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Acute and chronic malnutrition and their predictors in children aged 0-5 years in São Tomé: a cross-sectional,
A Valente1, D Silva2, E Neves3
1Division of Pediatric Nutrition, Integrated Pediatric Hospital, Centro Hospitalar São João, Porto, Portugal.
Insights
Adequate birth weight and first-year weight gain are key to preventing childhood undernutrition. Mother's education also plays a protective role against acute and chronic undernutrition in children.
Area of Science:
- Global Health
- Pediatric Nutrition
- Public Health
Background:
- Undernutrition is a major global contributor to child morbidity and mortality.
- Identifying nutritional status and predictors in young children is crucial for intervention.
Purpose of the Study:
- To evaluate the nutritional status of children aged 0-5 years in São Tomé.
- To identify predictors of undernutrition in this population.
Main Methods:
- Cross-sectional study involving 1285 children in São Tomé.
- Assessment of height-for-age (HAZ), weight-for-height (WHZ), and BMI-for-age (BAZ) Z-scores.
- Data collected via health bulletins and maternal questionnaires.
Main Results:
- High prevalence of global acute undernutrition (30.9% in <24 months) and chronic undernutrition (41.1% in ≥24 months).
- Appropriate birth weight, significant weight gain in the first semester, and higher maternal education were associated with reduced odds of undernutrition.
- Adjusted logistic regressions controlled for numerous child, maternal, and household variables.
Conclusions:
- Birth weight, infant weight gain, and maternal education are significant protective factors against childhood undernutrition.
- Emphasizes the importance of maternal nutrition and adequate infant weight gain for preventing stunting and wasting.
Objective:
Undernutrition is an important cause of morbidity and mortality in infants and children worldwide. The aim of this study was to evaluate the nutritional status and their predictors in children from 0 to 5 years of age in São Tomé.
Study Design:
A cross-sectional study was conducted in São Tomé Island.
Methods:
A total of 1285 individuals were enrolled between January and May 2011. Children were measured, and height for age (HAZ), weight for height (WHZ) and body mass index (BAZ) Z-score were computed. Global acute undernutrition is defined as weight for height <-1 Z-score (wasting < -2 Z-scores) and global chronic undernutrition as length/height for age <-1 Z-score (stunting < -2 Z-scores). Relevant information was collected from individual health bulletins, namely gestational age and birth weight, as well as weight at 6, 12, 18 and 24 months for all individual above these ages. Mothers were invited to answer a specific questionnaire.
Results:
A high percentage of global acute undernutrition (30.9% in <24 months and 21.9% in ≥24 months) and global chronic undernutrition (32.5% in <24 months and 41.1% in ≥24 months) was observed. Appropriate birth weight for gestational age (AGA) is significantly associated with lower odds for both acute (OR 0.485 [95% CI 0.299-0.785]) and chronic undernutrition (OR 0.427 [95% CI 0.270-0.675]) in children >12 months. Weight gain above 0.67 Z-score in the first semester of life was strongly related to lower odds for both acute (OR 0.109 [95% CI 0.040-0.291]) and chronic undernutrition (OR 0.379 [95% CI 0.187-0.770]) in children >12 months of age. Similarly, mother's education seems to protect against acute (>12 months: OR 0.448 [95% CI 0.244-0.825]; >24 months: OR 0.186 [95% CI 0.064-0.540]) and chronic undernutrition (>12 months: OR 0.389 [95% CI 0.232-0.653]; >24 months: OR 0.324 [95% CI 0.171-0.625]). All logistic regressions were adjusted for all children (gender, age, gestational age, birth weight, breastfeeding, begin consumption alcohol), mothers (age, height, body mass index, educational level, number of previous pregnancies, smoking during pregnancy, alcohol consumption during pregnancy) and household (number of siblings and persons at home) variables included in the protocol.
Conclusions:
Birth weight, nutritional status, and the mother's education and weight gain particularly in the first year of life were important factors protecting against undernutrition during infancy and childhood. These results emphasize the importance of women's nutrition and of adequate birth weight and particularly weight gain during the first year of life in order to prevent wasting and stunting in childhood.