Abstract
Suchana—a large-scale, 7-year nutrition program that started in 2015—is being implemented in 250,000 households in the marginalized segment in north-east Bangladesh, with the aim of improving childhood nutrition status. Untreated childhood moderate wasting may develop to severe wasting, which is associated with a 10-fold higher risk of mortality compared to children of normal weight relative to height/length. Identifying the diverse, age-specific risk factors for moderate wasting may help such programs to formulate tailored interventions to prevent and treat childhood malnutrition in rural communities. The objective of this study was to identify the age-specific factors associated with moderate wasting among 6‒23-month-old children in beneficiary households. Cross-sectional data on 4,400 children was collected through systematic sampling between November 2016 and February 2017 using the Suchana beneficiary list. In total, 8.1% of 6‒11 month-olds and 10.3% of 12‒23 month-olds suffered moderate wasting; 12‒23-month-olds had a 1.3-fold higher risk of moderate wasting than 6‒11-month-olds. Our results of logistic regression models suggest that larger household size, higher maternal body mass index (BMI), and maternal food consumption status more than usual during the recent pregnancy were associated with a reduced risk of moderate wasting among 6‒11-month-olds. Higher maternal BMI, normal maternal food consumption status during last pregnancy, being female and maternal knowledge on diarrheal management, were associated with a reduced risk of moderate wasting among 12‒23-month-olds. In conclusion, beyond maternal BMI and maternal food consumption status during the last pregnancy, the factors associated with moderate wasting among 6‒23-month-olds in the poorest households in Bangladesh are age-specific.
Highlights
Around 238 million children under five years-of-age are either undernourished or overweight [1]
The respondents were informed that their participation was voluntary and of their right to withdraw themselves from the study at any point for any reason
The descriptive results indicated that 8.1% and 10.3% of children in the 6–11 and 12– 23-month-old groups suffered moderate wasting, with respective mean weight-for-length z-scores of -2.35 ± 0.28and -2.37 ± 0.26
Summary
Around 238 million children under five years-of-age are either undernourished or overweight [1]. Undernutrition contributes to around 35% of the total disease burden and half. Factors associated with wasting in 6–23-month-olds of all preventable deaths in children under five worldwide each year [2,3,4]. Around 49.5 million children under five globally suffer wasting [1]. Wasting occurs due to a deficiency in one or more macronutrients due to poor food intake, malabsorption or chronic inflammation [5]. Wasting is pronounced in developing nations, with children in south and central Asia disproportionately affected [1, 2, 5,6,7] and is a major ongoing public health hazard that demands immediate attention [1, 8]
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