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Multicenter Study
. 2019 Apr 23;19(1):118.
doi: 10.1186/s12887-019-1482-y.

Childhood undernutrition in three disadvantaged East African Districts: a multinomial analysis

Kingsley E Agho  1 , Blessing J Akombi  2 , Akhi J Ferdous  3 , Irene Mbugua  4 , Joseph K Kamara  5
Affiliations
Multicenter Study

Childhood undernutrition in three disadvantaged East African Districts: a multinomial analysis

Kingsley E Agho et al. BMC Pediatr. .

Abstract

Background: Undernutrition is an important public health indicator for monitoring nutritional status and survival. In spite of its importance, undernutrition is a significant problem health problem in many East African communities. The aim of this study was to identify factors associated with childhood undernutrition in three disadvantaged East African Districts.

Methods: We examined data for 9270 children aged 0-59 months using cross-sectional survey from Gicumbi District in Rwanda, Kitgum District in Uganda and Kilindi District in Tanzania. We considered the level of undernutrition (stunting, wasting and underweight) as the outcome variables with four ordinal categories (severely undernourished, moderately undernourished, mildly undernourished, and nourished). Generalized linear latent and mixed models (GLLAMM) with the mlogit link and binomial family that adjusted for clustering and sampling weights were used to identify factors associated with undernutrition among children aged 0-59 months in three disadvantaged East African Districts.

Results: After adjusting for potential confounding factors, the odds of a child being stunted were higher in Gicumbi District in Rwanda while the odds of a child being wasted and underweight were higher in Kitgum District in Uganda. Having diarrhoea two weeks prior to the survey was significantly associated with severe undernutrition. Wealth index (least poor household), increasing child's age, sex of the child (male) and unavailability of water all year were reported to be associated with moderate or severe stunting/wasting. Children of women who did not attend monthly child growth monitoring sessions and children who had Acute Respiratory Infection (ARI) symptoms were significantly associated with moderate or severe underweight.

Conclusions: Findings from our study indicated that having diarrhoea, having ARI, not having water availability all year and not attending monthly child growth monitoring sessions were associated with undernutrition among children aged 0-59 months. Interventions aimed at improving undernutrition in these disadvantaged communities should target all children especially those children from households with poor sanitation practices.

Keywords: East Africa; Malnutrition; Morbidity; Mortality; Multinomial; Undernutrition.

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Conflict of interest statement

Ethics approval and consent to participate

Ethical clearance was obtained from Ministry of Health in Kigali, Kampala and Dar es Salaam, and necessary permission was also obtained from the Gicumbi, Kilindi and Kitgum regional health office and the Gicumbi, Kilindi and Kitgum health office and local administrators. Participants were given informed consent to sign before taking part in the survey, including assurance of anonymity and a description of how the data would be used. For illiterate participants, informed consent information was read aloud and signed. Mothers and children with serious illness were referred to the nearby health facilities. The data in this article presented as aggregate to ensure all respondents’ identification information is obscured.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Prevalence and 95% confidence intervals (CIs) of stunting by severity
Fig. 2
Fig. 2
Prevalence and 95% confidence intervals (CIs) of wasting by severity
Fig. 3
Fig. 3
Prevalence and 95% confidence intervals (CIs) of underweight by severity
See this image and copyright information in PMC

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