A Multi-causal Model for Chronic Malnutrition and Anemia in a Population of Rural Coastal Children in Ecuador

María F Rivadeneira,Betzabé Tello,Gladys J Buitrón,Ana L Torres,Todd R Fredricks,Mario J Grijalva,Ana L Moncayo,Fabricio Astudillo

doi:10.1007/s10995-019-02837-x

María F Rivadeneira, Betzabé Tello + Show 6 more

Open Access

https://doi.org/10.1007/s10995-019-02837-x

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Abstract

ObjectivesChronic malnutrition and anemia are prevalent in developing countries. This research aimed to determine the prevalence of chronic malnutrition and anemia and their associated factors in children under five using a multi-causal model in a rural community in the coast of Ecuador.MethodsThe study included 314 children under 5 years old who were residents of San Isidro, Ecuador. Indicators of chronic malnutrition and anemia were identified. Mothers/caregivers were surveyed on socio-economic and environmental conditions, feeding and care practices, access to health services and biological characteristics. Bivariate and multivariable Poisson regression were performed.ResultsThe prevalence was 12.42% (n = 39) for chronic malnutrition and 16.98% (n = 54) for anemia. There was a significant and independent association between chronic malnutrition and family income less than $80 USD per month (Prevalence Ratio [PR] = 2.74, 95% CI 1.04, 7.20), maternal height less than 150 cm (PR 3.00, 95% CI 1.69, 5.32) and residence in a household with more than 4 children (PR 3.05, 95% CI 1.48, 6.29). Anemia was 2.57 times higher (95% CI 1.17, 5.65) in children with more than two episodes of diarrhea in the last 6 months. Prenatal care (5 to 8 visits) provided a protective effect for anemia (PR 0.48, 95% CI 0.27, 0.89).Conclusions for PracticeFindings support the need for comprehensive interventions targeted toward chronic malnutrition and anemia in children from rural coastal communities. Improvement of socioeconomic conditions, family planning, prenatal care and reduction of diarrheal diseases should be prioritized.

Highlights

Chronic malnutrition and childhood anemia still remain significant public health problems worldwide (Aheto et al 2015; Black et al 2013; Fikadu et al 2014)
Iron-deficiency anemia is one of the most important causes of years lived with disability (YLDs) in children and adolescents (Kassebaum et al 2017)
The percentage of children that had more than two episodes of diarrhea and respiratory infections in the 6 months preceding the survey was 20.4% and 51%, respectively

Summary

Introduction

Chronic malnutrition and childhood anemia still remain significant public health problems worldwide (Aheto et al 2015; Black et al 2013; Fikadu et al 2014). The worldwide prevalent cases of iron-deficiency anemia in children and adolescents 19 years or younger was 713 million (Kassebaum et al 2017). In 2012, Ecuador had one of the highest rates of chronic malnutrition (25.3%) and anemia (25.7%) in children under 5 years in Latin America (Freire et al 2014). Iron-deficiency anemia is one of the most important causes of years lived with disability (YLDs) in children and adolescents (Kassebaum et al 2017)

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