Abstract
Background: Young children living in urban slums are vulnerable to malnutrition and subsequently poor health outcomes, but data on the correlates of stunting, underweight, wasting, and anemia specifically among 10–18 month-old children in India remain limited.Objective: In this analysis, we sought to describe the prevalence of and examine correlates for different markers of undernutrition, including stunting, underweight, and anemia among 10–18 month-old children living in urban slums, an understudied vulnerable group.Methods: Children and their mothers (n = 323) were screened for anthropometry, demographics, and complete blood counts for hemoglobin concentration between March and November 2017 (Clinicaltrials.gov ID: NCT02233764). Correlates included child and mother's age, sex, birth order, birth weight, illness episodes, hemoglobin concentration, family income, maternal height, and maternal education level. Risk ratios (RR, 95% CI) for binary outcomes (stunting, underweight, wasting and anemia) and mean differences (β, 95% CI) for continuous outcomes (anthropometric Z-scores, hemoglobin concentration) were calculated using multivariate binomial and linear regression (SAS 9.4).Results: The prevalence of stunting was 31.2%, underweight 25.1%, wasting (9.0%), and anemia (76%) among all children. Male children had a higher prevalence of poor growth indices and lower anthropometric Z-scores than females. Male sex, low birthweight, shorter maternal height, report of ≥1 episodes of illness within the past month, older maternal age, and birth order ≥2 were also associated with poor growth and anemia in multivariate models. Correlates of undernutrition were different among females and males. Female children had a 40% (20, 60%) higher risk of anemia associated with diarrhea, and male children who were firstborn had a 20% (0, 70%) lower risk of anemia.Conclusions: These results show that poor growth and anemia among young children is prevalent in urban slums of Mumbai, and that sex of the child may play an important role in informing interventions to address undernutrition.
Highlights
Describing the multifactorial determinants of undernutrition in young children living in urban slums—a high-risk group— in countries where undernutrition is highly prevalent such as India [1]—is of critical importance to identify and implement solutions that will enable the attainment of the current World Health Assembly Global Nutrition Targets for 2025 [2] and Sustainable Development Goals ( Goal 2) by 2030 [3].Slum conditions are defined by the United Nations as having inadequate access to durable housing, a sufficient living area, safe water, sanitation, basic services, and protection against forced eviction [4,5,6]
The current analysis included all participants screened who had complete weight and other demographic data. We determined that this sample was sufficient to achieve 81.3% power to detect a 1.5 higher risk ratio of stunting in male children when 31% of children were stunted overall
We note that external generalizability to children living in urban slums outside of India is limited, given that this analysis included children from 20 different urban slum areas, of varying socioeconomic status, we believe that the findings of this study may be generalizable to urban slums within India, for children in their 2nd year of life. This is the first study to investigate both the prevalence of poor growth and anemia as well as the impact of commonlyreported correlates on the likelihood of undernutrition among young children living in Mumbai urban slums
Summary
Describing the multifactorial determinants of undernutrition in young children living in urban slums—a high-risk group— in countries where undernutrition is highly prevalent such as India [1]—is of critical importance to identify and implement solutions that will enable the attainment of the current World Health Assembly Global Nutrition Targets for 2025 [2] and Sustainable Development Goals ( Goal 2) by 2030 [3].Slum conditions are defined by the United Nations as having inadequate access to durable housing, a sufficient living area, safe water, sanitation, basic services, and protection against forced eviction [4,5,6]. As a recent review by Goudet et al [8] argues, an improved understanding of the correlates for malnutrition in children in slums is needed to inform interventions, as well as provide guidance to practitioners and decision-makers. These correlates include both early-life determinants such as birth weight and maternal height/age, as well as current factors such as the child’s age, family size, illness, and income level [8]. Young children living in urban slums are vulnerable to malnutrition and subsequently poor health outcomes, but data on the correlates of stunting, underweight, wasting, and anemia among 10–18 month-old children in India remain limited
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
