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Torres MF, Garraza M, Quintero FA, Luna ME, Navazo B, Cesani MF. Decline in pubertal timing and its relationship with excess weight. A study of the secular trend in age at menarche in girls from La Plata district (Buenos Aires, Argentina). Am J Hum Biol 2024; 36:e24074. [PMID: 38517122 DOI: 10.1002/ajhb.24074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 02/29/2024] [Accepted: 03/12/2024] [Indexed: 03/23/2024] Open
Abstract
OBJECTIVE To provide information on the secular trend in age at menarche (AgM) in Argentinean girls in relation to excess weight (EW) and body adiposity. METHODS Two cohorts (C) (C1, 2005-2007 and C2, 2015-2019) of children aged 8-14 years from La Plata district were studied using identical methodological criteria. Each participating child was asked about menarche (M) status: M presence (MP) or absence (MA). The AgM was estimated using the status quo method and logistic regression analysis. Body weight, height, and tricipital and subscapular skinfolds were collected to estimate EW (overweight + obesity) according to WHO criteria, and body adiposity (sum of skinfolds, SSK = [tricipital + subscapular]). The prevalence of EW by C was estimated and compared using the Chi-square test. The MP probability in relation to age, C, and EW was analyzed by applying logistic regression. Parents completed a questionnaire to assess family socioeconomic conditions. Data were compared using the Chi-square test. RESULTS Differences in MP prevalence between C were significant (C1: 21.1% vs. C2: 28.7%). Median AgM was 12.81 years in C1 and 12.22 in C2. The prevalence of EW was higher in C2 (35.3%) than in C1 (24.6%). The probability of MP was higher in C2 than in C1 and children with EW. Both BMI and SSK showed inter-cohort increases. Socioeconomic conditions were substantially deteriorated between C. CONCLUSION In an obesogenic context marked by the significant increase in body adiposity and EW, M prevalence exhibited a positive secular trend and AgM reduced by nearly seven months between the cohorts studied.
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Affiliation(s)
- María Fernanda Torres
- Instituto de Ciencias Antropológicas (ICA), Facultad de Filosofía y Letras (FFyL), Universidad de Buenos Aires (UBA), Buenos Aires, Argentina
- Instituto de Genética Veterinaria (IGEVET, CONICET LA PLATA-UNLP), Facultad de Ciencias Veterinarias, Universidad Nacional de La Plata, La Plata, Argentina
- Laboratorio de Investigaciones en Ontogenia y Adaptación (LINOA), Facultad de Ciencias Naturales y Museo, Universidad Nacional de La Plata, La Plata, Argentina
| | - Mariela Garraza
- Laboratorio de Investigaciones en Ontogenia y Adaptación (LINOA), Facultad de Ciencias Naturales y Museo, Universidad Nacional de La Plata, La Plata, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Fabián Aníbal Quintero
- Laboratorio de Investigaciones en Ontogenia y Adaptación (LINOA), Facultad de Ciencias Naturales y Museo, Universidad Nacional de La Plata, La Plata, Argentina
| | - María Eugenia Luna
- Laboratorio de Investigaciones en Ontogenia y Adaptación (LINOA), Facultad de Ciencias Naturales y Museo, Universidad Nacional de La Plata, La Plata, Argentina
| | - Bárbara Navazo
- Laboratorio de Investigaciones en Ontogenia y Adaptación (LINOA), Facultad de Ciencias Naturales y Museo, Universidad Nacional de La Plata, La Plata, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - María Florencia Cesani
- Laboratorio de Investigaciones en Ontogenia y Adaptación (LINOA), Facultad de Ciencias Naturales y Museo, Universidad Nacional de La Plata, La Plata, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
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Ayres A, Dawed YA, Wedajo S, Alene TD, Gedefie A, Getahun FB, Muche A. Anthropometric failures and its predictors among under five children in Ethiopia: multilevel logistic regression model using 2019 Ethiopian demographic and health survey data. BMC Public Health 2024; 24:1149. [PMID: 38658941 PMCID: PMC11044359 DOI: 10.1186/s12889-024-18625-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 04/16/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Composite Index of Anthropometric Failure (CIAF) combines all three forms of anthropometric failures to assess undernutrition status of children. There is no study on CIAF to identify the real and severe form of under nutrition among Ethiopian children that addressed community level factors. So, this study determined CIAF and identified important factors which helps to design appropriate intervention strategies by using multi-level advanced statistical model. METHODS The study included 5,530 under five children and utilized a secondary data (EMDHS 2019) which was collected through community-based and cross-sectionally from March 21 to June 28, 2019. Composite index of anthropometric failure among under five children was assessed and a two-stage sampling technique was used to select the study participants. Descriptive summary statistics was computed. A multi-level binary logistic regression model was employed to identify important predictors of CIAF in under five children. Adjusted odds ratio with its 95% CI was estimated and level of significance 0.05 was used to determine significant predictors of CIAF. RESULTS The prevalence of composite index of anthropometric failure (CIAF) was 40.69% (95% CI: 39.41, 42.00) in Ethiopia. Both individual and community level predictors were identified for CIAF in under five children. Among individual level predictors being male sex, older age, short birth interval, from mothers who have not formal education, and from poor household wealth quintile were associated with higher odds of CIAF among under five children. Low community women literacy and being from agriculturally based regions were the community level predictors that were associated with higher odds of CIAF in under five children in Ethiopia. CONCLUSIONS The burden of composite index of anthropometric failure in under five children was high in Ethiopia. Age of child, sex of child, preceding birth interval, mother's education, household wealth index, community women literacy and administrative regions of Ethiopia were identified as significant predictors of CIAF. Therefore, emphasis should be given for those factors to decrease the prevalence of CIAF in under five children in Ethiopia.
