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Exploring the association of anthropometric indicators for under-five children in Ethiopia
Gashu Workneh Kassie1, Demeke Lakew Workie2
1Department of Statistics, University of Gondar, P.O. Box: 96, Gondar, Ethiopia.
Insights
Childhood undernutrition indicators like stunting, wasting, and underweight are linked, but not always together. Understanding these relationships is key to addressing global child malnutrition effectively.
Area of Science:
- Global health
- Pediatrics
- Nutritional epidemiology
Background:
- Child undernutrition is a significant global health issue.
- Previous research often examined predictors of undernutrition indicators separately.
- Limited studies have explored the interrelationships between stunting, wasting, and underweight.
Purpose of the Study:
- To investigate the association structures among key childhood undernutrition indicators: stunting, wasting, and underweight.
- To determine if these indicators are independently associated or if they interact.
- To provide insights for a more comprehensive assessment of child malnutrition.
Main Methods:
- Utilized data from the 2016 Ethiopia Demographic Health Survey.
- Employed a log-linear model to analyze a three-way contingency table of stunting, wasting, and underweight.
- Defined indicators based on WHO Child Growth Standards (z-scores below -2).
Main Results:
- Prevalence rates: 36.34% stunting, 12.09% wasting, 24.87% underweight; overall undernutrition 45.96%.
- Underweight was significantly associated with both stunting (P<0.001) and wasting (P<0.001).
- No significant association was found between stunting and wasting (P=0.999), nor a three-way interaction (P=1.000).
Conclusions:
- The study found no three-way association between stunting, wasting, and underweight.
- This supports the multi-dimensional nature of childhood undernutrition indicators.
- Recommends simultaneous consideration of all three indicators for accurate assessment of child malnutrition burden.
Background:
Child undernutrition is a global health concern. Many studies have focused on the association of childhood undernutrition indicators with their predictors. A few studies have looked at relationship between the undernutrition indicators. This study aimed at investigating the possible association structures of childhood undernutrition indicators.
Methods:
A log-linear model of cell counts of a three way table of stunting, wasting, and underweight was fitted based on the 2016 Ethiopia demographic health survey data. The variables of interest were generated based on the 2006 WHO Child Growth Standards as: stunted, wasted and underweight if z-scores of height-for-age, weight-for-height and weight-for age are below-2, respectively; otherwise not stunted, wasted and underweight.
Results:
This study showed that 36.34, 12.09 and 24.87% were stunted, wasted and underweight out of sampled children respectively and the prevalence of total undernutrition in children was about 45.96%.The fitted log-linear model showed that underweight was associated with both stunting (P-value< 0.001), and wasting (P-value< 0.001). There was no association between stunting and wasting (P-value = 0.999). Furthermore, the model showed that there is no a three way interaction among stunting, wasting, and underweight (P-value = 1.000).
Conclusion:
The authors conclude that there is lack of three way association of stunting, wasting, and underweight. This confirms that the three anthropometric indicators of children have multi-dimensional nature. Thus, the concerned body should consider the three undernutrition indicators simultaneously to estimate the actual burden of childhood undernourishment as they are not redundant of each other.
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