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
. 2023 Jun 30;81(1):119.
doi: 10.1186/s13690-023-01138-8.

Concurrent stunting and overweight or obesity among under-five children in sub-Saharan Africa: a multilevel analysis

Melkamu Aderajew Zemene  1 , Denekew Tenaw Anley  2 , Natnael Atnafu Gebeyehu  3 , Getachew Asmare Adella  4 , Gizachew Ambaw Kassie  5 , Misganaw Asmamaw Mengstie  6 , Mohammed Abdu Seid  7 , Endeshaw Chekol Abebe  6 , Molalegn Mesele Gesese  3 , Natnael Amare Tesfa  8 , Yenealem Solomon Kebede  9 , Berihun Bantie  10 , Sefineh Fenta Feleke  11 , Tadesse Asmamaw Dejenie  12 , Wubet Alebachew Bayeh  13   14 , Anteneh Mengist Dessie  2
Affiliations

Concurrent stunting and overweight or obesity among under-five children in sub-Saharan Africa: a multilevel analysis

Melkamu Aderajew Zemene et al. Arch Public Health. .

Abstract

Background: Globally, the co-occurrence of stunting and overweight or obesity (CSO) in the same individual is becoming an emerging layer of malnutrition and there is a paucity of information in low- and middle-income countries, particularly in sub-Saharan Africa. Hence, this study aimed to determine the pooled prevalence and determinants of concurrent stunting and overweight or obesity among under-five children in SSA.

Methods: Secondary data analysis was conducted from a recent nationally representative Demographic and Health Survey dataset of 35 SSA countries. A total weighted sample of 210,565 under-five children was included in the study. A multivariable multilevel mixed effect model was employed to identify the determinant of the prevalence of under-5 CSO. The Intra-class Correlation Coefficient (ICC) and Likelihood Ratio (LR) test were used to assess the presence of the clustering effect. A p-value of p < 0.05 was used to declare statistical significance.

Result: The pooled prevalence of concurrent stunting and overweight/obesity among under-five children was 1.82% (95% CI: 1.76, 1.87) in SSA. Across the SSA regions, the highest prevalence of CSO was reported in Southern Africa (2.64%, 95% CI: 2.17, 3.17) followed by the Central Africa region (2.21%, 95% CI: 2.06, 2.37). Under five children aged 12-23 months (AOR = 0.45, 95% CI: 0.34, 0.59), 24-35 months (AOR = 0.41, 95% CI: 0.32, 0.52), 36-59 months (AOR = 055, 95% CI: 0.43, 0.70), ever had no vaccination (AOR = 1.25, 95% CI: 1.09, 1.54), under-five children born from 25 to 34 years mother (AOR = 0.75, 95% CI: 0.61, 0.91), under-five children born from overweight/obese mothers (AOR = 1.63, 95% CI: 1.14, 2.34), and under-five children living in West Africa (AOR = 0.77, 95% CI: 0.61, 0.96) were significant determinants for under-five CSO.

Conclusion: Concurrent stunting and overweight or obesity is becoming an emerging layer of malnutrition. Under five children born in the SSA region had almost a 2% overall risk of developing CSO. Age of the children, vaccination status, maternal age, maternal obesity, and region of SSA were significantly associated with under-five CSO. Therefore, nutrition policies and programs should base on the identified factors and promote a quality and nutritious diet to limit the risk of developing CSO in early life.

Keywords: Concurrent stunting and overweight or obesity; The double burden of malnutrition.

PubMed Disclaimer

Conflict of interest statement

The authors declared that they have no competing interests.

Figures

Fig. 1
Fig. 1
Prevalence of concurrent stunting and overweight/obesity in regions of sub-Saharan African
See this image and copyright information in PMC

References

    1. World Health Organization (WHO)., 2022. Fact sheets - Malnutrition [Internet]. [cited 2022 Jan 16]. Available from: https://www.who.int/news-room/fact-sheets/detail/malnutrition.
    1. Calkins K, Devaskar SU. Fetal origins of adult disease. Curr Probl Pediatr Adolesc Health Care. 2011;41(6):158–76. doi: 10.1016/j.cppeds.2011.01.001. - DOI - PMC - PubMed
    1. Organization WH. Guideline: assessing and managing children at primary healthcare facilities to prevent overweight and obesity in the context of the double burden of malnutrition. 2017. - PubMed
    1. World Health Organization-double burden of malnutrition., 2022. Double burden of malnutrition [Internet]. World Health Organization; [cited 2022 Jun 2]. Available from: http://www.who.int/nutrition/double-burden-malnutrition/en/.
    1. Chowdhury MRK, Khan HT, Rashid M, Kabir R, Islam S, Islam MS, et al. 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(12):e052814. doi: 10.1136/bmjopen-2021-052814. - DOI - PMC - PubMed