Epidemiology of Underweight among Infants in Rural Burkina Faso.

Ali Sié,Elodie Lebas,Thomas M Lietman,Mamadou Ouattara,Clarisse Dah,Kieran S O’Brien,Benjamin F Arnold,Guillaume Compaore,Mamadou Bountogo,Jessica M Brogdon,Catherine E Oldenburg,William W Godwin,Ying Lin

doi:10.4269/ajtmh.21-0838

Abstract

ABSTRACT.Infant undernutrition is thought to contribute to growth failure and mortality. We evaluated the patterns in underweight in a population-based sample of children aged 1–11 months in rural northwestern Burkina Faso. Data were collected during the baseline assessment of a community-randomized trial evaluating mass azithromycin distribution in Nouna District, Burkina Faso. A door-to-door census was undertaken for all households in all communities. Infants aged 1–11 months were weighed for weight-based dosing in the trial and their weights were used to calculate weight-for-age Z-scores (WAZ). Underweight was defined as WAZ ≤ 2. We evaluated the age patterns in WAZ and underweight by demographic, seasonal, and geographic characteristics. Of 7,109 infants, 6,077 had accurate weight and global positioning system (GPS) coordinate data (85.5%). Infants were a median of 6 months old (interquartile range [IQR] 3–8) and 48.4% were female. Mean WAZ was −0.68 (SD 1.6) and 19.0% were underweight. The WAZ decreased with increasing age, and the prevalence of underweight increased from 2.5% among 1-month-olds to 27.6% among 11-month-olds. Underweight was more common among boys than girls (22.1% among boys versus 15.6% among girls). Improved latrine use by the household was associated with increased WAZ, and this effect was stronger in male compared with female infants. Given the large burden of underweight among infants, interventions addressing undernutrition should specifically include infants.

Highlights

The first 1,000 days of life is considered an essential period for access to adequate nutrition to reduce the risk of adverse developmental outcomes.[1,2] Growth failure occurring during this period can affect growth trajectories and cognitive development much later into childhood and adolescence.[3]
This study took place as part of the baseline assessment for the Community Health with Azithromycin Trial (CHAT), a community-randomized trial of mass azithromycin distribution compared with placebo for the prevention of under-5 mortality.[16]
6,465 (90.9%) had a weight measurement, of which 6,437 (99.9%) were considered valid based on Weight-for-age Z-score (WAZ)

Summary

Introduction

The first 1,000 days of life (from conception through age 2 years) is considered an essential period for access to adequate nutrition to reduce the risk of adverse developmental outcomes.[1,2] Growth failure occurring during this period can affect growth trajectories and cognitive development much later into childhood and adolescence.[3]. These interventions may be valuable early in life, as early growth failure is predictive of worse outcomes later in childhood.[8,9]

Methods

Results

Conclusion