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Affiliation(s)
- Aznamariam Ayres
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
| | - Yeshimebet Ali Dawed
- Department of Nutrition, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Shambel Wedajo
- School of Public Health, CMHS, Wollo University, Dessie, Ethiopia
| | - Tilahun Dessie Alene
- Department of Paediatrics, School of Medicine, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Alemu Gedefie
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Fekadeselassie Belege Getahun
- Department of Paediatrics Neonatal & Child Health, School of Nursing and Midwifery, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Amare Muche
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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Ahmmed F, Hasan MN, Hossain MF, Khan MTF, Rahman MM, Hussain MP, Hossain MJ. Association between short birth spacing and child malnutrition in Bangladesh: a propensity score matching approach. BMJ Paediatr Open 2024; 8:e002240. [PMID: 38499349 PMCID: PMC10953308 DOI: 10.1136/bmjpo-2023-002240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 03/04/2024] [Indexed: 03/20/2024] Open
Abstract
OBJECTIVES This study aimed to explore the effects of short birth spacing (SBS), which is defined as a period of less than 33 months between two successive births, on multiple concurrent forms of child malnutrition (MCFCM) and at least one form of child malnutrition (ALOFCM) using propensity score matching (PSM). METHODS This study used data extracted from the 2017-18 Bangladesh Demographic and Health Survey. PSM with four different distance functions, including logistic regression, classification and regression tree, single hidden layer neural network and random forest, were performed to evaluate the effects of SBS on MCFCM and ALOFCM. We also explored how the effects were modified in different subsamples, including women's empowerment, education and economic status (women's 3E index)-constructed based on women's decision-making autonomy, education level, and wealth index, and age at marriage, and place of residence. RESULTS The prevalence of SBS was 22.16% among the 4652 complete cases. The matched samples of size 2062 generated by PSM showed higher odds of MCFCM (adjusted OR (AOR)=1.25, 95% CI=1.02 to 1.56, p=0.038) and ALOFCM (AOR=1.20, 95% CI=1.01 to 1.42, p=0.045) for the SBS children compared with their counterparts. In the subsample of women with 3E index≥50% coverage, the SBS children showed higher odds of MCFCM (AOR: 1.43, 95% CI=1.03 to 2.00, p=0.041] and ALOFCM (AOR: 1.33, 95% CI=1.02 to 1.74, p=0.036). Higher odds of MCFCM (AOR=1.27, 95% CI=1.02 to 1.58, p=0.036) and ALOFCM (AOR=1.23, 95% CI=1.02 to 1.51, p=0.032) for SBS children than normal children were also evident for the subsample of mothers married at age≤18 years. CONCLUSION SBS was significantly associated with child malnutrition, and the effect was modified by factors such as women's autonomy and age at marriage.
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Affiliation(s)
- Foyez Ahmmed
- Department of Statistics, Comilla University, Cumilla, Bangladesh
- Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, KS, USA
| | - Md Nahid Hasan
- Department of Statistics, University of Dhaka, Dhaka, Bangladesh
- Department of Mathematics, Texas A&M University-Commerce, Commerce, Texas, USA
| | - Md Faruk Hossain
- Institute of Statistical Research and Training, University of Dhaka, Dhaka, Bangladesh
| | - Md Tareq Ferdous Khan
- Department of Mathematics and Statistics, Cleveland State University, Cleveland, OH, USA
| | - Mohammod Mahmudur Rahman
- Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, KS, USA
- Department of Statistics, University of Dhaka, Dhaka, Bangladesh
| | - Md Parvej Hussain
- Department of Economics, University of Chittagong, Chittagong, Bangladesh
| | - Md Jamal Hossain
- Department of Pharmacy, School of Pharmaceutical Sciences, State University of Bangladesh, Dhaka, Bangladesh
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Fenta HM, Zewotir T, Muluneh EK. Spatial regression models to assess variations of composite index for anthropometric failure across the administrative zones in Ethiopia. PLoS One 2024; 19:e0282463. [PMID: 38416735 PMCID: PMC10901317 DOI: 10.1371/journal.pone.0282463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 02/15/2023] [Indexed: 03/01/2024] Open
Abstract
BACKGROUND There are a number of previous studies that investigated undernutrition and its determinants in Ethiopia. However, the national average in the level of undernutrition conceals large variation across administrative zones of Ethiopia. Hence, this study aimed to determine the geographic distribution of composite index for anthropometric failure (CIAF) and identify the influencing factors it' might be more appropriate. METHODS We used the zonal-level undernutrition data for the under-five children in Ethiopia from the Ethiopian Demographic and Health Survey (EDHS) dataset. Different spatial models were applied to explore the spatial distribution of the CIAF and the covariates. RESULTS The Univariate Moran's I statistics for CIAF showed spatial heterogeneity of undernutrition in Ethiopian administrative zones. The spatial autocorrelation model (SAC) was the best fit based on the AIC criteria. Results from the SAC model suggested that the CIAF was positively associated with mothers' illiteracy rate (0.61, pvalue 0.001), lower body mass index (0.92, pvalue = 0.023), and maximum temperature (0.2, pvalue = 0.0231) respectively. However, the CIAF was negatively associated with children without any comorbidity (-0.82, pvalue = 0.023), from families with accessibility of improved drinking water (-0.26, pvalue = 0.012), and minimum temperature (-0.16). CONCLUSION The CIAF across the administrative zones of Ethiopia is spatially clustered. Improving women's education, improving drinking water, and improving child breast feeding can reduce the prevalence of undernutrition (CIAF) across Ethiopian administrative zones. Moreover, targeted intervention in the geographical hotspots of CIAF can reduce the burden of CIAF across the administrative zones.
