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BMC Pediatrics
Published in: BMC Pediatrics 1/2017

Open Access 01-12-2017 | Research article

Stunting, wasting and associated factors among children aged 6–24 months in Dabat health and demographic surveillance system site: A community based cross-sectional study in Ethiopia

Authors: Terefe Derso, Amare Tariku, Gashaw Andargie Biks, Molla Mesele Wassie

Published in: BMC Pediatrics | Issue 1/2017

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Abstract

Background

Though there is a marked decline in burden of undernutrition, about 44 and 10% of children under five are stunted and wasted, respectively in Ethiopia. The highest prevalence of wasting occurs in young children (6–23 months), however literature are limited in these population groups. Therefore, this study aimed to assess stunting, wasting and associated factors among children aged 6–24 months in Dabat Health and Demographic Surveillance System (HDSS) site, northwest Ethiopia.

Methods

A community based cross-sectional study was conducted in Dabat HDSS site from May 01 to June 29, 2015. A total of 587 mother-child pairs were included in the study. A multivariate logistic regression analysis was carried out to identify factors associated with stunting and wasting, separately.

Results

The prevalence of stunting and wasting among children aged 6–24 months were 58.1 and 17.0%, respectively. Poor wealth status [Adjusted Odds Ratio (AOR) = 2.20; 95% Confidence Interval (CI): 1.42, 3.40], unavailability of latrine [AOR = 1.76; 95% CI: 1.17, 2.66], child age: 12–24 months [AOR = 3.24; 95% CI: 2.24, 4.69], not receiving maternal postnatal vitamin-A supplementation [AOR = 1.54; 95%: 1.02, 2.33] and source of family food: own food production [AOR = 1.71; 95% CI: 1.14, 2.57] were significantly associated with higher odds of stunting. However, only history of diarrheal morbidity was significantly associated with wasting [AOR = 2.06; 95% CI: 1.29, 3.30].

