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Bilal JA, Osman AA, Al-Nafeesah A, AlEed A, Adam I. Prevalence and associated factors of stunting and thinness among adolescent Sudanese schoolchildren: a cross-sectional study. Trans R Soc Trop Med Hyg 2024; 118:69-76. [PMID: 37565333 DOI: 10.1093/trstmh/trad055] [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: 05/17/2023] [Revised: 06/29/2023] [Accepted: 07/27/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Malnutrition among adolescents is a considerable health problem worldwide. There are scarce data on undernutrition among adolescents in Sudan. METHODS A cross‑sectional study was conducted to investigate the prevalence and associated factors of stunting and thinness among adolescent schoolchildren in northern Sudan. The questionnaires were used to collect information on sociodemographics. Weights and heights were measured and the height-for-age and body mass index-for-age cut-offs recommended by the WHO were applied, followed by logistic regression analysis. RESULTS Of 384 enrolled adolescents, 202 (52.6%) were females and 182 (47.4%) were males. The median (IQR) age of these adolescents was 15.1 (14.0‒16.3) y. Seventy-six (19.8%) and 52 (15.4%) adolescents had stunting and thinness, respectively, and 15 (3.9%) had both stunting and thinness. Multivariate analysis showed that increased age (adjusted OR [AOR]=1.30, 95% CI 1.08 to 1.57) and male gender (AOR=5.82, 95% CI 3.11 to 10.91) were associated with stunting. Male gender (AOR=2.08, 95% CI 1.14 to 3.82) and smoking/tobacco snuff (AOR=2.61, 95% CI 1.07 to 6.36) were associated with thinness. CONCLUSIONS The findings of the current study are that both stunting and thinness are important health problems, especially among boys, older participants and smokers.
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Affiliation(s)
- Jalal A Bilal
- Department of Pediatrics, College of Medicine, Shaqra University, Shaqra, Saudi Arabia
| | | | - Abdullah Al-Nafeesah
- Department of Pediatrics, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah 56219, Saudi Arabia
| | - Ashwaq AlEed
- Department of Pediatrics, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah 56219, Saudi Arabia
- Department of Pediatrics, College of Medicine, Qassim University, Buraydah, Saudi Arabia
| | - Ishag Adam
- Department of Obstetrics and Gynecology, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Saudi Arabia
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Mchau G, Killel E, Azizi K, Henry S, Ainan S, Jumbe T, Bundara N, Kystikila W, Mwingira F, Machafuko P, Wilson B, Paulo HA, Epimack S, Mshinda H, Chacky F, Noor R, Masumo R, Leyna G. Co-occurrence of Overweight, Stunting, and Anemia among Adolescents (10-19 Years) in Tanzania Mainland: A School-Based Cross-Sectional Study. Curr Dev Nutr 2024; 8:102016. [PMID: 38304732 PMCID: PMC10832378 DOI: 10.1016/j.cdnut.2023.102016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 08/02/2023] [Accepted: 10/02/2023] [Indexed: 02/03/2024] Open
Abstract
Background Evidence on double and triple burdens of malnutrition among adolescents is an essential key to informing policy design, implementation, and tracking progress of adolescent nutritional programs. Tanzania has a scarcity of studies on the double and triple burden of malnutrition among adolescents. Objective The aim of this study was to assess the co-occurrence of malnutrition (overweight, stunting, and anemia) among adolescents (10-19 y) in mainland Tanzania. Methods A school-based cross-sectional study was conducted among 44,120 primary school adolescents aged 10 to 19 y in mainland Tanzania. Anthropometric assessments (weight, height, and body mass index), dietary assessments, and hemoglobin levels were used to calculate the single, double, and triple burden of malnutrition. Data were analyzed using Stata software 15. The chi-square test was used to test the association between the nutrition condition and social demographic variables, physical activity, and dietary quality. Log-binomial models were used to determine factors associated with stunting, overweight, and anemia. Multivariable log-binomial models were used to control confounders. All analyses were 2-tailed, and the significance level was set at 5%. Results The prevalence of anemia was 34.1%, while stunting and overweight had a prevalence of 32% and 4.2%, respectively. Approximately 41.7%, 13.5%, and 0.3% had single, double, and triple burden malnutrition-related conditions, respectively. Females were found to have a higher risk of being overweight compared with males (relative risk [RR]: 1.33; 95% confidence interval [CI]: 1.21, 1.45), while engaging in moderate to low levels of physical activity was associated with a decreased risk of being overweight. Additionally, residing in urban areas was linked to a decreased risk of stunting (RR: 0.78; 95% CI: 0.75, 0.80) and a 27% lower risk of anemia when compared with participants from rural areas. Conclusion The findings from this study suggest that the complex nature of malnutrition among school adolescents warrants consideration when designing policies and interventions to reduce the burden of malnutrition.