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Affiliation(s)
- Haile Mekonnen Fenta
- Department of Statistics, College of Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Temesgen Zewotir
- School of Mathematics, Statistics and Computer Science, University of KwaZulu-Natal, Durban, South Africa
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Salazar Burgos RJ, Longhi HF, Marrodán Serrano MD. Composite indexes of anthropometric failure in children under 5 years of age in Argentina: Comparative analysis among regions: 2019-2020. Am J Hum Biol 2024; 36:e23994. [PMID: 37747256 DOI: 10.1002/ajhb.23994] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 09/01/2023] [Accepted: 09/09/2023] [Indexed: 09/26/2023] Open
Abstract
OBJECTIVES Composite Index of Anthropometric Failure (CIAF) and Extended CIAF (ECIAF) allow for the identification of simultaneous presence of two or more types of malnutrition. The objective of this study was to analyze anthropometric failure in Argentinean children under 5 years old, taking into consideration regional and socioeconomic perspectives. MATERIALS AND METHODS Data from the National Survey of Children and Adolescents MICS 2019-2020 were used, which included 5473 children under 5 years old of both sexes residing in the six regions of Argentina. CIAF and ECIAF excludes children not in anthropometric failure (group A) and was calculated from a percentage of children included in malnutrition categories B: wasting only; C: wasting and underweight; D: wasting, stunting, and underweight; E: stunting and underweight; F: stunting only; Y: underweight only; G: only weight excess; and H: stunting and weight excess. The data were analyzed according to region and wealth quintile. RESULTS In children aged 0-2.99 years, CIAF was 12.5% and ECIAF was 27.7%, with boys being more affected. In children aged 3-4.99 years, the rates were 9.7% and 22.3%, respectively, with girls showing a higher prevalence. The highest ECIAF was recorded in the Patagonia region (31.3%), while the highest ECIAF was observed in the poorest quintile. DISCUSSION The presence of double burden of malnutrition has been observed across all regions and household income levels. Additionally, overweight has shown a higher intensity in economically prosperous regions and households, while stunting has been more prevalent in economically disadvantaged areas.
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Affiliation(s)
- Ramiro Joaquín Salazar Burgos
- Escuela Universitaria de Enfermería, Facultad de Medicina, Universidad Nacional de Tucumán (UNT), Tucumán, Argentina
- Instituto de Investigaciones Territoriales y Tecnologicas para la Produccion del Hábitat (INTEPH), CONICET-Universidad Nacional de Tucumán, Tucumán, Argentina
| | - Hugo Fernando Longhi
- Insituto Superior de Estudios Sociales (ISES), CONICET-Universidad Nacional de Tucumán, Tucumán, Argentina
- Facultad de Humanidades, Ciencias Sociales y de la Salud, Universidad Nacional de Santiago de Estero (UNSE), Santiago del Estero, Argentina
| | - María Dolores Marrodán Serrano
- Grupo de Investigación EPINUT, Universidad Complutense de Madrid, Madrid, Spain
- Departamento de Biodiversidad, Ecología y Evolución, Universidad Complutense de Madrid, Madrid, Spain
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Saif S, Anwar S. Unraveling the South Asian enigma: concurrent manifestations of child anthropometric failures and their determinants in selected South Asian countries. BMC Nutr 2023; 9:120. [PMID: 37904239 PMCID: PMC10614331 DOI: 10.1186/s40795-023-00771-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 09/28/2023] [Indexed: 11/01/2023] Open
Abstract
Malnutrition among children is pervasive in South Asia and there are also reports of overnutrition. To better understand this phenomenon, we need a composite measure. However, the existing measures such as CIAF (Composite Index of Anthropometric Failure) and its revised version have ignored the overnutrition aspect of the phenomenon. This study proposes an extended version of CIAF which also considers overnutrition. This new measure was compared with the existing measures by using data from 1990 to 2018 for three selected South Asian countries including Pakistan, India and Bangladesh. We also examined the effects of socioeconomic and environmental variables on the outcome variable. The results reveal that the new measure (ECIAF) is better at measuring the phenomena. The burden of overall malnutrition has been decreased in the region. However, an increase in the concomitant prevalence of wasting and underweight is observed in both Pakistan and India and stunting and overweight is observed only in India. Besides, political stability, prevalence of undernourishment, anemia in children, mother's education, household size, dependency ratio, air pollution and unimproved sanitation are significantly correlated with childhood malnutrition. The findings also testified to long-run cointegrating relationship among the variables.
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Affiliation(s)
- Sabeen Saif
- Department of Economics, Government College University, Faisalabad, Pakistan.
| | - Sofia Anwar
- Department of Economics, Government College University, Faisalabad, Pakistan
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Andrade LD, Vilca NG, Figueroa MI, Martínez JI, Alfaro Gómez EL, Dipierri JE. Somatotype altitudinal variation and its relationship with the nutritional status of children in the Jujuy province, Argentina. Am J Hum Biol 2023; 35:e23910. [PMID: 37171254 DOI: 10.1002/ajhb.23910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 04/26/2023] [Accepted: 04/27/2023] [Indexed: 05/13/2023] Open
Abstract
OBJECTIVES To study the somatotype variations adjusted by altitude, age, sex, and BMI categories, and to assess the health status of the children population. METHODS A sample of 460 children aged 8-13 years was assessed in a cross-sectional study conducted on anthropometric measurements between 2011 and 2015. Data were categorized into two age groups: Group 8-10, Group 11-13 and two altitudes: Highland (>2000 masl), lowland (<2000 masl). The somatotypic profile was determined by the Heath and Carter's study method and the Body Mass Index was used to assess children nutritional status. Generalized linear latent variable models (GLLVM) were performed to test the association between somatotype and geographic altitude. Individual age-sex specific somatotypes were plotted in a two-dimension somatochart, and group dispersion was displayed by the somatotype attitudinal mean. RESULTS The sample has an overall endomorph-mesomorph body type, exhibiting different patterns when altitude and sex were considered. The GLLVM showed that the whole somatotype was different by altitude. Highland children occupied central to endomorphic-mesomorphic places in the somatochart with lower variation. In both altitudes, girls exhibited higher endomorphy than boys. Several discrepancies between the BMI categorization and the somatotype were observed. CONCLUSIONS Jujenean children show differential body patterns across geographic altitude which exhibit age and sex variations. Children have a differential tendency to a fat mass gain. The BMI showed some inconsistencies with somatotype, leading to a misclassification of the child nutritional status, this highlights the importance of not to treat the BMI in isolation but with other determinants of the health status.