Conclusions

In this community, the magnitude of stunting and wasting exists as a severe public health concern. Therefore, improving socio-economic status, latrine and maternal postnatal vitamin-supplementation coverage are essential to mitigate the high burden of stunting. Besides, reducing the childhood diarrheal morbidity as well as strengthening early diagnosis and management of the problem are crucial to curve the high prevalence of wasting.
Literature
1.
de Onis M, Blössner M. WHO global database on child growth and malnutrition. Geneva: Programme of Nutrition (WHO); 1997. p. 447–8.
2.
Smith LC, Haddad LJ. Overcoming child malnutrition in developing countries: past achievements and future choices. Intl Food Policy Res Inst. 2000;30:1–6.
3.
Central Statistical Authority [Ethiopia] and ORC Macro. Mini Ethiopia demographic and health survey 2014. Addis Ababa. Maryland: Ethiopia and Calverton; 2014.
4.
Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, De Onis M, Ezzati M, Grantham-McGregor S, Katz J, Martorell R. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet. 2013;382(9890):427–51.CrossRefPubMed
5.
De Onis M, Brown D, Blossner M, Borghi E: Levels and trends in child malnutrition. UNICEF-WHO-the World Bank joint child malnutrition estimates. 2012.
6.
UNICEF. The state of the world's children 2007: women and children: the double dividend of gender equality. New York: UNICEF; 2006.
7.
Pollitt E, Gorman KS, Engle PL, Martorell R, Rivera J, Wachs TD, Scrimshaw NS. Early supplementary feeding and cognition: effects over two decades. Monogr Soc Res Child Dev. 1993;58(7):i-118.
8.
Moock PR, Leslie J. Childhood malnutrition and schooling in the Terai region of Nepal. J Dev Econ. 1986;20(1):33–52.CrossRef
9.
Grantham-McGregor S, Cheung YB, Cueto S, Glewwe P, Richter L, Strupp B, Group ICDS. Developmental potential in the first 5 years for children in developing countries. Lancet. 2007;369(9555):60–70.CrossRefPubMedPubMedCentral
10.
Olofin I, McDonald CM, Ezzati M, Flaxman S, Black RE, Fawzi WW, Caulfield LE, Danaei G, Study NIM. Associations of suboptimal growth with all-cause and cause-specific mortality in children under five years: a pooled analysis of ten prospective studies. PLoS One. 2013;8(5):e64636.CrossRefPubMedPubMedCentral
11.
McDonald CM, Olofin I, Flaxman S, Fawzi WW, Spiegelman D, Caulfield LE, Black RE, Ezzati M, Danaei G. The effect of multiple anthropometric deficits on child mortality: meta-analysis of individual data in 10 prospective studies from developing countries. Am J Clin Nutr. 2013;97(4):896–901.CrossRefPubMed
12.
Black RE, Allen LH, Bhutta ZA, Caulfield LE, De Onis M, Ezzati M, Mathers C, Rivera J, Maternal, Group CUS. Maternal and child undernutrition: global and regional exposures and health consequences. Lancet. 2008;371(9608):243–60.CrossRefPubMed
13.
Soon BT. The global action report on preterm birth: Eds. Howson CP, Kinney MV, Lawn JE. March of Dimes, PMNCH, save the children. New York: World Health Organization; 2012.
14.
Shekar M, Heaver R, Lee Y-K. Repositioning nutrition as central to development: A strategy for large scale action. Washington DC: World Bank Publications; 2006.
15.
World Health Organization. Global strategy for infant and young child feeding: UNICEF. Singapore: World Health Organization; 2003.
16.
17.
Getahun Z, Urga K, Genebo T, Nigatu A. Review of the status of malnutrition and trends in Ethiopia. Ethiop J Health Dev. 2001;15(2):55–74.CrossRef
18.
Kumar D, Goel N, Mittal PC, Misra P. Influence of infant-feeding practices on nutritional status of under-five children. Indian J Pediatr. 2006;73(5):417–21.CrossRefPubMed
19.
Asfaw M, Wondaferash M, Taha M, Dube L. Prevalence of undernutrition and associated factors among children aged between six to fifty nine months in Bule Hora district, South Ethiopia. BMC Public Health. 2015;15(1):1.CrossRef
20.
Disha A, Rawat R, Subandoro A, Menon P. Infant and young child feeding (IYCF) practices in Ethiopia and Zambia and their association with child nutrition: analysis of demographic and health survey data. Afr J Food Agric Nutr Dev. 2012;12(2):5895–914.
21.
Agho KE, Inder KJ, Bowe SJ, Jacobs J, Dibley MJ. Prevalence and risk factors for stunting and severe stunting among under-fives in North Maluku province of Indonesia. BMC Pediatr. 2009;9(1):1.CrossRef
22.
Bwalya BB, Lemba M, Mapoma CC, Mutombo N. Factors associated with stunting among children aged 6-23 months in Zambian: evidence from the 2007 Zambia demographic and health survey. Int J Adv Nutr Health Sci. 2015;3(1):116–31.
23.
Agedew E, Chane T. Prevalence of stunting among children aged 6–23 months in Kemba Woreda, Southern Ethiopia: a community based cross-sectional study. Adv Public Health. 2015;2015:1–6.
24.
Tamiru MW, Tolessa BE, Abera SF. Under nutrition and associated factors among under-five age children of Kunama Ethnic Groups in Tahtay Adiyabo Woreda, Tigray Regional State, Ethiopia: Community Based Study; 2015.
