A Multi-causal Model for Chronic Malnutrition and Anemia in a Population of Rural Coastal Children in Ecuador

Abstract

Objectives Chronic malnutrition and anemia are prevalent in developing countries. This research aimed to determine the prevalence of chronic malnutrition and anemia and their associated factors in children under five using a multi-causal model in a rural community in the coast of Ecuador. Methods The study included 314 children under 5 years old who were residents of San Isidro, Ecuador. Indicators of chronic malnutrition and anemia were identified. Mothers/caregivers were surveyed on socioeconomic and environmental conditions, feeding and care practices, access to health services and biological characteristics. Bivariate and multivariable Poisson regression were performed. Results The prevalence was 12.42% (n = 39) for chronic malnutrition and 16.98% (n = 54) for anemia. There was a significant and independent association between chronic malnutrition and family income less than $80 USD per month (Prevalence Ratio [PR] = 2.74, 95% CI 1.04, 7.20), maternal height less than 150 cm (PR 3.00, 95% CI 1.69, 5.32) and residence in a household with more than 4 children (PR 3.05, 95% CI 1.48, 6.29). Anemia was 2.57 times higher (95% CI 1.17, 5.65) in children with more than two episodes of diarrhea in the last 6 months. Prenatal care (5 to 8 visits) provided a protective effect for anemia (PR 0.48, 95% CI 0.27, 0.89). Conclusions for Practice Findings support the need for comprehensive interventions targeted toward chronic malnutrition and anemia in children from rural coastal communities. Improvement of socioeconomic conditions, family planning, prenatal care and reduction of diarrheal diseases should be prioritized.

Modelling for Anaemia and Malnutrition in Children Less Than Five Years of Age in Lesotho: A Case Study of a Cross-Sectional Dataset Using Multivariate Joint Model.

“…The same results showed that diarrhoea has a significant effect on anaemia, and the risk of having anaemia is high in children with diarrhoea. The findings from this study are in line with previous research (Gaston et al, 2018;Rivadeneira et al, 2020).…”

“…This positive association means that the two diseases move in the same direction, and controlling malnutrition by improving the nutrition status of children could result in reducing anaemia. The same results were found in studies by Yang et al (2012); Gari et al (2017); Mohammed et al (2019); Rahman et al (2019) and Rivadeneira et al (2020). The findings from this study indicate that the child's age has a significant effect on both anaemia and malnutrition.…”

“…Lastly, the findings from this study indicated that children from middle and richer classes have a lower risk of having malnutrition (Gari et al, 2017;Rivadeneira et al, 2020).…”

“…Generally, previous studies interested in modelling anaemia and malnutrition simultaneously, such as those by Olney et al (2009), Yang et al (2012), Adeyemi et al (2019), andRivadeneira et al (2020) among others, showed a significant effect between the two diseases.…”

Joint modelling of anaemia and stunting in children less than five years of age in Lesotho: a cross-sectional case study

“…The studies aimed to understand the association between anaemia and stunting in children younger than 5 years are limited [ 2 , 32 , 36 , 37 , 39 , 43 , 48 ]. We found no study in literature that has utilized the joint model for anaemia and stunting in children younger than 5 years of age in Lesotho.…”