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Affiliation(s)
- Lautaro D Andrade
- Instituto de Ecorregiones Andinas (INECOA), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), San Salvador de Jujuy, Argentina
- Instituto de Biología de la Altura (INBIAL), Universidad Nacional de Jujuy, San Salvador de Jujuy, Argentina
| | - Noelia G Vilca
- Instituto de Ecorregiones Andinas (INECOA), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), San Salvador de Jujuy, Argentina
- Instituto de Biología de la Altura (INBIAL), Universidad Nacional de Jujuy, San Salvador de Jujuy, Argentina
| | - Marcelo I Figueroa
- Instituto de Ecorregiones Andinas (INECOA), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), San Salvador de Jujuy, Argentina
- Hospital Materno Infantil "Dr. Héctor Quintana", San Salvador de Jujuy, Argentina
| | - Jorge I Martínez
- Instituto de Ecorregiones Andinas (INECOA), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), San Salvador de Jujuy, Argentina
- Instituto de Biología de la Altura (INBIAL), Universidad Nacional de Jujuy, San Salvador de Jujuy, Argentina
| | - Emma L Alfaro Gómez
- Instituto de Ecorregiones Andinas (INECOA), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), San Salvador de Jujuy, Argentina
- Instituto de Biología de la Altura (INBIAL), Universidad Nacional de Jujuy, San Salvador de Jujuy, Argentina
| | - José E Dipierri
- Instituto de Ecorregiones Andinas (INECOA), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), San Salvador de Jujuy, Argentina
- Hospital Materno Infantil "Dr. Héctor Quintana", San Salvador de Jujuy, Argentina
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Kuwornu JP, Amoyaw J, Manyanga T, Cooper EJ, Donkoh E, Nkrumah A. Measuring the Overall Burden of Early Childhood Malnutrition in Ghana: A Comparison of Estimates From Multiple Data Sources. Int J Health Policy Manag 2022; 11:1035-1046. [PMID: 33589568 PMCID: PMC9808187 DOI: 10.34172/ijhpm.2020.253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 12/09/2020] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Childhood malnutrition contributes to nearly half (45%) of all deaths among children under 5 globally. The United Nations' Sustainable Development Goals (SDGs) aims to end all forms of malnutrition by 2030; however, measuring progress towards these goals is challenging, particularly in countries with emerging economies where nationally-representative data are limited. The primary objective of this study was to estimate the overall burden of childhood malnutrition in Ghana at national and regional levels using 3 data sources. METHODS Using data from the long-standing Ghana Demographic and Health Surveys (GDHS), Ghana Multiple Indicator Cluster Survey (GMICS), and the emerging Ghana Socioeconomic Panel Survey (GSPS), we compared the prevalence of malnutrition using the extended composite index of anthropometric failure (eCIAF) for the period 2008- 2011. This study included data for children aged 6-59 months and calculated all anthropometric z-scores based on the World Health Organization (WHO) Growth Standards. We tested for differences in malnutrition subtypes using two-group configural frequency analysis (CFA). RESULTS Of the 10 281 children (6532 from GMICS, 2141 from GDHS and 1608 from GSPS) included in the study, the only demographic difference observed was the children included in the GSPS were slightly older than those included in the GDHS and GMICS (median age of 36 vs 30 vs 33 months, P<.001). Based on the eCIAF, the overall prevalence of malnutrition at the national level was higher among children in the GSPS (57.3%, 95% CI: 53.9%-60.6%), followed by the GDHS (39.7%, 95% CI: 37.0%-42.5%), and then those in the GMICS (31.2%, 95% CI: 29.3%-33.1%). The two-group CFA showed that the 3 data sources also estimated different prevalence rates for most of the malnutrition subtypes included in the eCIAF. CONCLUSION Depending on the data source adopted, our estimates of eCIAF showed that between one-third and half of all Ghanaian children aged 6-59 months had at least one form of malnutrition over the period 2008-2011. These eCIAF estimates should complement the commonly reported measures such as stunting and wasting when interpreting the severity of malnutrition in the country to inform policy decisions.
