SEARCHCROSS-SECTIONALpediatrics, nutrition

cross-sectional·pediatrics, nutrition, public health, epidemiology, observational study·PMC10024843

Prevalence and multi-level factors associated with acute malnutrition among children aged 6–59 months from war affected communities of Tigray, Northern Ethiopia, 2021: a cross-sectional study

Conflict and Health · 13 authors, 5 centres

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TL;DR

This cross-sectional study found a very high prevalence of acute malnutrition (26.9%) among young children in war-affected Tigray, Ethiopia, and identified individual and community-level factors like age, vitamin A supplementation, diarrhea, and household food insecurity as significantly associated with it.

Full summary

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This community-based cross-sectional study assessed the prevalence and factors associated with acute malnutrition among 3,614 children aged 6–59 months in Tigray, Ethiopia, during the 2021 armed conflict. Using multivariable multilevel logistic regression, the study found a very high burden of global acute malnutrition at 26.9%. Community-level factors with significant associations were unimproved drinking water sources (AOR=1.31), unimproved toilet facilities (AOR=1.24), and severe household food insecurity (AOR=1.55). The study limitations include its cross-sectional design, which precludes establishing causation, and the potential for unmeasured confounders.

STUDY TYPE

cross-sectional

SPECIALTY

pediatrics

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AI pipeline

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ORIGINAL PAPER

PMC10024843

Prevalence and multi-level factors associated with acute malnutrition among children aged 6–59 months from war affected communities of Tigray, Northern Ethiopia, 2021: a cross-sectional study

Conflict and Health

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ABSTRACT

Abstract Background Armed conflicts greatly affect the health, nutrition, and food security of conflict affected settings particularly children. However, no empirical data exist regarding context specific factors contributing towards acute malnutrition in the war-torn Tigray, Ethiopia. Thus, this study aimed to identify individual and community level factors associated with acute malnutrition among children aged 6–59 months from armed conflict affected settings of Tigray, Ethiopia. Methods A community based cross-sectional study was conducted among 3,614 children aged 6–59 months in Tigray, from July 15 to Aug 15, 2021. Study participants were selected using a two-stage random sampling method. A structured questionnaire was used to collect data by interviewing mothers/caregivers. Mid upper arm circumference (MUAC) measurements were taken from upper left arm of the children using MUAC tapes. Multivariable multilevel logistic regression analysis was used to determine factors associated with acute malnutrition. Adjusted Odds ratio (AOR) with 95% CI were estimated to describe the strength of associations at p < 0.05. Results More than half (52.5%) of the sampled children were males in sex. Immediately after the first nine months into the conflict, the prevalence of severe, moderate, and global acute malnutrition was very high (5.1%, 21.8%, and 26.9%, respectively) in Tigray. The lowest and highest burden of child acute malnutrition was reported from Mekelle zone (13.3%) and Southeastern zone (36.7%), respectively. Individual-level factors such as older child age (AOR = 0.13, 95% CI: 0.10, 0.18), female child sex (AOR = 1.24, 95% CI 1.05, 1.480.95), Vitamin-A supplementation (AOR = 1.3, 95% CI: 1.05, 1.65), and history of diarrhea (AOR = 1.22, 95%CI: 1.02, 1.53) and community-level factors like unimproved drinking water source (AOR = 1.31, 95%CI: 1.08, 1.58), unimproved toilet facility (AOR = 1.24, 95% CI: 1.01, 1.52), and severe food insecurity (AOR = 1.55, 95% CI: 1.16. 2.07) were significantly associated with childhood acute malnutrition. Conclusions The burden of acute malnutrition is a severe public health problem in Tigray. To prevent the untimely suffering and death of children, regular nutrition screening, speedy, and appropriate referral of all malnourished children to nutritional services and large-scale humanitarian assistance including access to food; nutrition supplies; water, sanitation and hygiene supplies; and health care in a timely manner are required. In the prevailing armed conflict, these have been very difficult to achieve. Thus, immediate international intervention is needed. Supplementary Information The online version contains supplementary material available at 10.1186/s13031-023-00508-x. Keywords: War, Tigray, Acute malnutrition, Children under-five, Associated factors, Multilevel

CITATION EXPORT

Gebretsadkan Gebremedhin Gebretsadik, Mahlet Abraha, Tedros Bereket et al.. Prevalence and multi-level factors associated with acute malnutrition among children aged 6–59 months from war affected communities of Tigray, Northern Ethiopia, 2021: a cross-sectional study. Conflict and Health. (2023). https://doi.org/10.1186/s13031-023-00508-x

AUTHORS

13 · 5 CENTRES

Gebretsadkan Gebremedhin Gebretsadik, Mahlet Abraha, Tedros Bereket, Ferehiwot Hailemariam, Freweini Gebrearegay, Tigist Hagos, Mizan Assefa, Kidanemaryam Berhe, Hadush Gebregziabher, Amaha Kahsay Adhanu, Mekonnen Haileselassie, Mulugeta Gebregziabher, Afework Mulugeta

1Department of Nutrition and Dietetics, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Tigray Ethiopia
2Department of Environmental Health and Behavioral Sciences, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Tigray Ethiopia
3Department of Reproductive Health, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Tigray Ethiopia
4Tigray Health Bureau, Mekelle, Tigray Ethiopia
5Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC 29425 USA