Abstract
BackgroundArmed conflict is a significant social determinant of child health with nuanced effects. There is a dearth of knowledge on the public health issues facing vulnerable populations in conflict-stricken areas. The objective was to determine the prevalence and determinants of moderate to severe anaemia (MdSA) and severe stunting (SS) in children ≤3 years in conflict-hit Dibanda, Ekona and Muea in the Mount Cameroon area.MethodsHaematological parameters were obtained using an automated haematology analyser while undernutrition indices standard deviation (SD) scores (z- scores), were computed based on the WHO growth reference curves for 649 children in a community based cross-sectional study in 2018. Binomial logistic regression models were used to evaluate the determinants of MdSA and SS against a set of predictor variables.ResultsAnaemia was prevalent in 84.0% (545) of the children with a majority having microcytic anaemia (59.3%). The prevalence of MdSA was 56.1% (364). Educational level of parents/caregiver (P < 0.001) and site (P = 0.043) had a significant negative effect on the occurrence of MdSA. Stunting, underweight and wasting occurred in 31.3, 13.1 and 6.3% of the children, respectively. Overall, SS was prevalent in 17.1% (111) of the children. The age groups (0.1–1.0 year, P = 0.042 and 1.1–2.0 years, P = 0.008), educational levels (no formal education, P < 0.001 and primary education P = 0.028) and SS (P = 0.035) were significant determinants of MdSA while MdSA (P = 0.035) was the only significant determinant of SS. On the contrary, age group 0.1–1 year (OR = 0.56, P = 0.043) and site (Dibanda, OR = 0.29, P = 0.001) demonstrated a significant protective effect against SS.ConclusionsModerate to severe anaemia, severe stunting and wasting especially in children not breastfed at all are public health challenges in the conflict-hit area. There is a need for targeted intervention to control anaemia as well as increased awareness of exclusive breast feeding in conflict-hit areas to limit the burden of wasting and stunting.
Highlights
Armed conflict is a significant social determinant of child health with nuanced effects
Anaemia prevalence and type Anaemia was prevalent in 84.0% of the children
Severe stunting (SS) Overall, severe stunting (SS) was prevalent in 17.1% (111, 95% confidence interval (CI) = 14.4– 20.2%) of the children
Summary
Armed conflict is a significant social determinant of child health with nuanced effects. The violent and destructive nature of armed conflicts and the breakdown in health systems may harm vulnerable populations like children under 5 years and pregnant women residing in such areas who themselves are rarely combatants. A significant portion of child deaths in Africa take place in countries with recent history of armed conflict and political instability. A country once known for its stability, has faced violence in an armed conflict since 2017 with serious human rights abuses and humanitarian consequences of great concern in the North West and South West Regions [4]. Armed conflict is a significant social determinant of child health with nuanced effects on physical, developmental, mental health and wellbeing [5]
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