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Affiliation(s)
- John Paul Kuwornu
- Research Department, Saskatchewan Health Authority, Regina, SK, Canada
| | - Jonathan Amoyaw
- Department of Sociology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Taru Manyanga
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Elizabeth J. Cooper
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK, Canada
| | - Elvis Donkoh
- Department of Mathematics and Statistics, University of Energy and Natural Resources, Sunyani, Ghana
| | - Amos Nkrumah
- Department of Sociology & Anthropology, Mount Saint Vincent University, Halifax, NS, Canada
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Cesani MF, Garraza M, Zonta ML, Torres MF, Navazo B, Bergel Sanchís ML, Luna ME, Gauna ME, Quintero FA. Changes in the prevalence of undernutrition, overweight and obesity in children and adolescents from Buenos Aires, Mendoza, and Misiones provinces (Argentina) over the last two decades. Am J Hum Biol 2022; 34:e23755. [DOI: 10.1002/ajhb.23755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 04/12/2022] [Accepted: 04/13/2022] [Indexed: 11/09/2022] Open
Affiliation(s)
- María F. Cesani
- Laboratorio de Investigaciones en Ontogenia y Adaptación (LINOA), Facultad de Ciencias Naturales y Museo (FCNyM) Universidad Nacional de La Plata (UNLP) La Plata Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) La Plata Argentina
| | - Mariela Garraza
- Laboratorio de Investigaciones en Ontogenia y Adaptación (LINOA), Facultad de Ciencias Naturales y Museo (FCNyM) Universidad Nacional de La Plata (UNLP) La Plata Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) La Plata Argentina
| | - María L. Zonta
- Centro de Estudios Parasitológicos y de Vectores (CEPAVE) (CONICET‐UNLP) La Plata Argentina
| | - María F. Torres
- Instituto de Genética Veterinaria (IGEVET) (CONICET‐UNLP) La Plata Argentina
- Instituto de Ciencias Antropológicas (ICA), Facultad de Filosofía y Letras (FFyL) Universidad de Buenos Aires (UBA) Ciudad Autónoma de Buenos Aires Argentina
| | - Bárbara Navazo
- Laboratorio de Investigaciones en Ontogenia y Adaptación (LINOA), Facultad de Ciencias Naturales y Museo (FCNyM) Universidad Nacional de La Plata (UNLP) La Plata Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) La Plata Argentina
| | - María L. Bergel Sanchís
- Departamento de Salud Comunitaria Universidad Nacional de Lanús (UNLa) Lanús Argentina
- Centro de Estudios en Nutrición y Desarrollo Infantil (CEREN) Comisión de Investigaciones Científicas de la Provincia de Buenos Aires (CIC‐PBA) La Plata Argentina
| | - María E. Luna
- Laboratorio de Investigaciones en Ontogenia y Adaptación (LINOA), Facultad de Ciencias Naturales y Museo (FCNyM) Universidad Nacional de La Plata (UNLP) La Plata Argentina
| | - María E. Gauna
- Laboratorio de Investigaciones en Ontogenia y Adaptación (LINOA), Facultad de Ciencias Naturales y Museo (FCNyM) Universidad Nacional de La Plata (UNLP) La Plata Argentina
| | - Fabián A. Quintero
- Laboratorio de Investigaciones en Ontogenia y Adaptación (LINOA), Facultad de Ciencias Naturales y Museo (FCNyM) Universidad Nacional de La Plata (UNLP) La Plata Argentina
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Chowdhury MRK, Khan HTA, Rashid M, Kabir R, Islam S, Shariful Islam M, Kader M. Differences in risk factors associated with single and multiple concurrent forms of undernutrition (stunting, wasting or underweight) among children under 5 in Bangladesh: a nationally representative cross-sectional study. BMJ Open 2021; 11:e052814. [PMID: 34903543 PMCID: PMC8672009 DOI: 10.1136/bmjopen-2021-052814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES The study aims to differentiate the risk factors of single and multiple concurrent forms of undernutrition among children under 5 in Bangladesh. DESIGN A nationally representative cross-sectional study. SETTING Bangladesh. RESPONDENTS Children age under 5 years of age. OUTCOME MEASURE This study considered two dichotomous outcomes: single form (children without single form and with single form) and multiple concurrent forms (children without multiple forms and with multiple forms) of undernutrition. STATISTICAL ANALYSIS Adjusted OR (AOR) and CI of potential risk factors were calculated using logistic regression analysis. RESULTS Around 38.2% of children under 5 in Bangladesh are suffering from undernutrition. The prevalence of multiple concurrent forms and single form of child undernutrition was 19.3% and 18.9%, respectively. The key risk factors of multiple concurrent forms of undernutrition were children born with low birth weight (AOR 3.76, 95% CI 2.78 to 5.10); children in the age group 24-35 months (AOR 2.70, 95% CI 2.20 to 3.30) and in the lowest socioeconomic quintile (AOR 2.57, 95% CI 2.05 to 3.23). In contrast, those children in the age group 24-35 months (AOR 1.94, 95% CI 1.61 to 2.34), in the lowest socioeconomic quintile (AOR 1.79, 95% CI 1.45 to 2.21) and born with low birth weight (AOR 1.52, 95% CI 1.11 to 2.08) were significantly associated with a single form of undernutrition. Parental education, father's occupation, children's age and birth order were the differentiating risk factors for multiple concurrent forms and single form of undernutrition. CONCLUSION One-fifth of children under 5 years of age are suffering multiple concurrent forms of undernutrition, which is similar to the numbers suffering the single form. Parental education, father's occupation, children's age and birth order disproportionately affect the multiple concurrent forms and single form of undernutrition, which should be considered to formulate an evidence-based strategy for reducing undernutrition among these children.
