Factors Associated with Stunting in School Children of an Urban Community in Cameroon

Abstract

Background: Stunting is a condition that occurs as a result of a defective growth process. It may remain unnoticed in some children, with the diagnosis made as late as during adolescence. The accurate diagnosis of stunting is mainly done by physical examination, including the assessment of anthropometric parameters, while etiological explorations may require deeper and more complex investigations such as radiological and hormonal or endocrinal analyses. The various etiologies described in the literature may vary from nutritional, hormonal, pathological to psychological factors. A number of determinants of stunting in children have equally been documented, but they may vary from one context to another according to environmental factors. The effective management of stunting generally relies on the treatment of the underlying causes and the prevention of risk factors. Our objective was to determine the factors associated with stunting in school children living in an urban community of Yaounde, Cameroon. Methods: An analytic cross-sectional study was carried out on primary and secondary school children aged from 8 to 15 years, between January and June 2015. Bivariate and multivariate analyses were made to identify risk factors and eventually predictive factors. Results: The study involved 1442 children of which 79 presented stature delay. After bivariate analysis, the risk factors associated with stunting were: the presence of chronic pathological conditions (p=0.03), low socioeconomic level (p=0.0022), poor or limited diet (p=0.03), delayed puberty (p=0), and children “living with their mothers only” (p=0.02). After multivariate analysis, low socioeconomic level (OR=4.2; CI=1.7-10.3), children “living with their mother only” (OR=0.2; CI=0.6-0.8), and delayed puberty (OR=12.6; CI=4.9-31.8) persisted as independent predictive factors. Conclusion: Common risk factors such as chronic pathologies, low socioeconomic level, poor or limited diet and delayed puberty which are generally incriminated by various researches were verified in this survey. Delayed puberty was the most strongly associated factor, followed by “low socioeconomic level” and children “living with their mothers only”, which appeared as predictive factors as well. Nevertheless, children “living with their mothers only” were protected from stunting. Therefore, improvement of socioeconomic standards, food quality, prevention of chronic pathologies and delayed puberty may help to reduce stunting in such children. While mothers’ presence for nurturing and affective attention is necessary.