Factors associated with nutritional status of children aged 0-60 months residing in Eastern Cape and KwaZulu-Natal provinces
Lesiapeto, Maemo Seponga
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Background: Poor health, death, reduced human capacity, increased risk of chronic diseases later in life and poverty are the most prominent consequences of child malnutrition. Aim: This study sought to assess the anthropometric status of 0-60 month-old children living in Eastern Cape and KwaZulu-Natal Provinces using the new WHO child growth standards; identify risk factors of child malnutrition. In addition, assess the prevalence and associated factors of the occurrence of a stunted child with a living-in overweight mother (SCOWT). Methods: Secondary analysis was done on household socio-economic data, child health, child feeding practices, and anthropometric measurements for 2485 children and their mothers. Logistic regression was used to determine risk factors of stunting, overweight and underweight taking into account hierarchical relationships between risk factors. The Chi-square test and analysis of variance were used to identify related variables which were significantly different between SCOWT and non-SCOWT mother-child pairs as well as between wasted and non-wasted children. Results: Prevalence of wasting, underweight, stunting and overweight was 3.4%, 7.3%, 28.6% and 16.1% respectively. The WHO child growth standards gave higher rates of stunting and overweight but lower rates of underweight. Risk factors for child stunting were male gender (Odds ratio (OR) =1.233; p=0.019) and the fact that the mother thinks her child is growing well (OR=1.346; p=O.O 18). On the other hand, handouts as source of food (OR=0.719; p=0.005) and mother making important household decisions (OR=0.760; p=0.009) were protective. Underweight was positively associated with child male gender (OR=1.432; p=0.021), maternal education (minimum of 5 years of schooling: OR=1.720; p=0.002), the fact that the mother thinks her child is growing well (OR=2.526; p<O.OOO), still breastfeeding (in children <24 months: OR=2.022; p=0.014) and history of gastrointestinal symptoms (OR=1.527; p=O.013). Child overweight on the other hand was positively associated with household having a regular source of income (OR=1.473; p=O.002) but negatively with maternal education (OR=O.595; p=O.OOl) and the fact that the mother thinks her child is growing well (OR=O.361; p<O.OOl). Prevalence of SCOWT was 13.9% and SCOWT mother-child pairs were more likely to be older (both mother and child), have hand-outs as source of food, have used bottle-feeds in the 24 hours preceding survey (children<24months) but less likely to increase fluid intakes during episodes of diarrhoea. The children were more likely to be males. Conclusion: The double burden of malnutrition occurred in these poor communities, households and individual children. Other than the effect of maternal education on the risk of underweight; the most important factors associated with stunting and underweight were child male gender and the fact that the mother thinks her child is growing well. On the other hand overweight was associated with maternal BMI and household having a regular source of income.
- Health Sciences