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Affiliation(s)
| | - Hafiz T A Khan
- College of Nursing, Midwifery and Healthcare, University of West London, Brentford, London, UK
| | - Mamunur Rashid
- Department of Public Health and Sports Sciences, University of Gävle, Gavle, Gävleborg, Sweden
| | - Russell Kabir
- School of Allied Health, Faculty of Health, Education, Medicine, and Social Care, Anglia Ruskin University, Chelmsford, London, UK
| | - Sazin Islam
- Department of Public Health, First Capital University of Bangladesh, Chuadanga, Bangladesh
| | - Md Shariful Islam
- Department of Public Health, First Capital University of Bangladesh, Chuadanga, Bangladesh
| | - Manzur Kader
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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Anthropometric failures and its associated factors among preschool-aged children in a rural community in southwest Ethiopia. PLoS One 2021; 16:e0260368. [PMID: 34843555 PMCID: PMC8629177 DOI: 10.1371/journal.pone.0260368] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 11/08/2021] [Indexed: 11/23/2022] Open
Abstract
Background In 2019, 144 million under-five-year-old children were stunted, and 47 million were wasted globally. In Ethiopia, approximately 350,000 children are estimated to die each year. Preschool aged children need focused attention because this age group not only has special needs, but also forms the platform for growth and development of all children. Under nutrition among preschool children is the result of a complex interplay of diverse elements, such as birth weight, household access to food, availability and use of drinking water. This study aimed at determining the anthropometric failures and associated factors using composite indictors. Methods A community-based cross-sectional study design was used among randomly selected 588 caregivers with pre-school aged children. Under-nutrition of pre-school aged children was computed by using the composite index of anthropometric failure. A multi-stage sampling technique followed by a systematic random sampling technique was used to select study participants. Structured questionnaires were used to collect data. WHO Anthro software was used to calculate height for age, weight for age and weight for height. The overall prevalence of anthropometric failure (CIAF). Both bivariable and multivariable binary logistic regressions were used to identify factors associated with under-nutrition. Results The overall prevalence of under-nutrition among pre-school children was 50.8%, which was significantly associated with being a female (AOR = 1.51, CI: 1.076, 2.12), being from a large family (AOR = 1.78, CI: 1.19, 2.663), having acute respiratory infection (AOR = 1.767, CI: 1.216, 2.566), lack of improved source of drinking water (AOR = 1.484 CI: 1.056, 2.085) and poor dietary diversity score (AOR = 1.5, CI: 1.066, 2.112). Conclusions The study area has a high prevalence of CIAF in pre-school aged children. The CIAF was found to be significantly associated with the sex of the child, family size, ARI within the last two weeks, and dietary diversity score. To promote the use of family planning and the prevention of infectious diseases, health education is required. The government should adapt CIAF as a metric for assessing children’s nutritional status.
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Destaw Z, Wencheko E, Zemenfeskidus S, Challa Y, Tiruneh M, Fite MT, Shaleka D, Ashenafi M. Use of modified composite index of anthropometric failure and MUAC-for-age to assess prevalence of malnutrition among school-age children and adolescents involved in the school feeding program in Addis Ababa, Ethiopia. BMC Nutr 2021; 7:81. [PMID: 34836546 PMCID: PMC8620559 DOI: 10.1186/s40795-021-00471-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 10/05/2021] [Indexed: 01/20/2023] Open
Abstract
Background Malnutrition hampers educational performance of schoolchildren coming from low-income families. School feeding program was, thus, launched in public primary schools in Addis Ababa very recently. It is, thus, important to measure the initial nutritional status of participating students to see the effect of the program on their nutritional wellbeing. Methods The first-round survey was made at the initiation of the program. A multi-stage stratified sampling from 50 schools located in the ten sub cities of Addis Ababa yielded 4500 children and adolescents of ages five to 19 years. Data was collected on age, height, weight and MUAC of the schoolchildren. Nutritional status was evaluated using conventional anthropometric indicators, modified Composite Index of Anthropometric Failure (mCIAF), and MUAC-for-age. Receiver Operating Characteristic (ROC) curve was used to examine classification of malnourishment by MUAC-for-age versus BMI-for-age and mCIAF versus MUAC-for-age. Multilevel mixed effects model was applied to investigate variations in the prevalence of malnutrition across sub cities. Findings The area under the ROC curves (AUC) for MUAC-for-age against BMI-for-age z-scores was 0.68 and that of mCIAF against MUAC-for-age was 0.70, respectively, indicating an overall better classification of malnourishment. Mixed effects model showed significant variations in nutritional status of schoolchildren across sub cities. Conventional measures showed that prevalence of stunting, thinness, or underweight among the sample children and adolescents was 23.4, 18.4, and 16.5%, respectively. Assessment by mCIAF, instead, showed a higher prevalence of overall malnutrition (43.4%). MUAC-for-age indicated an acute malnutrition measurement of 33.4%. Significant differences (p < 0.0001) in nutritional status were seen between boys and girls, and among age groups as measured by mCIAF. Interpretation Conventional measures of nutritional status undermined level of malnutrition. Instead, mCIAF and MUAC-for-age gave higher estimates of the magnitude of the existing prevalence of malnutrition among the school children and adolescents.
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Affiliation(s)
- Zelalem Destaw
- Center for Food Security Studies, College of Development Studies, Addis Ababa University, Addis Ababa, Ethiopia
| | - Eshetu Wencheko
- Department of Statistics, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | | | | | | | | | - Dilu Shaleka
- College of Development Studies, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mogessie Ashenafi
- Center for Food Security Studies, College of Development Studies, Addis Ababa University, Addis Ababa, Ethiopia.
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Fenta HM, Zewotir T, Muluneh EK. Spatial data analysis of malnutrition among children under-five years in Ethiopia. BMC Med Res Methodol 2021; 21:232. [PMID: 34706661 PMCID: PMC8549278 DOI: 10.1186/s12874-021-01391-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 08/28/2021] [Indexed: 12/22/2022] Open
Abstract
Background Childhood malnutrition is a major cause of child mortality under the age of 5 in the sub-Saharan Africa region. This study sought to identify the risk factors and spatial distribution of the composite index of anthropometric failure (CIAF). Methods Secondary data from 2000, 2005, 2011, and 2016 Ethiopian Health and Demographic Survey (EDHS) were used. The generalized geo-additive mixed model was adopted via the Integrated Nested Laplace Approximation (INLA) with a binomial family and logit link function. Results The CIAF status of children was found to be positively associated with the male gender, the potency of contracting a disease, and multiple births. However, it was negatively associated with family wealth quartiles, parental level of education, place of residence, unemployment status of mothers, improved sanitation, media exposure, and survey years. Moreover, the study revealed significant spatial variations on the level of CIAF among administrative zones. Conclusions The generalized geo-additive mixed-effects model results identified gender of the child, presence of comorbidity, size of child at birth, dietary diversity, birth type, place of residence, age of the child, parental level of education, wealth index, sanitation facilities, and media exposure as main drivers of CIAF. The results would help decision-makers to develop and carry out target-oriented programs. Supplementary Information The online version contains supplementary material available at 10.1186/s12874-021-01391-x.
