Thinness among children aged 5–17 years living in Nakivale refugee settlement, South Western Uganda: a cross-sectional study

Abstract

Background Hunger and malnutrition are rampant among refugees and displaced populations, many of whom are infants and children. We sought to determine the prevalence and factors associated with thinness among children aged 5–17 years living in Nakivale refugee settlement, Isingiro district, southwestern Uganda. Methods This was a cross sectional study that enrolled 420 children aged 5 to 17 years. The World Health Organization cluster sampling was used to select 30 villages from which 14 households were selected by consecutive sampling and participants were then chosen per household by simple random sampling. Data were collected on the participant socio-demographic, family, dietary, medical, hygiene and refugee status factors. Thinness was defined as having a z-score < -2 standard deviations of Body Mass Index-for-age from the median WHO growth standards. The prevalence of thinness was determined by ascertaining the total number of children with thinness over the total number of children studied. Multivariable logistic regression model was used to determine the factors independently associated with thinness with p < 0.05 level of significance. Results A total of 420 children aged 5–17 years were enrolled into the study. The median age (IQR) was 8.6 (6.8–11.8) and majority 248 (59.1%) were female. The prevalence of thinness was 5.5% (95% CI: 3.7-8.1%). The factors independently associated with thinness were; living with a chronic disease (aOR 6.47, 95%CI; 1.63–24.64, p = 0.008), use of water from natural sources (aOR 3.32, 95%CI; 1.27–8.71, p = 0.015), and duration of stay in the settlement of less or equal to 10 years (aOR 3.19, 95%CI; 1.15–8.83, p = 0.025). Conclusion Five in every 100 children aged 5–17 years in Nakivale refugee settlement have thinness. Thinness was more likely among children who are living with a chronic disease, used water from natural sources and those whose families had stayed shorter in the settlement. Our findings suggest that children with chronic disease should receive extra food supplementation and have routine growth monitoring as part of their chronic care. The study reiterates a need to have clean and safe water supply and close nutrition assessment and monitoring, especially for newly registered refugee children.

Undernutrition in older children and adolescents in peri-urban Zambia

“…In Zambia, adolescents (aged 10–19 years) comprise about 25% of the population ( 2 ). While there have been multiple calls in recent years to further understand the impact of adolescent undernutrition ( 1 , 3 , 4 ), most research and programming on a global scale has focused on the under 5 (U5) population ( 4 , 5 ). The importance of malnutrition in older children and adolescents has come into greater focus over the last several years given that the importance of this population is a crucial demographic to maintain a healthy society and workforce ( 1 ).…”

“…Despite the noted importance of nutrition in child and adolescent health, there have been few studies quantifying the prevalence of malnutrition or undernutrition among older children and adolescents in sub-Saharan Africa, particularly in Zambia ( 5 , 6 , 8 , 9 ). Moderate and severe thinness among children and adolescents globally is 8.4% in girls and 12.4% in boys ( 1 ).…”

“…While there have been significant strides in U5 malnutrition rates, older children and adolescents are often neglected. One study from Uganda showed that the prevalence of thinness was higher for children 5–17 years compared to U5 children (5.5% vs. 3.8%) ( 5 ). This can largely be attributed to the limited availability of nutrition programs and interventions for children over 5 years ( 5 ).…”