Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jan;17(1):e13074.
doi: 10.1111/mcn.13074. Epub 2020 Aug 23.

Factors associated with concurrent wasting and stunting among children 6-59 months in Karamoja, Uganda

Gloria Adobea Odei Obeng-Amoako  1 , Charles Amnon Sunday Karamagi  1   2 , Joanita Nangendo  1 , Jaffer Okiring  1 , Yerusa Kiirya  1 , Richmond Aryeetey  3 , Ezekial Mupere  3 , Mark Myatt  4 , André Briend  5   6 , Joan Nakayaga Kalyango  1   7 , Henry Wamani  8
Affiliations

Factors associated with concurrent wasting and stunting among children 6-59 months in Karamoja, Uganda

Gloria Adobea Odei Obeng-Amoako et al. Matern Child Nutr. 2021 Jan.

Abstract

Children with concurrent wasting and stunting (WaSt) and children with severe wasting have a similar risk of death. Existing evidence shows that wasting and stunting share similar causal pathways, but evidence on correlates of WaSt remains limited. Research on correlates of WaSt is needed to inform prevention strategies. We investigated the factors associated with WaSt in children 6-59 months in Karamoja Region, Uganda. We examined data for 33,054 children aged 6-59 months using June 2015 to July 2018 Food Security and Nutrition Assessment in Karamoja. We defined WaSt as being concurrently wasted (weight-for-height z-scores <-2.0) and stunted (height-for-age z-score <-2.0). We conducted multivariate mixed-effect logistic regression to assess factors associated with WaSt. Statistical significance was set at p < 0.05. In multivariate analysis, being male (adjusted odds ratio [aOR] = 1.79; 95% confidence interval [CI] [1.60-2.00]), aged 12-23 months (aOR = 2.25; 95% CI [1.85-2.74]), 36-47 months (aOR = 0.65; 95% CI [0.50-0.84]) and 48-59 months (aOR = 0.71; 95% CI [0.54-0.93]) were associated with WaSt. In addition, acute respiratory infection (aOR = 1.30; 95% CI [1.15-1.48]), diarrhoea (aOR = 1.25; 95% CI [1.06-1.48]) and malaria/fever (aOR = 0.83; 95% CI [0.73-0.96]) episodes were associated with WaSt. WaSt was significantly associated with maternal underweight (body mass index <18.5 kg/m2 ), short stature (height <160 cm), low mid-upper arm circumference (MUAC <23 cm) and having ≥4 live-births. WaSt was prevalent in households without livestock (aOR = 1.30; 95% CI [1.13-1.59]). Preventing the occurrence of WaSt through pragmatic and joint approaches are recommended. Future prospective studies on risk factors of WaSt to inform effective prevention strategies are recommended.

Keywords: Uganda; concurrent wasting and stunting; factors associated with WaSt; stunting; wasting.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Flow chart showing participant selection among children 6–59 months in Karamoja (June 2015–July 2018 Food Security and Nutrition Assessment [FSNA]). HAZ, height for age z‐score; WHZ, weight for height z‐score
FIGURE 2
FIGURE 2
Proportion of undernutrition by age groups among children 6–59 months in Karamoja (June 2015–July 2018 Food Security and Nutrition Assessment [FSNA]). MUAC, mid‐upper arm circumference; WaSt, concurrent wasting and stunting
See this image and copyright information in PMC

References

    1. Agho, K. E. , Akombi, B. J. , Ferdous, A. J. , Mbugua, I. , & Kamara, J. K. (2019). Childhood undernutrition in three disadvantaged East African districts: A multinomial analysis. BMC Pediatrics, 19(1), 118 10.1186/s12887-019-1482-y - DOI - PMC - PubMed
    1. Akombi, B. J. , Agho, K. E. , Hall, J. J. , Wali, N. , Renzaho, A. M. N. , & Merom, D. (2017). Stunting, wasting and underweight in sub‐saharan Africa: A systematic review. International Journal of Environmental Research and Public Health, 14(8). 10.3390/ijerph14080863 - DOI - PMC - PubMed
    1. Bahya‐Batinda, D. , Dramaix‐Wilmet, M. , & Donnen, P. (2018). Factors associated with moderate acute malnutrition among 6–59 months children in the Lake Tchad region: A case‐control study. Revue d'Épidémiologie et de Santé Publique, 66, S347–S348. 10.1016/j.respe.2018.05.300 - DOI
    1. Behnke, R. H. , & Arasio, R. L. (2019). The productivity and economic value of livestock in Karamoja sub‐region, Uganda Karamoja Resilience Support Unit, USAID/Uganda, UK aid, and Irish Aid, Kampala Uganda. Retrieved from https://www.karamojaresilience.org/publications/item/the-productivity-an...
    1. Bergeron, G. , & Castleman, T. (2012). Program responses to acute and chronic malnutrition: Divergences and convergences. Advances in nutrition (Bethesda, Md.), 3(2), 242–249. 10.3945/an.111.001263 - DOI - PMC - PubMed

Publication types