Variations in the association between standalone and coexisting forms of undernutrition and common infectious morbidities among children in sub-Saharan Africa.
Children with multiple forms of undernutrition are more likely to suffer from common infectious diseases, highlighting the need for targeted nutritional interventions.
Where it sits
this study against the rest of the ipamorelin corpusSummary and findings
This study examined the association between different forms of undernutrition and common infectious morbidity among children under five in sub-Saharan Africa. A total of 157,800 children were assessed for nutritional status and morbidity data was collected. The study found that coexisting forms of undernutrition were linked to higher odds of infectious morbidity.
Abstract
<h4>Background</h4>Undernutrition is a major driver of common infectious morbidity among children under five; however, the relationship between different forms of undernutrition and childhood infectious morbidity remains poorly understood. This study examined variations in the association between different forms of undernutrition measured according to the Composite Index of Anthropometric Failure (CIAF) and common infectious morbidity among children under the age of five in sub-Saharan Africa (SSA).<h4>Methods</h4>We performed a multilevel binary logistic regression analysis using country and community clusters as random effects. Our study utilised demographic and health survey (DHS) data collected between 2016 and 2024 in 27 SSA countries. A total weighted sample of 157, 800 under-five children whose nutritional status was assessed based on the World Health Organization (WHO) anthropometric techniques and data on Acute Respiratory tract Infection (ARI) and diarrhea recorded were included. An adjusted odds ratio (AOR) with a 95% Confidence Interval (CI) was reported, and variables' effects with a <i>p</i>-value less than 0.05 were declared significant determinants of common infectious morbidity.<h4>Results</h4>The prevalence of common infectious morbidity among children under five in SSA was 30.20% (95% CI: 27.34, 33.06). The lowest and highest prevalences were reported in Mozambique (16.96%; 95% CI: 16.94, 16.98) and Uganda (53.26%; 95% CI: 53.24, 53.28), respectively. The odds of infectious morbidity significantly differs between children with standalone, double and triple forms of undernutrition. Children with double (AOR: 1.25; 95% CI: 1.16, 1.34 for stunting-underweight; AOR: 1.36; 95% CI: 1.22, 1.51 for wasting-underweight) and triple undernutrition (AOR: 1.51; 95% CI: 1.36, 1.68) were more susceptible to common infectious morbidity.<h4>Conclusions</h4>Children with coexisting undernutrition were more likely to experience common infectious morbidity, and those affected by the coexistence of stunting-wasting-underweight experienced the highest odds of infectious morbidity. Among the standalone forms, only underweight children were more likely to experience common infectious morbidity. Therefore, to mitigate the burden of childhood infectious morbidity, it is crucial for policymakers to implement targeted nutritional interventions for children experiencing coexisting undernutrition.
Background
This paper addresses the relationship between various forms of undernutrition and infectious morbidity in children under five, a significant public health concern in sub-Saharan Africa. Prior research has established that undernutrition is a major driver of morbidity, but the specific associations between different forms of undernutrition and infectious diseases remain inadequately explored. Understanding these relationships is crucial for developing effective nutritional interventions.
Methods
The study utilized a multilevel binary logistic regression analysis with country and community clusters as random effects. Data were collected from demographic and health surveys conducted between 2016 and 2024 across 27 sub-Saharan African countries. The sample included 157,800 children under five, with nutritional status assessed using WHO anthropometric techniques and morbidity data on Acute Respiratory Tract Infection (ARI) and diarrhea.
Results
The primary endpoint revealed a 30.20% prevalence of common infectious morbidity among children under five in SSA (95% CI: 27.34, 33.06). The odds of infectious morbidity were significantly higher in children with double forms of undernutrition, with adjusted odds ratios of 1.25 for stunting-underweight and 1.36 for wasting-underweight. Children with triple undernutrition had an adjusted odds ratio of 1.51.
Interpretation
The findings indicate that children with coexisting forms of undernutrition are at a higher risk for infectious morbidity, aligning with previous literature that suggests compounded nutritional deficiencies exacerbate health outcomes. However, the effect sizes, while statistically significant, may not be clinically meaningful without considering the broader context of healthcare access and intervention strategies. Limitations such as the observational nature of the study and potential confounding factors should be acknowledged when interpreting these results.
Key findings
- 30.20% prevalence of common infectious morbidity among children under five in SSA (95% CI: 27.34, 33.06)
- Lowest prevalence in Mozambique: 16.96% (95% CI: 16.94, 16.98)
- Highest prevalence in Uganda: 53.26% (95% CI: 53.24, 53.28)
- Children with double undernutrition (AOR: 1.25; 95% CI: 1.16, 1.34 for stunting-underweight; AOR: 1.36; 95% CI: 1.22, 1.51 for wasting-underweight) were more susceptible to infectious morbidity
- Children with triple undernutrition had an AOR of 1.51 (95% CI: 1.36, 1.68) for infectious morbidity
Limitations
- observational data may have confounding factors
- cross-sectional design limits causal inferences
- data collected from surveys may have reporting biases
- not all forms of undernutrition may have been assessed