Prevalence and Determinants of Chronic Malnutrition among Preschool Children: A Cross-sectional Study in Dhaka City, Bangladesh

Abstract

Chronic malnutrition is one of the major causes of morbidity and mortality among preschool children and the future productivity of nations. To understand the prevalence of chronic malnutrition and to identify the factors affecting height-for-age z-score (HAZ) among preschool children, a cross-sectional study was conducted among 380 randomly-selected children aged less than five years in Dhaka city, Bangladesh. Results of analysis of this study data revealed that the prevalence of stunting among preschool children in Dhaka city was 39.5%, with 25% severely stunted and 14% moderately stunted (p<0.001). Results of bivariate analysis revealed that socioeconomic and demographic factors were most significantly associated with the stunting of children. Children were found to be well-nourished if their parents had a tertiary-level education or higher and if the mother held a job and had good knowledge of nutrition. Well-nourishment of the children were also associated with the height of mothers (above 148 cm), good family educational background, normal birthweight, greater frequency of food intake (more than six times/day), and fewer fever episodes in the last six months. Results of multivariate linear regression models showed that height of mothers, birthweight of children, education of fathers, knowledge of mothers on nutrition, and frequency of feeding were the most significant factors that had an independent and direct influence on the stunting of children. To achieve the Millennium Development Goal target of 34% malnutrition prevalence by 2015, it is important to have specific government intervention to focus on the causes that directly influence the stunting of children.

Chronic undernutrition amongst under-five in an urban slum of Central India

“…Studying stunting is important as it reflects the cumulative effects of socioeconomic, health and nutritional problems. 3 It is projected that more than half of the Indian population will live in urban areas by 2020 and nearly one third of this urban population will be of slum dwellers. 6 The growth and development of the slum children is compromised due to poverty and low social status because of their mobility, lack of public services and poor sanitation.…”

“…It silently destroys the future productivity of nations. 3 Adequate nutrition is essential for achieving millennium development goal (MDG) 1, which is to eradicate extreme poverty and hunger, as well as MDGs 4 and 5, which are to reduce child mortality and improve maternal health. 4 In any community, under five children are one of the most vulnerable groups for nutritional deficiencies, owing to many factors ranging from low birth weight to maternal ill health to socioeconomic and environmental factors.…”

Forecasting the progress towards the target of Millennium Development Goal 1C in children under 5 years of age in Bangladesh

“…A number of studies have documented parental education, maternal nutritional status, maternal employment status, exposure to mass media, household socio-economic status, community environment, the number of under-5s in the family, size of the baby at birth, birth order and area of residence as important determinants of child undernutrition in Bangladesh (5)(6)(7)(8)(9) . Studies have consistently reported that children residing in rural areas, belonging to poorer household and whose parents have less formal education are at higher risk of undernutrition (3,9,10) .…”

An assessment of the nutritional status of underfive children in a rural area of Thrissur district, Kerala, India

“…Study done by Jesmin A et al, in Bangladesh also found a significant association between frequent episodes of illness and nutritional status of children. 17 The study also found that the risk of underweight and stunting was significantly higher among children who suffered from acute respiratory infections and acute diarrheal diseases in the past one year as compared to other children. These findings are corroborated by a study by Ray SK et al 14 Presence of one or more clinical signs of nutritional deficiency among the study subjects placed them at a higher risk of underweight and stunting.…”