Trends and Determinants of Children’s Wasting and Women’s Thinness in Chad, 2015 to 2021

Abstract

Background: Cross-sectional surveys using the Standardized Monitoring and Assessment of Relief and Transitions methodology have been conducted annually in Chad since 2015 to evaluate population-level nutritional status. Objective: This analysis characterizes national and subnational trends in child wasting and women’s thinness from 2015 to 2021 in Chad and identifies risk factors during the COVID-19 pandemic. Methods: Annual survey data with 12,000 to 15,000 households were included. Wasting was estimated for children 6 to 59 months using the WHO child growth standards, and among women 15 to 49 years, thinness was defined as mid-upper arm circumference <23 cm. Trends were stratified by agroecological zone, and chi-square tests used to assess statistical significance. Simple and multivariate logistic regression models were conducted for 2020 and 2021 to identify risk factors of wasting and thinness. Results: About 11,958 to 17,897 children and 9883 to 15,535 women contributed values each year. National wasting and thinness rates did not significantly decrease over the 7-year period (wasting: 14.1% to 12.1%, P = .43; thinness: 15.2% to 13.4%, P = .51) and wasting rose from 2020 to 2021. The Saharan and Sahelian zones had consistently higher rates compared to the Sudanian zone. Younger age, male sex, inadequate infant and young child feeding practices, and poorer household socio-economic factors were associated with greater odds of child wasting. For women, younger age, lack of nutrition knowledge, and poorer household socio-economic factors increased the odds of thinness. Conclusions: Undernutrition in Chad has not improved since 2015, and the COVID-19 pandemic likely exacerbated the crisis among children nationally and among women subnationally. Multisectoral approaches and regional targeting of interventions are recommended.

Trends and determinants of anemia in children 6–59 months and women of reproductive age in Chad from 2016 to 2021

“…Recent analyses have demonstrated that between 2016 and 2021, households in the Sudanian zone consistently had higher food consumption scores than those in the Saharan and Sahelian zones, and households in the Sudanian zone were less likely to have COVID-19 income losses as compared to those in the other agro-ecological zones [ 24 , 25 ]. Additionally, children 6–23 months of age in the Sudanian zone had lower odds of wasting as compared to the Sahelian and Saharan zones, even after adjusting for child diet [ 26 ]. In this analysis, we observed that adjusting for MDD, MMF, or MAD in 2019 slightly decreased the odds of anemia in the Sudanian zone and, in 2021, attenuated the odds of anemia such that no significant difference was perceivable when compared to the Saharan zone.…”