The coexistence of stunting and overweight or obesity in Ethiopian children: prevalence, trends and associated factors

BMC Pediatrics · 13 authors, 7 centres

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This pooled analysis of three national surveys found the overall prevalence of concurrent stunting and overweight/obesity among Ethiopian children under five was 1.33%, with factors including breastfeeding status, maternal overweight, and small household size.

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This study analyzed pooled, weighted data from the 2005, 2011, and 2016 Ethiopian Demographic and Health Surveys to estimate the prevalence, trends, and factors associated with the coexistence of stunting and overweight/obesity (CSO) in 23,756 children aged 0–59 months. Stunting and overweight/obesity were defined using WHO growth standards. The overall prevalence of CSO was 1.33%, with a trend showing a decline from 2.36% in 2005 to 0.87% in 2011, and a slight increase to 1.34% in 2016. Multilevel logistic regression identified three significant factors: children currently breastfeeding (AOR 1.64), those born to an overweight mother (AOR 2.65), and those living in households with 1–4 members (AOR 1.52). The study used multilevel models to account for clustering. Limitations include reliance on secondary data and potential recall bias.

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cohort

SPECIALTY

pediatrics

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ORIGINAL PAPER

PMC10163774

The coexistence of stunting and overweight or obesity in Ethiopian children: prevalence, trends and associated factors

BMC Pediatrics

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ABSTRACT

Abstract Background Double burden of childhood malnutrition is a condition where undernutrition (stunting) along with overweight and obesity coexist within individuals, households, and populations. It reflects a new layer of malnutrition and an understudied phenomenon in many low-income settings. To date, the prevalence and factors that are associated with concurrent stunting and overweight or obesity (overweight/obesity) (CSO) in the same children have not been well researched in Ethiopia. Hence, this study aimed to assess the prevalence, trends, and factors associated with the coexistence of stunting and overweight or obesity among children aged 0–59 months in Ethiopia. Methods Pooled data from 2005, 2011 and 2016 Ethiopian Demographic and Health Survey (EDHS) were used. A total of 23,756 (weighted sample) children aged 0–59 months were included in the study. Height-for-age z-scores (HAZ) less than − 2 SD and weight-for-height z-scores (WHZ) above 2 SD were calculated, and children were classified as stunted and overweight/obese, respectively. A child who is simultaneously stunted and overweight/obese was considered as having HAZ below − 2 SD and WHZ above 2 SD computed into a variable named CSO, and reported as a binary outcome (yes or no). Multilevel logistic regression analysis that adjusts for sampling weights and clustering was used to identify factors associated with CSO. Results The prevalence of stunting, overweight or obesity, and CSO among under-five children was 43.12% [95% CI: (42.50, 43.75%)], 2.62% [95% CI: (2.42, 2.83%)], and 1.33% [95% CI: (1.18, 1.48%)], respectively. The percentage of CSO children was reported to have declined from 2.36% [95% CI: (1.94–2.85)] in 2005 to 0.87% [95%CI: (0.07–1.07)] in 2011, and the same appeared to have increased slightly to 1.34% [95%CI: (1.13–1.59)] in 2016. Children who were currently breastfeeding [AOR: 1.64, 95%CI: (1.01–2.72)], born to an overweight mother [AOR: 2.65, 95%CI: (1.19–5.88)], and lived in families with 1–4 household members [AOR: 1.52, 95%CI: (1.02–2.26)] were significantly associated with CSO. At the community level the odds of having CSO were higher among children included from EDHS-2005 [AOR: 4.38, 95%CI: (2.42–7.95)]. Conclusion The study revealed that less than 2% of children had CSO in Ethiopia. CSO was linked to factors at both the individual (i.e. breastfeeding status, maternal overweight, and household size) and community-levels. Overall, the study findings indicated the necessity of focused interventions to simultaneously address double burden of childhood malnutrition in Ethiopia. To further combat the double burden of malnutrition, early identification of at-risk children, including those born to overweight women and children living with multiple household members, is indispensable. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-023-04037-7. Keywords: Double burden, Malnutrition, Concurrent stunting and overweight or obesity, Ethiopia

CITATION EXPORT

Biniyam Sahiledengle, Lillian Mwanri, Abera Kumie et al.. The coexistence of stunting and overweight or obesity in Ethiopian children: prevalence, trends and associated factors. BMC Pediatrics. (2023). https://doi.org/10.1186/s12887-023-04037-7

AUTHORS

13 · 7 CENTRES

Biniyam Sahiledengle, Lillian Mwanri, Abera Kumie, Girma Beressa, Daniel Atlaw, Yohannes Tekalegn, Demisu Zenbaba, Fikreab Desta, Chala Kene, Kenbon Seyoum, Degefa Gomora, Demelash Woldeyohannes, Kingsley Emwinyore Agho

1Department of Public Health, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia
2Centre for Public Health Research, Equity and Human Flourishing, Torrens University, Adelaide Campus, Adelaide, SA 5000 Australia
3School of Public Health, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
4Department of Human Anatomy, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia
5Department of Midwifery, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia
6Department of Public Health, College of Medicine and Health Science, Wachemo University, Hossana, Ethiopia
7School of Health Sciences, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751 Australia