Abstract
BackgroundMalnutrition accounts for 45% of mortality in children under five years old, despite a global mobilization against chronic malnutrition. In Madagascar, the most recent data show that the prevalence of stunting in children under five years old is still around 47.4%. This study aimed to identify the determinants of stunting in children in rural areas of Moramanga and Morondava districts to target the main areas for intervention.MethodsA case-control study was conducted in children aged from 6 to 59.9 months, in 2014–2015. We measured the height and weight of mothers and children and collected data on child, mother and household characteristics. One stool specimen was collected from each child for intestinal parasite identification. We used a multivariate logistic regression model to identify the determinants of stunting using backwards stepwise methods.ResultsWe included 894 and 932 children in Moramanga and in Morondava respectively. Stunting was highly prevalent in both areas, being 52.8% and 40.0% for Moramanga and Morondava, respectively. Stunting was most associated with a specific age period (12mo to 35mo) in the two study sites. Infection with Trichuris trichiura (aOR: 2.4, 95% CI: 1.1–5.3) and those belonging to poorer households (aOR: 2.3, 95% CI: 1.6–3.4) were the major risk factors in Moramanga. In Morondava, children whose mother had activities outside the household (aOR: 1.7, 95% CI: 1.2–2.5) and those perceived to be small at birth (aOR: 1.6, 95% CI: 1.1–2.1) were more likely to be stunted, whereas adequate birth spacing (≥24months) appeared protective (aOR: 0.4, 95% CI: 0.3–0.7).ConclusionInterventions that could improve children’s growth in these two areas include poverty reduction, women’s empowerment, public health programmes focusing on WASH and increasing acceptability, and increased coverage and quality of child/maternal health services.
Highlights
Infection with Trichuris trichiura and those belonging to poorer households were the major risk factors in Moramanga
The World Health Organization has called for global action to reduce child stunting by 40% by 2025 [1], and there is currently a global mobilization effort against chronic malnutrition
Madagascar is a very low-income country [10], and the latest data show that the prevalence of stunting among children aged less than 5 years is still approximately 47.4% [11]
Summary
The World Health Organization has called for global action to reduce child stunting by 40% by 2025 [1], and there is currently a global mobilization effort against chronic malnutrition. Malnutrition accounts for 45% of the mortality in children under 5 in 2011 [2], and recent estimates in 2015 showed that nutritional deficiencies caused 405 700 deaths [3]. In low-income countries, 37.6% of children under 5 years were stunted in 2014 [9]. Madagascar is a very low-income country (gross national annual income per capita of 420 USD) [10], and the latest data show that the prevalence of stunting among children aged less than 5 years is still approximately 47.4% [11]. The National Office of Nutrition (ONN) of Madagascar initiated a large-scale community-based nutrition intervention in 1999 that included monthly growth-monitoring activities for infants and young children, cooking demonstrations, community mobilization, and nutrition and hygiene education for primary caregivers [14]. This study aimed to identify the determinants of stunting in children in rural areas of Moramanga and Morondava districts to target the main areas for intervention.
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.
