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2005
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23 May 2006
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MALNUTRITION
Wamani H, Astrom AN, Peterson S, Tumwine JK, Tylleskar T.
Predictors of poor anthropometric status among children under 2 years of age in
rural Uganda. Public Health Nutr. 9(3):320-6, 2006.
Objective: To assess predictors of poor anthropometric
status among infants and young children. Design: Cross-sectional survey.Setting:
The rural subsistence agricultural district of Hoima, western Uganda.Subjects:
Seven hundred and twenty children aged 0-23 months with their mothers/carers.
Methods: Participants were recruited in September 2002, using a two-stage
cluster sampling methodology. A structured questionnaire was administered to
mothers in their home settings. Information on health, household socio-economic
status, child feeding practices and anthropometric measurement was gathered.
Conditional logistic regression analysis was applied taking into account the
hierarchical relationships between potential determinants of poor anthropometric
status. Results: The mean Z-score for weight-for-height was -0.2 (95% confidence
interval (CI) -0.1, -0.7), for height-for-age was -1.1 (95% CI -1.2, -0.9) and
for weight-for-age was -0.7 (95% CI -0.8, -0.6). Wasting was independently
associated only with a history of fever in the 2 weeks prior to the survey (odds
ratio (OR)=4.4, 95% CI 1.5, 13), while underweight was associated with a history
of fever (OR=2.4, 95% CI 1.3, 4.4) and cough (OR=3.0, 95% CI 1.3, 6.8). Stunting
was positively associated with a wider range of factors, including: history of a
fever episode (OR=1.7, 95% CI 1.0, 2.9), lack of a latrine in the household
(OR=2.7, 95% CI 1.5, 4.9), failure to de-worm children 12 months or older
(OR=1.7, 95% CI 1.1, 2.8), and being born to a non-formally educated mother
compared with mothers educated above primary school (OR=2.1, 95% CI 1.1,
4.0).Conclusions: In analyses guided by the hierarchical interrelationships of
potential determinants of malnutrition, wasting and underweight turned out to be
independently predicted by morbidity (proximal) factors. Stunting, however, was
predicted by socio- economic (distal), environmental and health-care
(intermediate) factors in addition to morbidity. Strategies aimed at improving
the growth of infants and young children in rural communities should address
morbidity due to common childhood illness coupled with environmental and
socio-economically oriented measures.
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