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Affiliation(s)
- Geofrey Mchau
- Department of Community Health and Nutrition, Tanzania Food Nutrition Centre (TFNC), Dar es Salaam, Tanzania
- Department of Epidemiology and Biostatistics, Muhimbili University of Health Allied Sciences (MUHAS), Dar es Salaam, Tanzania
| | - Erick Killel
- Department of Community Health and Nutrition, Tanzania Food Nutrition Centre (TFNC), Dar es Salaam, Tanzania
| | - Kaunara Azizi
- Department of Food Sciences and Nutrition, Tanzania Food Nutrition Centre (TFNC), Dar es Salaam, Tanzania
| | - Stanslaus Henry
- Department of Community Health and Nutrition, Tanzania Food Nutrition Centre (TFNC), Dar es Salaam, Tanzania
| | - Samafilan Ainan
- Department of Pediatric and Child Health, Muhimbili University of Health Allied Sciences (MUHAS), Dar es Salaam, Tanzania
| | - Theresia Jumbe
- Hellen Keller International (HKI), Tanzania
- Department of Human Nutrition and Consumer Studies, Sokoine University of Agriculture (SUA), Tanzania
| | | | - Wiggins Kystikila
- Department of Statistics, University of Dar es Salaam (UDSM), Dar es Salaam, Tanzania
| | | | | | - Bwire Wilson
- Department of Statistics, University of Dar es Salaam (UDSM), Dar es Salaam, Tanzania
| | - Heavenlight A. Paulo
- Department of Epidemiology and Biostatistics, Muhimbili University of Health Allied Sciences (MUHAS), Dar es Salaam, Tanzania
| | - Sauli Epimack
- Department of Community Health and Nutrition, Tanzania Food Nutrition Centre (TFNC), Dar es Salaam, Tanzania
| | - Hoyce Mshinda
- Department of Community Health and Nutrition, Tanzania Food Nutrition Centre (TFNC), Dar es Salaam, Tanzania
| | - Frank Chacky
- National Malaria Control Program, Ministry of Health (MoH), Tanzania
| | | | - Ray Masumo
- Department of Community Health and Nutrition, Tanzania Food Nutrition Centre (TFNC), Dar es Salaam, Tanzania
| | - Germana Leyna
- Department of Community Health and Nutrition, Tanzania Food Nutrition Centre (TFNC), Dar es Salaam, Tanzania
- Department of Epidemiology and Biostatistics, Muhimbili University of Health Allied Sciences (MUHAS), Dar es Salaam, Tanzania
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Ahamada H, Sunguya BF. The Burden of Undernutrition and Its Associated Factors Among Children Below 5 Years of Age in Bambao Region, Comoros. Front Nutr 2022; 9:885002. [PMID: 35558747 PMCID: PMC9089165 DOI: 10.3389/fnut.2022.885002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 03/28/2022] [Indexed: 11/21/2022] Open
Abstract
Background Undernutrition remains a major public health problem in low- and middle-income countries and Comoros is no exception. This study aimed to examine the prevalence and identify the risk factors of undernutrition among children under-five years in Bambao region, Comoros. Methods This cross-sectional study was conducted in Bambao region among 837 under-five years and their caregivers. Analyses were conducted using both descriptive and logistic regression to examine the magnitude and factors associated with stunting, wasting and underweight. Results Prevalence of stunting, wasting and underweight were 21.6, 13.7, and 13.6% respectively. Factors associated with stunting were caregiver's secondary education level compared to no education (AOR = 1.89, 95% CI: 1.04–3.43, P < 0.04), age of child between 13–24 months compared to 0–12 months (AOR = 2.69, 95% CI: 1.44–5.01, P < 0.001), and food insecurity (AOR = 2.55, 95% CI: 1.20–5.41, P < 0.02). Children aged 