Abstract
Diarrhoea is associated with undernutrition and this association is related to increased morbidity and mortality in children under-five. In this analysis we aimed to assess the frequency and associated factors of undernutrition in children under-five with diarrhoea. A hospital-based cross-sectional study was conducted from January 2015 to December 2019 through a surveillance system in five sentinel hospitals in Mozambique. Sociodemographic and clinical information was collected, including anthropometry. A total of 963 children were analysed. The overall undernutrition frequency was 54.1% (95% CI: 50.9–57.2), with 32.5% (95% CI: 29.6–35.5) stunting, 26.6% (95% CI: 23.9–29.6) wasting and 24.7% (95% CI: 22.1–27.5) underweight. Children from Nampula province had 4.7 (p = 0.016) higher odds for stunting compared with children from Maputo. Children whose caregiver was illiterate had higher odds of being underweight 5.24 (p < 0.001), and the wet season was associated with higher odds 1.70 (p = 0.012) of being wasted. Children born under 2500 g of weight had 2.8 (p = 0.001), 2.7 (p < 0.001) and 2.6 (p = 0.010) higher odds for being underweighted, wasted and stunted, respectively. The HIV positive status of the children was associated with higher odds of being underweight 2.6 (p = 0.006), and stunted 3.4 (p = 0.004). The province, caregiver education level, wet season, child’s birthweight and HIV status were factors associated with undernutrition in children with diarrhoea. These findings emphasise the need for additional caregiver’s education on the child’s nutrition and associated infectious diseases. More studies are needed to better understand the social context in which a child with diarrhoea and undernutrition is inserted.
Highlights
Diarrhoea is one of the main causes of child morbidity and mortality in developing countries [1] and undernutrition is one of the most important risk factors for this illness globally [2]
Our study aims to assess the burden of undernutrition in children under-five with diarrhoea in five sentinel sites across the country, representing the three main regions of the country and the potential factors that might be associated with undernutrition conditions
Children born with a low birthweight were related to the three types of undernutrition, and a HIV positive status was related to underweight and stunting
Summary
Diarrhoea is one of the main causes of child morbidity and mortality in developing countries [1] and undernutrition is one of the most important risk factors for this illness globally [2]. In 2019, diarrhoea was the third leading cause of death in children under-five years old with 9.9% of deaths worldwide [3]. In 2017, it was the fourth major cause of mortality in children under-five years old and responsible for approximately 6.9% of deaths in this age group [4,5]. According to data from a health survey conducted in Mozambique in 2015, the national prevalence was estimated at 11% and higher percentages were observed in children aged 6–11 months and. Undernutrition in children was shown to increase the risk of occurrence of infectious diseases, death and delayed cognitive development, that can lead to low adult incomes, poor economic growth and an intergenerational transmission of poverty [7].
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