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Affiliation(s)
- Haile Mekonnen Fenta
- Department of Statistics, College of Science, Bahir Dar University, Bahir Dar, Ethiopia. .,Department of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
| | - Temesgen Zewotir
- School of Mathematics, Statistics and Computer Science, College of Agriculture Engineering and Science, University of KwaZulu-Natal, Durban, South Africa
| | - Essey Kebede Muluneh
- Department of Statistics, College of Science, Bahir Dar University, Bahir Dar, Ethiopia
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14
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Pedrero-Tomé R, López-Ejeda N, Sánchez Alvarez M, Herrero-Jaúregui C, Acosta Gallo B, Dolores Marrodán M. Household food insecurity and nutritional status of schoolchildren in rural regions of Bajo Lampa, El Salvador (2018-2019). Ecol Food Nutr 2021; 61:128-143. [PMID: 34428106 DOI: 10.1080/03670244.2021.1968851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
In 2018, a cross-sectional study was conducted in six communities of Tecoluca, Bajo Lempa (El Salvador). Weight, height, sitting-height, skinfolds thickness and head, arm, and waist circumferences were measured in a sample of 334 schoolchildren. Nutritional status, body composition, and Extended Composite Index for Anthropometric Failure (ECIAF) were estimated. The Food Security Perception Survey (Spanish acronym: EPSA) was applied to 143 households. Anthropometric failure was observed in 37.5% of the schoolchildren. Association between stunting and underweight in boys and stunting and weight excess in girls was observed. About 58.7% of the households suffered from food insecurity.
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Affiliation(s)
- Roberto Pedrero-Tomé
- Research Group Epinut (Ref 920325), Complutense University of Madrid, Madrid, Spain.,Department of Biodiversity, Ecology and Evolution, Complutense University of Madrid, Madrid, Spain
| | - Noemí López-Ejeda
- Research Group Epinut (Ref 920325), Complutense University of Madrid, Madrid, Spain.,Department of Biodiversity, Ecology and Evolution, Complutense University of Madrid, Madrid, Spain
| | - María Sánchez Alvarez
- Research Group Epinut (Ref 920325), Complutense University of Madrid, Madrid, Spain.,Department of Biodiversity, Ecology and Evolution, Complutense University of Madrid, Madrid, Spain
| | | | - Belén Acosta Gallo
- Department of Biodiversity, Ecology and Evolution, Complutense University of Madrid, Madrid, Spain
| | - María Dolores Marrodán
- Research Group Epinut (Ref 920325), Complutense University of Madrid, Madrid, Spain.,Department of Biodiversity, Ecology and Evolution, Complutense University of Madrid, Madrid, Spain.,Institute of Environmental Sciences (IUCA), Complutense University of Madrid, Madrid, Spain
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15
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Martín-Turrero I, Lescure Rodríguez J, Lora Pablos D, López-Ejeda N, Vargas Brizuela A, Martínez Álvarez JR, Marrodán Serrano MD. Growth patterns of normo-nourished Afghan, Haitian and Congolese children aged 6-59 months: A comparative study. Am J Hum Biol 2021; 34:e23620. [PMID: 34042248 DOI: 10.1002/ajhb.23620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/24/2021] [Accepted: 05/07/2021] [Indexed: 11/11/2022] Open
Affiliation(s)
- Irene Martín-Turrero
- EPINUT Research Group, Department of Biodiversity, Ecology and Evolution, Complutense University of Madrid, Madrid, Spain.,Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, Madrid, Spain
| | - Javier Lescure Rodríguez
- EPINUT Research Group, Department of Biodiversity, Ecology and Evolution, Complutense University of Madrid, Madrid, Spain
| | - David Lora Pablos
- Research Institute Hospital 12 de Octubre (i+12), CIBER Epidemiology and Public Health (CIBERESP), Department of Statistics and Data Science, Faculty of Statistical Studies, Complutense University of Madrid, Madrid, Spain
| | - Noemí López-Ejeda
- EPINUT Research Group, Department of Biodiversity, Ecology and Evolution, Complutense University of Madrid, Madrid, Spain.,NGO, Action Against Hunger, Madrid, Spain
| | | | - Jesús Román Martínez Álvarez
- EPINUT Research Group, Department of Biodiversity, Ecology and Evolution, Complutense University of Madrid, Madrid, Spain
| | - María Dolores Marrodán Serrano
- EPINUT Research Group, Department of Biodiversity, Ecology and Evolution, Complutense University of Madrid, Madrid, Spain.,Institute of Environmental Sciences (IUCA), Complutense University of Madrid, Madrid, Spain
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Bustamante MJ, Alfaro EL, Dipierri JE, Román MD. Excess weight and thinness over two decades (1996-2015) and spatial distribution in children from Jujuy, Argentina. BMC Public Health 2021; 21:196. [PMID: 33482789 PMCID: PMC7821675 DOI: 10.1186/s12889-021-10239-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 01/14/2021] [Indexed: 11/24/2022] Open
Abstract
