Abstract
BackgroundUndernutrition continues to pose challenges to Uganda's children, but there is limited knowledge on its association with physical and intellectual development.ObjectiveIn this cross-sectional study, we assessed the nutritional status and milestone development of 6- to 8-month-old children and associated factors in two districts of southwestern Uganda.DesignFive hundred and twelve households with mother–infant (6–8 months) pairs were randomly sampled. Data about background variables (e.g. household characteristics, poverty likelihood, and child dietary diversity scores (CDDS)) were collected using questionnaires. Bayley Scales of Infant and Toddler Development (BSID III) and Ages and Stages questionnaires (ASQ) were used to collect data on child development. Anthropometric measures were used to determine z-scores for weight-for-age (WAZ), length-for-age (LAZ), weight-for-length (WLZ), head circumference (HCZ), and mid-upper arm circumference. Chi-square tests, correlation coefficients, and linear regression analyses were used to relate background variables, nutritional status indicators, and infant development.ResultsThe prevalence of underweight, stunting, and wasting was 12.1, 24.6, and 4.7%, respectively. Household head education, gender, sanitation, household size, maternal age and education, birth order, poverty likelihood, and CDDS were associated (p<0.05) with WAZ, LAZ, and WLZ. Regression analysis showed that gender, sanitation, CDDS, and likelihood to be below the poverty line were predictors (p<0.05) of undernutrition. BSID III indicated development delay of 1.3% in cognitive and language, and 1.6% in motor development. The ASQ indicated delayed development of 24, 9.1, 25.2, 12.2, and 15.1% in communication, fine motor, gross motor, problem solving, and personal social ability, respectively. All nutritional status indicators except HCZ were positively and significantly associated with development domains. WAZ was the main predictor for all development domains.ConclusionUndernutrition among infants living in impoverished rural Uganda was associated with household sanitation, poverty, and low dietary diversity. Development domains were positively and significantly associated with nutritional status. Nutritional interventions might add value to improvement of child growth and development.
Highlights
Undernutrition continues to pose challenges to Uganda’s children, but there is limited knowledge on its association with physical and intellectual development
The results indicated improvement in breastfeeding practices, growth rates in the youngest children, and parental attitudes and behaviour supporting early child development, but little effect on the cognitive development of children aged 3.5Á6 years [25]
Undernutrition was significantly higher in boys than girls as shown by stunting (30.2% vs. 18.8%), underweight (15.3% vs. 8.8%), and wasting (6.5% vs. 2.8%) (Supplementary Table 1)
Summary
Undernutrition continues to pose challenges to Uganda’s children, but there is limited knowledge on its association with physical and intellectual development. Data about background variables (e.g. household characteristics, poverty likelihood, and child dietary diversity scores (CDDS)) were collected using questionnaires. Bayley Scales of Infant and Toddler Development (BSID III) and Ages and Stages questionnaires (ASQ) were used to collect data on child development. Gender, sanitation, household size, maternal age and education, birth order, poverty likelihood, and CDDS were associated (p B0.05) with WAZ, LAZ, and WLZ. Regression analysis showed that gender, sanitation, CDDS, and likelihood to be below the poverty line were predictors (p B0.05) of undernutrition. All nutritional status indicators except HCZ were positively and significantly associated with development domains. Conclusion: Undernutrition among infants living in impoverished rural Uganda was associated with household sanitation, poverty, and low dietary diversity. Development domains were positively and significantly associated with nutritional status. Nutritional interventions might add value to improvement of child growth and development
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