Prevalence and Path Analysis on the Effects of Diarrhea and Life Course Determinants on Stunting in Children Under Two Years of Age in Kupang, East Nusa Tenggara

Abstract

Background:The interaction between infections and malnutrition has been recognized as a vicious cycle. Repeated diarrhoeal illnesses as well as other common childhood infections progressively altered the normal growth trajectories of children. This study aimed to analyze the effects of diarrhea and lifelong determinants on the incidence of stunting in children under two years in Kupang. Subjects and Method: This was a case control study conducted in 25 integrated health posts in Alak and Oebobo Subdistricts, in Kupang, East Nusa Tenggara, from November December 2018. A sample of 200 children under two years was selected by multi-stage random sampling. The dependent variable was stunting. The independent variables were diarrhea, birth length, parental income, maternal education, exclusive breastfeeding, maternal height, maternal mid-upper arm circumference (MUAC), complementary feeding, maternal hygiene practice, and sanitation. The data were collected by questionnaire and analyzed by path analysis. Results: Stunting prevalence in Kupang was 30.5%. The risk of stunting was directly decreased by appropriate complementary feeding (b= -1.97; 95% CI= -3.55 to -0.39; p= 0.014), good hygiene practice (b= -4.38; 95% CI= -6.63 to -2.12; p<0.001), good sanitation (b= -2.32; 95% CI= -4.00 to -0.64; p= 0.007), and birth length ≥48 cm (b= -2.22; 95% CI= -3.74 to -0.69; p= 0.004). The risk of stunting was directly increased by diarrhea (b= 2.55; 95% CI= 1.01 to 4.09; p= 0.001). It was indirectly affected by parental income, maternal education, exclusive breastfeeding, maternal height, and maternal MUAC at pregnancy. Conclusion:The risk of stunting is directly decreased by appropriate complementary feeding, good hygiene practice, good sanitation, and birth length ≥48 cm. The risk of stunting is directly increased by diarrhea. It is indirectly affected by parental income, maternal education, exclusive breastfeeding, maternal height, and maternal MUAC at pregnancy.

Analysis of Factors Associated with Stunted Growth in Children Aged 12-60 Months Living in Lenda Village, Manggarai Regency, NTT

“…The results of this study are in line with the research conducted by (Ilma, Salimo, & Pamungkasari, 2019) which shows that recurrent diarrhea events affect the risk of stunted growth b = 2.55%; 95% CI = 1.01-4.09; p = 0.001). The many risk factors for diarrhea in children include good hygiene practices from the mother, the provision of additional food and sanitation.…”

“…A good supply of additional food will reduce the risk of recurrent diarrhea in children (b = -0.89; 95% CI = -1.68 to -0.09; p = 0.028). Families who have good basic sanitation will reduce the risk of recurrent diarrhea in children (b = -1.73; 95% CI = -2.57 to -0.88; p < 0.001) (Ilma et al, 2019).…”

Multilevel Analysis Association of Soil Transmitted Helminths and Stunting in Children Aged 6-12 Years Old in Pinrang District, South Sulawesi

“…The results of a study conducted in Pinrang Regency are in line with the results of research conducted by Ilma, Salimo and Pamungkasari (2019) in Kupang, which stated that children with a long history of normal birth weight reduce the risk of stunting. Child birth length significantly increases the risk of stunting by up to 2 years in an early life, which can increase the risk of various chronic diseases.…”

Faktor Risiko Stunting pada Balita (Studi Perbedaan antara Dataran Rendah dan Dataran Tinggi)

“…Anak usia 0-23 bulan tahun mempunyai riwayat diare berisiko mengalami stunting dengan nilai OR 1.22 (95% Cl: 0.99-1.49) artinya anak dengan riwayat diare berisiko mengalami stunting sebesar 1.22 kali dibandingkan dengan anak yang tidak memiliki riwayat diare (21). Hasil penelitian di Kupang menunjukkan bahwa diare pada anak merupakan penyebab langsung terjadinya stunting (22). Anak dengan riwayat diare yang sering berisiko mengalami stunting dengan nilai OR 3.619 dan nilai p = 0.025 yang berarti anak yang sering diare berisiko mengalami stunting sebesar 3.6 kali dibandingkan dengan anak yang tidak sering diare (23).…”