25.
Tiwari R, Ausman LM, Agho KE. Determinants of stunting and severe stunting among under-fives: evidence from the 2011 Nepal demographic and health survey. BMC Pediatr. 2014;14(1):1.CrossRef
26.
Vitolo MR, Gama CM, Bortolini GA, Campagnolo PD, MDL D. Some risk factors associated with overweight, stunting and wasting among children under 5 years old. J Pediatr. 2008;84(3):251–7.CrossRef
27.
SM Mostafa Kamal: Socio-economic determinants of severe and moderate stunting among under-five children of rural Bangladesh. 2011.
28.
Chirande L, Charwe D, Mbwana H, Victor R, Kimboka S, Issaka AI, Baines SK, Dibley MJ, Agho KE. Determinants of stunting and severe stunting among under-fives in Tanzania: evidence from the 2010 cross-sectional household survey. BMC Pediatr. 2015;15(1):1.CrossRef
29.
Onsa ZO, Ahmed NMK. Impact of exclusive breast feeding on the growth of Sudanese children (0-24 months). Pak J Nutr. 2014;13(2):99.CrossRef
30.
Sreedhara M, Banapurmath C. A study of nutritional status of infants in relation to their complementary feeding practices. Nature. 2013;4:9.
31.
Engle PL, Menon P, Haddad L. Care and nutrition: concepts and measurement. World Dev. 1999;27(8):1309–37.CrossRef
32.
Bantamen G, Belaynew W, Dube J. Assessment of factors associated with malnutrition among under five years age children at Machakel Woreda, Northwest Ethiopia: a case control study. J Nutr Food Sci. 2014;4:1.
33.
Ayana AB, Hailemariam TW, Melke AS. Determinants of acute malnutrition among children aged 6–59 months in public hospitals, Oromia region, West Ethiopia: a case–control study. BMC Nutr. 2015;1(1):1.CrossRef
34.
Amsalu S, Tigabu Z. Risk factors for severe acute malnutrition in children under the age of five: a case control study. Ethiop J Health Dev. 2008;22:21.CrossRef
35.
Gebretsadik A, Worku A, Berhane Y, Morries L, Cassano P, Henderson T, Stalker C, Elander J. Factors associated with acute respiratory infection in children under the age of 5 years: evidence from the 2011 Ethiopia demographic and health survey [corrigendum]. Neuropsychiatr Dis Treat. 2015(11):2159–75.
36.
Tariku B, Mulugeta A, Tsadik M, Azene G. Prevalence and risk factors of child malnutrition in community based nutrition program implementing and Nonimplementing districts from south East Amhara, Ethiopia. Open Access Libr J. 2014;1(03):1.
37.
Fotso J-C. Urban–rural differentials in child malnutrition: trends and socioeconomic correlates in sub-Saharan Africa. Health Place. 2007;13(1):205–23.CrossRefPubMed
38.
Central Statistical Authority [Ethiopia] and ORC Macro. Ethiopia demographic and health survey 2011. Addis Ababa. Maryland: Ethiopia and Calverton; 2011.
39.
Federal Ministry of Health, Family Health Department Ethiopia. National strategy for infant and young child feeding. Addis Ababa: Federal Ministry of Health, Family Health Department Ethiopia; 2004.
40.
UNICEF. The cost of hunger in Ethiopia. The social and economic impact of child undernourishment in Ethiopia summary report. Addis Ababa: UNICEF; 2014.
41.
Bhutta ZA, Ahmed T, Black RE, Cousens S, Dewey K, Giugliani E, Haider BA, Kirkwood B, Morris SS, Sachdev H. What works? Interventions for maternal and child undernutrition and survival. Lancet. 2008;371(9610):417–40.CrossRefPubMed
42.
43.
Federal Ministry of Health. Ethiopian National Strategy on infant and young child feeding; 2004
44.
World Health Organization: Indicators for assessing infant and young child feeding practices part 3: country profiles. 2010.
45.
World Health Organization, UNICEF: WHO child growth standards and the identification of severe acute malnutrition in infants and children: joint statement by the World Health Organization and the United Nations Children's fund. 2009.
46.
WHO: Nutrition landscape information system (NLIS) country profile indicators: interpretation guide. 2010.
47.
Wanga Y, Tokunaga M, Ikuta S. Factors associated with nutritional status in children aged 6–24 months in Central African Republic-An anthropometric study at health centers in Bangui. J Int Health. 2009;24(4):289–98.
48.
Adeladza A. The influence of socio-economic and nutritional characteristics on child growth in Kwale District of Kenya. Afr J Food Agr Nutr Dev. 2009;9(7):570–90.
49.
Seedhom AE, Mohamed ES, Mahfouz EM. Determinants of stunting among preschool children, Minia, Egypt. Int Public Health Forum. 2014;1(2):6.
50.
Siddiqi A, Hertzman E, Irwin LG, Hertzman C. Early child development: a powerful equalizer. Improving equity in health by addressing social determinants; 2012. p. 115–41.
51.
De Onis M, Blössner M, Borghi E. Prevalence and trends of stunting among pre-school children, 1990–2020. Public Health Nutr. 2012;15(01):142–8.CrossRefPubMed
52.
Ethiopia trade and transformation: Diagnostic trade integration study. Addis Ababa; 2004.
53.
