Child malnutrition in Ifanadiana district, Madagascar: associated factors and timing of growth faltering ahead of a health system strengthening intervention

Autor: Ranto Ramananjato, Michele Barry, Lara Hall, Victor R Rabeza, Matthew H. Bonds, Ann C. Miller, Andres Garchitorena, Sarah McCuskee, Mohammed Ali Ouenzar, Hery-Tiana Rahaniraka Razanadrakato, Marius Randriamanambintsoa
Přispěvatelé: Health, Emergence, Adaptation and Transmission (MIVEGEC-HEAT), Processus Écologiques et Évolutifs au sein des Communautés (PEEC), Maladies infectieuses et vecteurs : écologie, génétique, évolution et contrôle (MIVEGEC), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud])-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud])-Maladies infectieuses et vecteurs : écologie, génétique, évolution et contrôle (MIVEGEC), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud])-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud]), Harvard Medical School [Boston] (HMS)
Jazyk: angličtina
Rok vydání: 2018
Předmět:
0301 basic medicine
Male
Rural Population
Sanitation
Psychological intervention
chronic malnutrition
Growth
household survey
0302 clinical medicine
Medicine
030212 general & internal medicine
Wasting
Cause of death
2. Zero hunger
lcsh:Public aspects of medicine
Health Policy
1. No poverty
stunting
Child Health
3. Good health
Child
Preschool
Original Article
Female
medicine.symptom
wasting
Nutritional Status
Disease cluster
Child Nutrition Disorders
03 medical and health sciences
Child undernutrition
Intervention (counseling)
Environmental health
Madagascar
Humans
Poverty
030109 nutrition & dietetics
business.industry
Body Weight
Public Health
Environmental and Occupational Health
Infant
lcsh:RA1-1270
medicine.disease
Body Height
Malnutrition
Logistic Models
Socioeconomic Factors
[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie
business
[SDV.AEN]Life Sciences [q-bio]/Food and Nutrition
acute malnutrition
Zdroj: Global Health Action
Global Health Action, Häggeby : Co-Action Publishing, 2018, 11 (1), pp.1452357. ⟨10.1080/16549716.2018.1452357⟩
Global Health Action, 2018, 11 (1), pp.1452357. ⟨10.1080/16549716.2018.1452357⟩
Global Health Action, Vol 11, Iss 1 (2018)
ISSN: 1654-9716
1654-9880
Popis: International audience; Background: Child malnutrition, a leading cause of death and disability worldwide, is particularly severe in Madagascar, where 47% of children under 5 years are stunted (low height-forage) and 8% are wasted (low weight-for-height). Widespread poverty and a weak health system have hindered attempts to implement life-saving malnutrition interventions in Madagascar during critical periods for growth faltering. Objective: This study aimed to shed light on the most important factors associated with child malnutrition, both acute and chronic, and the timing of growth faltering, in Ifanadiana, a rural district of Madagascar. Methods: We analyzed data from a 2014 district-representative cluster household survey, which had information on 1175 children ages 6 months to 5 years. We studied the effect of child health, birth history, maternal and paternal health and education, and household wealth and sanitation on child nutritional status. Variables associated with stunting and wasting were modeled separately in multivariate logistic regressions. Growth faltering was modeled by age range. All analyses were survey-adjusted. Results: Stunting was associated with increasing child age (OR = 1.03 (95%CI 1.02-1.04) for each additional month), very small birth size (OR = 2.32 (1.24-4.32)), low maternal weight (OR = 0.94 (0.91-0.97) for each kilogram, kg) and height (OR = 0.95 (0.92-0.99) for each centimeter), and low paternal height (OR = 0.95 (0.92-0.98)). Wasting was associated with younger child age (OR = 0.98 (0.97-0.99)), very small birth size (OR = 2.48 (1.23-4.99)), and low maternal BMI (OR = 0.84 (0.75-0.94) for each kg/m 2). Height-forage faltered rapidly before 24 months, then slowly until age 5 years, whereas weight-for-height faltered rapidly before 12 months, then recovered gradually until age 5 years but did not reach the median. Conclusion: Intergenerational transmission of growth faltering and early life exposures may be important determinants of malnutrition in Ifanadiana. Timing of growth faltering, in the first 1000 days, is similar to international populations; however, child growth does not recover to the median.
Databáze: OpenAIRE
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