 2008; Addis Ababa, Ethiopia, 2008.
60.
Federal Minister of Health of Ethiopia (FMoH), National Nutritional Program (NNP) 2013; Addis Ababa, Ethiopia, 2013.
61.
Woodruff BA, Duffield A. Anthropometric assessment of nutritional status in adolescent population in humanitarian emergencies. Eu J Clin Nutr. 2002;56:1108–18.CrossRef
62.
Ahmed F, Zareen M, Khan MR, Banu CP, Haq MN, Jackson AA. Dietary patterns, nutrient intake and growth of adolescent school girls in urban Bangladesh. Pub Health Nutr. 1998;1:83–92.CrossRef
Metadata
Title
Prevalence and factors associated with stunting and thinness among adolescent students in Northern Ethiopia: a comparison to World Health Organization standards
Authors
Yohannes Adama Melaku
Gordon Alexander Zello
Tiffany K. Gill
Robert J. Adams
Zumin Shi
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Archives of Public Health / Issue 1/2015
Electronic ISSN: 2049-3258
DOI
https://doi.org/10.1186/s13690-015-0093-9

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