Background The increase of excess weight around the world is progressive and sustained in children. This is the most prevalent form of malnutrition in this population and they represent the major public health problem in developed and developing countries. The aim of this study was to analyze the magnitude of change in thinness and excess weight prevalence in 4–7 years-old schoolchildren from Jujuy (Argentina), between 1996 and 2015 and to examine the association according to sex and school location. Methods Cross-sectional study. Data was obtained from databases of School Health programs and it is representative of the city school population. For the analysis, 31,014 schoolchildren between 4 and 7 years old were evaluated, 20,224 from the first period (1996–2001) and 10,790 from the second (2010–2015). The city was partitioned in three different areas determined by the rivers that cross it. Nutritional status was determined by BMI for age with the criteria suggested by the International Obesity Task Force. The percentage of malnutrition change between periods was calculated and a binomial regression model was adjusted. Results Between periods, a significant (p-value< 0.0001) increase in the prevalence of overweight from 15.1% (CI 14.6–15.6%) to 18.1% (CI 17.4–18.8%) and obesity from 5% (CI 4.7–5.3) to 10.7% (CI 10.1–11.3%), and a decrease of thinness prevalence from 6.3% (CI 6.0–6.7%) to 4.7% (CI 4.3–5.1%) were observed. The percentage of change in the prevalence of obesity was very high in all areas and in both sexes (103.5% girls; 125.6% in boys), being higher in the south for girls (122.4%) and in the north for boys (158.8%). Besides, being a boy was inversely associated with the presence of excess weight and, as the age increases, the presence of obesity does it too. By analyzing the effect of the school location, the south and north zones had an inverse association with the presence of obesity. The period has a direct association with the presence of excess weight. Conclusion The study contributes with valuable information on the magnitude of the increase in obesity in schoolchildren and suggests a possible correlation with sex and spatial distribution in the capital city of Jujuy.
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Affiliation(s)
- María José Bustamante
- Instituto de Ecorregiones Andinas, Consejo Nacional de Investigaciones Científicas y Técnicas - Universidad Nacional de Jujuy, Avenida Bolivia 1239, CP 4600, San Salvador de Jujuy, Argentina. .,Instituto de Biología de la Altura, Universidad Nacional de Jujuy, 1661 Bolivia Avenue, CP 4600, San Salvador de Jujuy, Argentina.
| | - Emma Laura Alfaro
- Instituto de Ecorregiones Andinas, Consejo Nacional de Investigaciones Científicas y Técnicas - Universidad Nacional de Jujuy, Avenida Bolivia 1239, CP 4600, San Salvador de Jujuy, Argentina.,Instituto de Biología de la Altura, Universidad Nacional de Jujuy, 1661 Bolivia Avenue, CP 4600, San Salvador de Jujuy, Argentina
| | - José Edgardo Dipierri
- Instituto de Biología de la Altura, Universidad Nacional de Jujuy, 1661 Bolivia Avenue, CP 4600, San Salvador de Jujuy, Argentina
| | - María Dolores Román
- Centro de Investigaciones en Nutrición Humana, Escuela de Nutrición, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Boulevard de la Reforma s/n, CP 5000, Córdoba, Argentina
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The burden and correlates of childhood undernutrition in Tanzania according to composite index of anthropometric failure. BMC Nutr 2020. [DOI: 10.1186/s40795-020-00366-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Abstract
Background
Undernutrition is a public health problem worldwide. Tanzania has made significant achievements in the reduction of childhood undernutrition over the past two decades. However, the exact burden of undernutrition was under-estimated when using conventional indices of stunting, wasting and underweight. The objective of this study was to determine the overall prevalence of undernutrition, describe the trends and examine the correlates associated with undernutrition among children under-five years using the composite index of anthropometric failure (CIAF). This study aims to understand the real burden and drivers of undernutrition to improve design, implementation and monitoring of appropriate interventions to ameliorate all form of childhood undernutrition in the country.
Methods
About 37,205 mother-child pairs were retrieved and analyzed from the Tanzania Demographic and Health Surveys (TDHS) conducted in various years from 1991, 1996, 1999, 2004–05, 2009–10, to 2015–16. The anthropometric data of children under-five years were used to determine the overall burden and trends of undernutrition using CIAF. The recent TDHS surveys from 2005 to 2015 were used to examine the correlates of CIAF. To determine the correlates, multivariate analysis was conducted to estimate the prevalence ratios (PR) with 95% confidence intervals (CI) using Poisson regression with robust variance.
Results
The prevalence of CIAF declined significantly from 50% in 1991 to 38.2% in 2015 (p < 0.001). The correlates of CIAF vary across surveys. The multivariate analysis of recent 2015 survey revealed that the prevalence of CIAF was significantly higher for older children (p < 0.001), children living in rural areas (p = 0.028), and those born with non-educated (p = 0.009) or single mothers (p = 0.008). The prevalence of CIAF was significantly lower for girls (p < 0.001), being born with overweight/obese mothers (p < 0.001), living with older head of the household (p < 0.001) or living in richest household (p < 0.001). Moreover, children who were born with low birth weight (p < 0.001), or having fever (p = 0.044) were most likely to have anthropometric failure. However, consumption of diversified diet was not found to be associated with anthropometric failure (p > 0.05).
Conclusion
About one in every three under-five years children are suffering from either one or multiple forms of anthropometric failure in Tanzania. There is a significant decline trends in overall burden of undernutrition in Tanzania from the past 25 years, as measured by CIAF. Multiple factors including those related to mothers, children and household socio-economic characteristics have the potential to influence childhood undernutrition. Efforts to reduce the burden of undernutrition should mainly focus on reducing poverty and raising people’s living standards.
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