25–59 months were 78% less likely to have wasting compared to those with 0–12 months (AOR = 0.22, 95% CI: 0.10–0.51, P < 0.001). Wasting was also associated with food insecurity (AOR = 2.70, 95% CI: 1.12–6.49, P < 0.03), and low birthweight (AOR = 3.21, 95% CI: 1.73–5.94, P < 0.001). Children aged between 25–59 months were 86% less likely to have underweight compared to those aged 0–12 months (AOR = 0.14, 95% CI: 0.06–0.36, P < 0.001). Food insecurity (AOR = 2.65, 95% CI: 1.08–6.54, P < 0.03), low birthweight (AOR = 3.15, 95% CI: 1.67–5.93, P < 0.001), and non-exclusively breastfeeding (AOR = 2.37, 95% CI: 1.15–4.90, P < 0.02) were also associated with underweight. Conclusion More than one in five children under-five is stunted in Bambao region, Comoros. Moreover, more than 13% are underweight or wasted calling for streamlined efforts to address poor feeding practices, food insecurity, low birthweight, and socio-demographic disadvantages in this and other areas with similar context.
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Affiliation(s)
- Hadji Ahamada
- School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Bruno F Sunguya
- School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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Cordeiro LS, Otis NP, Sibeko L, Nelson-Peterman J. Rural-urban disparities in the nutritional status of younger adolescents in Tanzania. PLoS One 2021; 16:e0261480. [PMID: 34929005 PMCID: PMC8687541 DOI: 10.1371/journal.pone.0261480] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 12/02/2021] [Indexed: 11/21/2022] Open
Abstract
Research on geographic differences in health focuses largely on children less than five years; little is known about adolescents—and even less regarding younger adolescents—a vulnerable group at a critical stage of the life course. Africa’s rapid population growth and urbanization rates, coupled with stagnant rates of undernutrition, further indicate the need for country-specific data on rural-urban health disparities to inform development policies. This study examined rural-urban disparities in body mass index-for-age-and-sex (BAZ) and height-for-age-and-sex z-scores (HAZ) among younger adolescents in Tanzania. Participants were randomly selected adolescents aged 10–14 years (N = 1,125) residing in Kilosa (rural) and Moshi (urban) districts of Tanzania. Individual and household-level data were collected using surveys and anthropometric data was collected on all adolescents. Age, sex, household living conditions, and assets were self-reported. BAZ and HAZ were calculated using the WHO reference guide. The prevalence of undernutrition was 10.9% among rural and 5.1% among urban adolescents (p<0.001). Similarly, stunting prevalence was greater in rural (64.5%) than urban (3.1%) adolescents (p<0.001). After adjusting for covariates, rural residence was significantly and inversely associated with BAZ (B = -0.29, 95% CI: -0.52, -0.70, p = 0.01), as well as with HAZ (B = -1.79, 95% CI: -2.03, -1.54, p<0.001). Self-identified males had lower BAZ (B = -0.23, 95% CI: -0.34, -0.11, p<0.001) and HAZ (B = -0.22, 95% CI: -0.35, -0.09, p = 0.001) than self-identified female adolescents. Rural-urban disparities in nutritional status were significant and gendered. Findings confirm place of residence as a key determinant of BAZ and HAZ among younger adolescents in Tanzania. Targeted gender-sensitive interventions are needed to limit growth faltering and improve health outcomes in rural settings.
