Factors associated with early childhood stunted growth in a 2012–2015 birth cohort monitored in the rural Msambweni area of coastal Kenya: a cross-sectional study

Abstract

Background Chronic malnutrition, often measured as stunted growth, is an understudied global health problem. Though poor nutritional intake has been linked to stunted growth, there is evidence suggesting environmental exposures may have a significant role in its occurrence. Here, we characterize the non-nutritional prenatal and postnatal factors that contribute to early childhood stunted growth in rural coastal Kenya. Methods Overall, 232 women and 244 children from a 2012–2015 maternal-child cohort in Msambweni, Kenya were included. Women were tested for parasitic infections during the prenatal period and at the time of delivery. Children were tested for parasitic infections and assessed for stunted growth using height-for-age Z-scores (HAZ) at 6-month intervals after birth. Socioeconomic status (SES) was evaluated using both a simplified water, asset, maternal education, and income (WAMI) index and a principal component analysis (PCA) asset score. Multivariate logistic regression analysis was used to determine the relative influence of prenatal and postnatal factors on the occurrence of stunted growth. Results Of the 244 children (ages 6–37 months), 60 (25%) were stunted at the study endpoint. 179 mothers (77%) had at least one parasitic infection during pregnancy and 94 children (38%) had at least one parasitic infection during the study period. There was no significant association between maternal parasitic infection and child stunted growth (p = 1.00). SES as determined using the WAMI index was not associated with HAZ in linear regression analysis (p = 0.307), however, the PCA asset score was (p = 0.048). Multivariate logistic regression analysis identified low birth weight (AOR: 3.24, 95% CI: [1.38, 7.57]) and child parasitic infectious disease burden (AOR: 1.41, 95% CI: [1.05, 1.95]) as independent predictors of stunted growth, though no significant association was identified with PCA asset score (AOR: 0.98, 95% CI: [0.88, 1.10]). Conclusions Stunted growth remains highly prevalent in rural Kenya, with low birth weight and child parasitic infectious disease burden demonstrated to be significantly associated with this indicator of chronic malnutrition. These results emphasize the multifaceted nature of stunted growth and the need to address both the prenatal and postnatal environmental factors that contribute to this problem.

Dietary Intake and Pneumococcal Vaccine Response Among Children (5–7 Years) in Msambweni Division, Kwale County, Kenya

“…Prevalence of wasting (4%) was within acceptable levels of >5%. The level of malnutrition reported in this study was comparable with earlier studies in the region ( 75 , 76 ).…”

Stunting in pre-school and school-age children in the Peruvian highlands and its association with Fasciola infection and demographic factors

“…In a study in rural Kenya, parasitic infections during the first three years of life, particularly hookworm, Ascaris, E. histolytica, malaria, and Schistosoma infection, were associated with decreased growth [41]. In a study of 244 children under three years of age in rural Kenya, child parasitic infectious disease burden was associated with stunted growth, though this was primarily driven by malaria infection during the first three years of life [42]. The odds ratio of stunted growth increased by 1.41 with each parasitic infection during childhood (95% CI 1.05, 1.95).…”

Association of Low Birth Weight with the Risk of Childhood Stunting in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis

“…Of the included studies, 11 were cross-sectional [20-22, 25, 26, 28-33], 3 were cohort [23,27,34], and 1 was a casecontrol [38] study, with a sample size ranging from 244 to 9,001 participants and publication year ranging from 2010 to 2021. The LMIC in the selected studies were from 6-37 months in 1 study [28], and 36-59 months in 1 study [21].…”

“…LBW can be caused either by prematurity or intrauterine growth restriction (IUGR) or both [17]. LBW becomes one of the main contributors to neonatal morbidity and mortality [18] and also increases the risk of morbidity and mortality during childhood [19], but the strength of the association varies across studies and the mediating mechanisms remain unclear [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34]. Therefore, the present systematic review was conducted to examine the role of LBW on the risk of childhood stunting under the age of 5 years (0-60 months) in Asia and Africa.…”