Malnutrition is the main cause of illness and death in children under the age of five [1]. It affects millions of children worldwide, putting their health and future in jeopardy [2]. Even though the decline has not been consistent worldwide, its prevalence has decreased. In middle- and low-income countries, notably in Sub-Saharan Africa, child malnutrition is still an issue, and many children still suffer from chronic malnutrition [3, 4]. The most common symptom of chronic undernutrition in children is an inadequate intake of the nutrients and energy needed for growth and development [5]. Three anthropometric indices of malnutrition, stunting, underweight, and wasting, are used to evaluate nutritional deficiency or imbalance, the underlying causes of a number of children’s health problems [6,7,8]. The three are well-known indicators of the severity of child malnutrition [9]. In poor countries, malnutrition contributes to more than half of under-five mortality. Sub-Saharan Africa has a very high proportion of under-five malnourished children, and daily death rates are rising [7].
Indicators of child malnutrition include stunting, wasting, and underweight, which refer to children who are, respectively, too short for their age (low height-for-age), too thin for their height (low weight-for-height), and too thin for their age (low weight-for-age). Height-for-age, weight-for-height, and weight-for-age z-scores are generated using the 2006 WHO child growth standards. Children who have a weight-for-height z-score (WHZ), a height-for-age z-score (HAZ), or a weight-for-age z-score (WAZ) below two are referred to as stunting, wasting, and underweight, respectively [6]. According to UNICEF, environmental, social, and economic factors all have a major impact on childhood malnutrition [8].
Each year, more than half of all children under the age of five die from malnutrition and its complications [10]. It has been established that undernourishment has a major negative impact on young children’s growth and development [11]. The negative effects of childhood malnutrition are both short-term and long-term [12]. Long-term effects of undernutrition include poor educational practices [13], early mortality [11], and an increased risk of chronic illnesses like diabetes mellitus (DM), hypertension (HTN), and heart disease [14, 15]. Short-term effects of undernutrition include increased severity of illnesses [16], a delayed recovery period from disease [17], and delayed physical and mental development in children [18]. Additionally, undernutrition has a detrimental effect on female adolescents’ reproductive health [19, 20]. Due to how frequently it occurs, undernutrition not only has detrimental impacts on a person’s health but also negatively affects the economy. Through both direct production reduction owing to physical infirmity and indirect cognitive dysfunction and educational impairments, this condition limits economic growth and perpetuates poverty. In addition, a poor diet raises the cost of medical care [21].
In 2020, undernutrition was a factor in about half of the cases of childhood mortality [22]. In the same year, 12.6% of children under the age of five are underweight, 6.7% are wasted, and 22% are stunted [22]. Around 149.2 million children under the age of five were affected by stunting in 2020, with 53% of these children residing in Asia and 30.7% in Africa [22]. 45.4 million Children under the age of five perished because of waste. More than two-thirds of all wasted children are located in Asia, and more than a quarter are found in Africa [22]. Stunting occurs more frequently in Eastern Africa (32.6%) than in Western Africa (30.9%), Northern Africa (21.4%), or Southern Africa (23.3%), according to a more thorough analysis of the distribution of undernutrition on the African continent [22].
Numerous factors contribute to childhood stunting, wasting, and being underweight. The collective causes reported by several studies include the age of the child in a month [23,24,25,26], the gender of the child [27, 28], the birth size of children [29, 30], the birth order of the child [31, 32], age of mother at first birth and the maternal education [32, 33], household wealth index [23, 31, 34], the source of drinking water [24, 34], the family size [27], the place of residence [27], the husband’s education level [31, 34], breastfeeding [35, 36], diarrhea [36, 37], fever [35] and cough [36, 38] in the last two weeks prior to the survey, the birth type of child [24, 32], number of children aged under-five [30] have been identified as some of the factors of childhood undernutrition status in East Africa.
Numerous studies on stunting, underweight, and wasting were carried out in East Africa. However, they paid little attention to their relationship and were unable to identify the associated determinants of anthropometric indicators among East African children under the age of five. In a study carried out in Ethiopia, India, and Malawi [9, 39, 40], the link between undernutrition indices was examined. The association was determined without taking into account the impact of additional factors linked to stunting, underweight, and wasting. Other East African and international researchers examined each indicator of undernutrition separately and determined the corresponding factors [32, 41,42,43,44]. However, it was noted that there is a dearth of research available or undertaken in East Africa that identifies and estimates the drivers of undernutrition indicators in children under the age of five, such as stunting, underweight, and wasting, by taking into account the relationships between them. Furthermore, despite the fact that the population of East Africa is not uniform in terms of its culture, language, and other characteristics, the cluster effect receives little consideration. When there is a chance that the outcomes of patients in comparable groups may correlate, clustering effects may develop, which may lead to a loss of observational independence [45]. Children from the same nation are more likely to have similar undernutrition status than children from different countries; therefore, when the cluster effect is ignored, the key determinants of a child’s undernutrition status within and between countries (cluster) are inadequately taken into account. As a result, the aim of this study was to identify and estimate the influence of significant factors on indicators of undernutrition.
Source link : https://bmcnutr.biomedcentral.com/articles/10.1186/s40795-023-00741-w
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Publish date : 2023-07-07 07:00:00
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