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Affiliation(s)
- Lorraine S. Cordeiro
- Department of Nutrition, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, United States of America
- * E-mail:
| | - Nicholas P. Otis
- Department of Nutrition, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, United States of America
| | - Lindiwe Sibeko
- Department of Nutrition, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, United States of America
| | - Jerusha Nelson-Peterman
- Department of Food and Nutrition, Framingham State University, Framingham, MA, United States of America
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Kumar P, Srivastava S, Chauhan S, Patel R, Marbaniang SP, Dhillon P. Associated factors and socio-economic inequality in the prevalence of thinness and stunting among adolescent boys and girls in Uttar Pradesh and Bihar, India. PLoS One 2021; 16:e0247526. [PMID: 33626097 PMCID: PMC7904204 DOI: 10.1371/journal.pone.0247526] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 02/09/2021] [Indexed: 11/19/2022] Open
Abstract
Background Despite economic growth observed in developing countries, under-nutrition still continues to be a major health problem. Undernutrition in adolescence can disrupt normal growth and puberty development and may have long-term impact. Therefore, it is important to study the undernutrition among adolescents. This study aimed to assess the prevalence and the associated factors of stunting, thinness and the coexistence of both (stunting and thinness) among the adolescent belonging to Uttar Pradesh and Bihar, India. Methods The study utilized data from Understanding the Lives of Adolescents and Young Adults (UDAYA) project survey, which was conducted in two Indian states Uttar Pradesh and Bihar, in 2016 by Population Council under the guidance of Ministry of Health and Family Welfare, Government of India. Utilizing information on 20,594 adolescents aged 10–19 years (adolescent boys-5,969 and adolescent girls-14,625), the study examined three outcome variables, i.e., thinness, stunting, and co-existence of both. The study used descriptive and bivariate analysis. Furthermore, the study examined income-related inequality in stunting and thinness through concentration index. At last, the study used Wagstaff decomposition analysis to decompose the concentration index. Results The prevalence of thinness was higher among adolescent boys as compared to girls (25.8 per cent vs. 13.1 per cent). However, stunting was more prevalent among girls (25.6 per cent) than in boys (39.3 per cent). The odds of stunting were higher among late adolescents [Boys- OR:1.79; CI: 1.39, 2.30] and [Girls- OR: 2.25; CI: 1.90,2.67], uneducated adolescents [Boys- OR:2.90; CI: 1.67, 5.05] and [Girls- OR: 1.82; CI: 1.44,2.30], and poorest adolescents [Boys- OR:2.54; CI: 1.80, 3.58] and [Girls- OR: 1.79; CI: 1.38,2.32]. Similarly age, educational status, working status and wealth index were significantly associated with thinness among adolescent boys and girls. Media exposure [Boys- OR: 11.8% and Girls- 58.1%] and Wealth index [Boys: 80.1% and Girls: 66.2%] contributed significantly to the inequality in the prevalence of thinness among adolescents. Similarly, wealth index [Boys: 85.2% and Girls: 84.1%] was the only significant contributor to the inequality in the prevalence of stunting among adolescents. Conclusion The study provides an understanding that stunting and thinness is a significant public health concern among adolescents, and there is a need to tackle the issue comprehensively. By tackling the issue comprehensively, we mean that the state government of Uttar Pradesh and Bihar shall screen, assess, and monitor the nutritional status of adolescent boys and girls. The interventions shall focus towards both boys as well as girl adolescents, and particular emphasis should be given to adolescents who belonged to poor households. Also, efforts should be taken by stakeholders to increase family wealth status.
