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

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/m 2 ), 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.

Prevalence and determinants of concurrent wasting and stunting and other indicators of malnutrition among children 6–59 months old in Kersa, Ethiopia

“…Boys had higher odds of wasting, stunting, underweight and WaSt compared with girls in this study (p < 0.05). This is consistent with other similar studies for stunting (Blankenship et al, 2020;De Vita et al, 2019;Fenta et al, 2020;Geda et al, 2021;Wali et al, 2020) Geda et al, 2021) and WaSt (Garenne et al, 2019;Odei Obeng-Amoako, et al, 2021). Little is known about gender effects on all forms of malnutrition.…”

“…This is in line with a study in Senegal and a meta-analysis of 84 countries that found that WaSt declined after 24 months of age (Garenne et al, 2019;Khara et al, 2018). A Ugandan study reported this decline after 36 months (Odei Obeng-Amoako, et al, 2021). These findings suggest that children aged less than 24 months (maybe up to 36 months) need special attention from families, programmers and the Ministry of Health.…”

“…Ghanaian study (Saaka & Galaa, 2016). Studies indicate that WaSt was more prevalent among boys (Odei Obeng-Amoako, et al, 2021;Saaka & Galaa, 2016) and found to be a strong risk factor for child mortality (Garenne et al, 2019;Myatt et al, 2019). There is limited evidence on the burden of this condition, and it is an element that is worth pursuing in future work.…”

Spatial Variations and Determinants of Acute Malnutrition among Under-Five Children in Ethiopia: Evidence from 2019 Ethiopian Demographic Health Survey

“…Acute malnutrition also known as wasting is characterized by a rapid deterioration in nutritional status over a short period that causes a child to become too thin for his or her height because of weight loss or failure to gain weight [3][4][5]. For children, it can be measured using the weight-for-height nutritional index or mid-upper arm circumference [6,7]. It is de ned as moderate acute malnutrition (MAM) and severe acute malnutrition (SAM) whereas; MAM: is WHZ≥ -3Z score &<-2Z score or MUAC ≥ 115 mm & < 125 mm (≥ 11.5 cm & < 12.5 cm) and SAM: is de ned by visible severe wasting, or by the presence of bilateral pitting edema of nutritional origin, or WHZ< -3Z score or MUAC < 115 mm (< 11.5 cm) in children aged 6-59 months [2].…”

“…Multiple factors contribute to childhood wasting. The common determinants reported by several studies include gender, age of the child [7,[22][23][24], monthly income [22,24], diarrhea in the previous two weeks [25][26][27], not consuming additional food during pregnancy/lactation [28,29], non-exclusive breastfeeding practices [26,30], larger family size [26], mothers education [22,26], presence of ARI [26,31], attending ANC [7,29,32], immunization status [33,34], mother not having consumed extra food during this pregnancy/lactation [4,22].…”