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Predictors of poor anthropometric status among children under 2 years of age in rural Uganda

Published online by Cambridge University Press:  02 January 2007

Henry Wamani ,
Anne Nordrehaug Åstrøm ,
Stefan Peterson ,
James K Tumwine  and
Thorkild Tylleskär
Henry Wamani*
Affiliation:
Centre for International Health, University of Bergen, Norway Ministry of Health, PO Box 16705, Kampala, Uganda
Anne Nordrehaug Åstrøm
Affiliation:
Centre for International Health, University of Bergen, Norway
Stefan Peterson
Affiliation:
Division of International Health (IHCAR), Karolinska Institute, Stockholm, Sweden
James K Tumwine
Affiliation:
Department of Paediatrics and Child Health, Makerere University Medical School, Kampala, Uganda
Thorkild Tylleskär
Affiliation:
Centre for International Health, University of Bergen, Norway
*
*Corresponding author: Email [email protected]
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Abstract

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Objective

To assess predictors of poor anthropometric status among infants and young children.

Design

Cross-sectional survey.

Setting

The rural subsistence agricultural district of Hoima, western Uganda.

Subjects

Seven hundred and twenty children aged 0–23 months with their mothers/carers.

Methods

Participants were recruited in September 2002, using a two-stage cluster sampling methodology. A structured questionnaire was administered to mothers in their home settings. Information on health, household socio-economic status, child feeding practices and anthropometric measurement was gathered. Conditional logistic regression analysis was applied taking into account the hierarchical relationships between potential determinants of poor anthropometric status.

Results

The mean Z-score for weight-for-height was −0.2 (95% confidence interval (CI) −0.1, −0.7), for height-for-age was −1.1 (95% CI −1.2, −0.9) and for weight-for-age was −0.7 (95% CI −0.8, −0.6). Wasting was independently associated only with a history of fever in the 2 weeks prior to the survey (odds ratio (OR) = 4.4, 95% CI 1.5, 13), while underweight was associated with a history of fever (OR = 2.4, 95% CI 1.3, 4.4) and cough (OR = 3.0, 95% CI 1.3, 6.8). Stunting was positively associated with a wider range of factors, including: history of a fever episode (OR = 1.7, 95% CI 1.0, 2.9), lack of a latrine in the household (OR = 2.7, 95% CI 1.5, 4.9), failure to de-worm children 12 months or older (OR = 1.7, 95% CI 1.1, 2.8), and being born to a non-formally educated mother compared with mothers educated above primary school (OR = 2.1, 95% CI 1.1, 4.0).

Conclusions

In analyses guided by the hierarchical interrelationships of potential determinants of malnutrition, wasting and underweight turned out to be independently predicted by morbidity (proximal) factors. Stunting, however, was predicted by socio-economic (distal), environmental and health-care (intermediate) factors in addition to morbidity. Strategies aimed at improving the growth of infants and young children in rural communities should address morbidity due to common childhood illness coupled with environmental and socio-economically oriented measures.

Keywords

WastingStuntingUnderweightInfantsHierarchical conceptual analysis
Type
Research Article
Information
Public Health Nutrition , Volume 9 , Issue 3 , May 2006 , pp. 320 - 326
Copyright
Copyright © The Authors 2006

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