Prevalence and determinants of child undernutrition and stunting in semiarid region of Brazil

Abstract

OBJECTIVETo analyze the evolution in the prevalence and determinants of malnutrition in children in the semiarid region of Brazil.METHODSData were collected from two cross-sectional population-based household surveys that used the same methodology. Clustering sampling was used to collect data from 8,000 families in Ceará, Northeastern Brazil, for the years 1987 and 2007. Acute undernutrition was calculated as weight/age < -2 standard deviation (SD); stunting as height/age < -2 SD; wasting as weight/height < -2 SD. Data on biological and sociodemographic determinants were analyzed using hierarchical multivariate analyses based on a theoretical model.RESULTSA sample of 4,513 and 1,533 children under three years of age, in 1987 and 2007, respectively, were included in the analyses. The prevalence of acute malnutrition was reduced by 60.0%, from 12.6% in 1987 to 4.7% in 2007, while prevalence of stunting was reduced by 50.0%, from 27.0% in 1987 to 13.0% in 2007. Prevalence of wasting changed little in the period. In 1987, socioeconomic and biological characteristics (family income, mother’s education, toilet and tap water availability, children’s medical consultation and hospitalization, age, sex and birth weight) were significantly associated with undernutrition, stunting and wasting. In 2007, the determinants of malnutrition were restricted to biological characteristics (age, sex and birth weight). Only one socioeconomic characteristic, toilet availability, remained associated with stunting.CONCLUSIONSSocioeconomic development, along with health interventions, may have contributed to improvements in children’s nutritional status. Birth weight, especially extremely low weight (< 1,500 g), appears as the most important risk factor for early childhood malnutrition.

Predictors of Chronic Undernutrition (Stunting) among Under Five Children in Rural East Wollega, Oromiya Region, West Ethiopia: A Community Based Unmatched Case - Control Study

“…On the other hand the finding of this study is in contrary to the result of many other previous studies conducted elsewhere [12,19,21,22,24].…”

“…The odds of stunting were significantly higher in male children than female counterparts which are consistent with previous studies [9][10][11][12][13][14][15][16][17][18][19][20][21]. This may be attributed to diseased status during the study period.…”

Prognostic factors at birth for stunting at 24 months of age in rural Indonesia

“…[13][14][15][16]29 A metaanalysis of 16 demographic and health surveys from Sub-Saharan Africa observed that boys were more vulnerable to inequalities in health, especially in families with low socioeconomic status. 13 Moreover, the conclusion from 131 demographic health surveys and 48 multiple indicator cluster surveys from 80 countries done from 1990 to 2011 was that countries with higher prevalence of stunting tended to have larger socioeconomic inequalities.…”

“…6,14 Children born with low birth weight had a risk of neurological abnormalities that led to poor growth. 14 However, a Filipino study showed that the effect of low birth weight on stunting was strongest during the first 6 months of age, then declined.…”

“…Stool regenerating gene protein (REG 1ß) has been observed to be higher at 3 months of age and predictive of a shortfall in linear growth later in life. 12 In addition, genetic studies among stunted children in developing countries revealed that male gender, 6,13-15 short mothers, 6,15 paternal education, 6,15 paternal occupation, 6,16 low birth weight, 6,14 early supplemental feeding, 6 poor preventive health care, 6 maternal zinc deficiency, 17 low weight gain during pregnancy, 18 short length at birth, 19 history of malnutrition during early life, 19 unhygienic environments, 19 tap water and toilet facilities, 14,15 family income, 14,16 poor breastfeeding practice, 20 lack of supplementation with vitamin A, 16 anemia, 16 infections such as diarrhea and respiratory infections, food-insecure households, maternal tobacco use, 22 preterm, and small-for-gestational age 23 were all potential risk factors for stunting. 21 However, other results have been inconclusive, as gender as well as maternal education and occupation were not found to be predictors of stunting in another study.…”