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Affiliation(s)
- Pradeep Kumar
- Department of Mathematical Demography & Statistics, International Institute for Population Sciences, Mumbai, India
| | - Shobhit Srivastava
- Department of Mathematical Demography & Statistics, International Institute for Population Sciences, Mumbai, India
| | - Shekhar Chauhan
- Department of Population Policies and Programmes, International Institute for Population Sciences, Mumbai, India
| | - Ratna Patel
- Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, India
| | - Strong P. Marbaniang
- Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, India
- * E-mail:
| | - Preeti Dhillon
- Department of Mathematical Demography & Statistics, International Institute for Population Sciences, Mumbai, India
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Charles Shapu R, Ismail S, Ahmad N, Lim PY, Abubakar Njodi I. Food Security and Hygiene Practice among Adolescent Girls in Maiduguri Metropolitan Council, Borno State, Nigeria. Foods 2020; 9:foods9091265. [PMID: 32927593 PMCID: PMC7555868 DOI: 10.3390/foods9091265] [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: 06/11/2020] [Revised: 06/25/2020] [Accepted: 07/06/2020] [Indexed: 01/05/2023] Open
Abstract
Inadequate food security contributes to poor health outcome for all, including adolescent girls. The study aims at determining the level of food security and hygiene among adolescent girls. A school-based cross-sectional study was carried out among adolescent girls aged 10 to 19 years old from six schools in Maiduguri Metropolitan Council, Borno State. The instrument for data collection was a questionnaire using KoBoCollect Toolbox between June and July 2019. Multivariable logistic regression was used to identify the predictors of food security and hygiene among respondents. A majority of the respondents (73.5%) were in a very low food security level. Three factors were significantly associated with food security level, these included schools (p = 0.007), age of mother (p = 0.004), and occupation of mother (p < 0.001). School (p = 0.003), age (father p = 0.017; mother; p = 0.012), hygiene (p = 0.005), and occupation of mother (p = 0.002) were predictors of food security. About (46.6%) of respondents had poor hygiene practice, school (p = 0.016) was significantly associated with hygiene practice. School (p = 0.019; and p = 0.005) and food security (p = 0.009) were predictors of hygiene practice. This study reveals a high prevalence of low food security among adolescent girls.
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Affiliation(s)
- Ruth Charles Shapu
- Department of Community Health, Faculty of Medicine and Health Science, University Putra Malaysia, Serdang 43400, Malaysia; (R.C.S.); (N.A.); (P.Y.L.)
- College of Nursing and Midwifery, Damboa Road, Maiduguri, 600252 Maiduguri, Nigeria
| | - Suriani Ismail
- Department of Community Health, Faculty of Medicine and Health Science, University Putra Malaysia, Serdang 43400, Malaysia; (R.C.S.); (N.A.); (P.Y.L.)
- Correspondence: ; Tel.: +60-19-2249828
| | - Norliza Ahmad
- Department of Community Health, Faculty of Medicine and Health Science, University Putra Malaysia, Serdang 43400, Malaysia; (R.C.S.); (N.A.); (P.Y.L.)
| | - Poh Ying Lim
- Department of Community Health, Faculty of Medicine and Health Science, University Putra Malaysia, Serdang 43400, Malaysia; (R.C.S.); (N.A.); (P.Y.L.)
| | - Ibrahim Abubakar Njodi
- Department of Physical and Health Education, University of Maiduguri, 600230 Maiduguri, Nigeria;
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Bukenya JN, Canavan CR, Bärnighausen T, Fawzi WW. Strengthening our knowledge base and research capacity for improved adolescent health in sub-Saharan Africa: a South-South-North collaboration. Trop Med Int Health 2019; 25:2-4. [PMID: 31777153 DOI: 10.1111/tmi.13342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
| | - Chelsey R Canavan
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Till Bärnighausen
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany.,Africa Health Research Institute, Somkhele, South Africa
| | - Wafaie W Fawzi
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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