Ali Naser I, Jalil R, Muda W, Manan W, Nik W, Suriati W, Mohd Shariff Z, Abdullah MR. Association between household food insecurity and nutritional outcomes among children in northeastern of peninsular Malaysia. Nutr Res Pract. 2014;8(3):304–11.CrossRefPubMedPubMedCentral
54.
Ubeysekara NH, Jayathissa R, Wijesinghe CJ. Nutritional status and associated feeding practices among children aged 6-24 months in a selected community in Sri Lanka: a cross sectional study. Eur J Prev Med. 2015;3(2–1):15–23.
55.
Reinbott A, Kuchenbecker J, Herrmann J, Jordan I, Muehlhoff E, Kevanna O, Krawinkel M. A child feeding index is superior to WHO IYCF indicators in explaining length-for-age Z-scores of young children in rural Cambodia. Paediatr Int Child Health. 2015;35(2):124–34.CrossRefPubMedPubMedCentral
56.
Ruel MT, Alderman H, Maternal, Group CNS. Nutrition-sensitive interventions and programmes: how can they help to accelerate progress in improving maternal and child nutrition? Lancet. 2013;382:536–51.CrossRefPubMed
57.
Gillespie S, Haddad L, Mannar V, Menon P, Nisbett N, et al. The politics of reducing malnutrition: building commitment and accelerating progress. Lancet. 2013;382:552–69.CrossRefPubMed
58.
Bhutta ZA, Das JK, Rizvi A, Gaffey MF, Walker N, et al. Evidence-based interventions for improvement of maternal and child nutrition: what can be done and at what cost? Lancet. 2013;382:452–77.CrossRefPubMed
59.
Von Braun J, Olofinbiyi T. Famine and food insecurity in Ethiopia “FOOD POLICY FOR DEVELOPING COUNTRIES : THE ROLE OF GOVERNMENT IN THE GLOBAL FOOD SYSTEM”. New York: Cornell University; 2007.
60.
Endalew B, Muche M, Tadesse S: Assessmen of food security situation in Ethiopia: a review Asian Journal of Agricalture Research, 2015.
61.
Victora CG, Vaughan JP, Kirkwood BR, Martines JC, Barcelos LB. Risk factors for malnutrition in Brazilian children: the role of social and environmental variables. Bull World Health Organ. 1986;64(2):299.PubMedPubMedCentral
62.
Getaneh T, Assefa A, Tadesse Z. Protein-energy malnutrition in urban children: prevalence and determinants. Ethiop Med J. 1998;36(3):153–66.PubMed
63.
UNICEF. Strategies of improving nutrition of children and women in developing countries. New York: UNICEF; 1990.
64.
Sommerfelt A, KStewart M: Children’s nutritional status. Demographic and health surveys comparative studies no. 12. Calverton, MD: Macro International. Inc, Zimbabwe 1994.
65.
Mekonnen A, Jones N, Tefera B: Tackling child malnutrition in Ethiopia: do the sustainable development poverty reduction programme's underlying policy assumptions reflect local realities? 2005.
66.
Vitamin A Global Initiative. A strategy for acceleration of progress in combating Vitamin A deficiency. Consensus of an Informal Technical Consultation. New York: UNICEF; 1997.
67.
Ezzati M, Lopez AD, Rodgers A, Murray CJ. Comparative quantification of health risks. Global and regional burden of disease attributable to selected major risk factors Geneva: World Health Organization; 2004. pp. 1987–97.
68.
Pinstrup Andersen P, Burger S, Habicht JP, Peterson K. Protein–energy malnutrition. In: Jamison DT, Mosley WH, Measham AR, Bobadilla JL, editors. Disease control priorities in developing countries. 2nd ed. Oxford (UK): Oxford University Press; 1993. pp. 391-420.
69.
Gebreselassie SG, Gase FE, Deressa MU. Prevalence and correlates of prenatal vitamin a deficiency in rural Sidama, southern Ethiopia. J Health Popul Nutr. 2013;31(2):185.CrossRefPubMedPubMedCentral
70.
Thiombiano-Coulibaly N, Rocquelin G, Eymard-Duvernay S, et al. Effects of early extra fluid and food intake on breast milk consumption and infant nutritional status at 5 months of age in an urban and a rural area of Burkina Faso. Eur J Clin Nutr. 2004;58(1):80–9.CrossRefPubMed
71.
Ricci JA, Becker S. Risk factors for wasting and stunting among children in metro Cebu, 72. 65.Philippines. Am J Clin Nutr. 1996;63(6):966–75.PubMed
72.
Ahmed T, Ali M, Ullah MM, Choudhury IA, Haque ME, Salam MA, Rabbani GH, Suskind RM, Fuchs GJ. Mortality in severely malnourished children with diarrhoea and use of a standardised management protocol. Lancet. 1999;353(9168):1919–22.CrossRefPubMed
73.
Tessema F, Asefa M, Ayele F. Mothers’ health services utilization and health care seeking behaviour during infant rearing: a longitudinal community based study, south west Ethiopia. Ethiop J Health Dev. 2002;16:51–8.CrossRef
74.
Olango P, Aboud F. Determinants of mothers’ treatment of diarrhea in rural Ethiopia. Soc Sci Med. 1990;31:1245–9.CrossRefPubMed
Metadata
Title
Stunting, wasting and associated factors among children aged 6–24 months in Dabat health and demographic surveillance system site: A community based cross-sectional study in Ethiopia
Authors
Terefe Derso
Amare Tariku
Gashaw Andargie Biks
Molla Mesele Wassie
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2017
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-017-0848-2

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