Predictors of wasting among children under-five years in largely food insecure area of north Wollo, Ethiopia: a cross-sectional study

Abstract

Child undernutrition is widespread in low- and middle-income countries and is linked with weakened immunity and increased risks of morbidity and mortality. Ethiopia has made a marked reduction in stunting, but there has, however, been little progress in wasting reduction and limited evidence in food insecure areas may hamper the design of effective interventions. Therefore, the aim of the present study was to determine the contributing factors to persistent high prevalence of wasting among 6–59-month-old children. A community-based cross-sectional study was employed in February to March 2020, and included 384 mother–child pairs. Data were collected using a structured interviewer-administered questionnaire. Bivariate and multivariable logistic regression analyses were conducted. The overall prevalence of wasting was 12⋅8 % (95 % CI 9⋅1, 16⋅1); with 5⋅8 % severely wasted. Factors significantly associated with wasting were child age 6–23 (v. 24–59 months), delayed initiation of breast-feeding, diarrhoeal illness in the last 2 weeks, poor dietary diversity and low socioeconomic status. The present findings support that aligning poverty reduction interventions and healthcare services is important to accelerate wasting reduction more equitably and achieve the World Health Assembly's target and SDG goal #2 in the coming years. Improving accessibility and affordability of nutritious foods and early diagnosis and treatment of childhood morbidity are critical to address childhood wasting in the context of food insecure areas.

Prevalence and determinants of wasting among under‐5 Egyptian children: Application of quantile regression

“…Undernourished children have weakened immunity and impaired cognitive function, which leads to their poor health outcomes, loss of future productivity, and low academic performance (Anato, 2022 ; WHO & UNICEF, 2009 ). Consequently, undernutrition is responsible for almost half (45%) of all deaths in under‐5 children worldwide (Anato, 2022 ; FAO et al, 2017 ). Wasting or acute malnutrition refers to a child's thinness due to a lack of nutritional intake and/or illness (Karlsson et al, 2022 ; Motbainor & Taye, 2019 ).…”

“…Severe wasting is one of the leading hazards to child survival, resulting in one in five deaths of under‐5 children worldwide, killing more than 1 million children every year (UNICEF, 2022 ). Annually, 8 million deaths are anticipated to be caused by wasting, with severe wasting responsible for 60% of these deaths in low‐ and middle‐income countries (LMICs) (Anato, 2022 ; Black et al, 2013 ).…”

“…There were 45.4 million wasted children worldwide under the age of 5 in 2020, with 13.6 million of those being severely wasted (Anato, 2022 ; UNICEF et al, 2020 ). Africa has the second highest prevalence of wasting (27%) in the world (Anato, 2022 ).…”

“…There were 45.4 million wasted children worldwide under the age of 5 in 2020, with 13.6 million of those being severely wasted (Anato, 2022 ; UNICEF et al, 2020 ). Africa has the second highest prevalence of wasting (27%) in the world (Anato, 2022 ). In Egypt, the prevalence of wasting in children under the age of 5 is 9.5% which is more than 1.5 times the average rate of wasting (6.0%) for the African region (Global Nutrition Report, 2022 ).…”

“…The socio‐demographic and economic profiles of all the wasted children and their families are not the same. Therefore, earlier studies explored that many child's features—including sex, age, birth order, low birth weight, inadequate breast feeding, infectious diseases, vaccination, insufficient energy and micronutrient intake, and inappropriate complementary feeding practices; parental characteristics—such as education, low nutritional knowledge and awareness, mother's age and body mass index (BMI), ANC visits during pregnancy period, and birth spacing; as well as some social factors—including types of living area, wealth status, and food availability; environmental factors and many more have significant contribution in explaining the wasting status of children under the age of 5 (Ali et al, 2017 ; Anato, 2022 ; Biadgilign et al, 2016 ; Black et al, 2013 ; Harding et al, 2018 ; Karlsson et al, 2022 ; Khan et al, 2019 ; Li et al, 2020 ; Manda et al, 2015 ; Molla et al, 2022 ; Motbainor & Taye, 2019 ; Mukabutera et al, 2016 ; Ntenda & Chuang, 2018 ; Rahman et al, 2008 ; Rahman & Chowdhury, 2007 ; Tigga & Sen, 2016 ; Vollmer et al, 2017 ).…”