The burden and correlates of childhood undernutrition in Tanzania according to composite index of anthropometric failure
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RESEARCH ARTICLE
Open Access
The burden and correlates of childhood undernutrition in Tanzania according to composite index of anthropometric failure Ahmed Gharib Khamis1* , Akwilina Wendelin Mwanri2, Katharina Kreppel3,4 and Gideon Kwesigabo1
Abstract Background: Undernutrition is a public health problem worldwide. Tanzania has made significant achievements in the reduction of childhood undernutrition over the past two decades. However, the exact burden of undernutrition was under-estimated when using conventional indices of stunting, wasting and underweight. The objective of this study was to determine the overall prevalence of undernutrition, describe the trends and examine the correlates associated with undernutrition among children under-five years using the composite index of anthropometric failure (CIAF). This study aims to understand the real burden and drivers of undernutrition to improve design, implementation and monitoring of appropriate interventions to ameliorate all form of childhood undernutrition in the country. Methods: About 37,205 mother-child pairs were retrieved and analyzed from the Tanzania Demographic and Health Surveys (TDHS) conducted in various years from 1991, 1996, 1999, 2004–05, 2009–10, to 2015–16. The anthropometric data of children under-five years were used to determine the overall burden and trends of undernutrition using CIAF. The recent TDHS surveys from 2005 to 2015 were used to examine the correlates of CIAF. To determine the correlates, multivariate analysis was conducted to estimate the prevalence ratios (PR) with 95% confidence intervals (CI) using Poisson regression with robust variance. Results: The prevalence of CIAF declined significantly from 50% in 1991 to 38.2% in 2015 (p < 0.001). The correlates of CIAF vary across surveys. The multivariate analysis of recent 2015 survey revealed that the prevalence of CIAF was significantly higher for older children (p < 0.001), children living in rural areas (p = 0.028), and those born with noneducated (p = 0.009) or single mothers (p = 0.008). The prevalence of CIAF was significantly lower for girls (p < 0.001), being born with overweight/obese mothers (p < 0.001), living with older head of the household (p < 0.001) or living in richest household (p < 0.001). Moreover, children who were born with low birth weight (p < 0.001), or having fever (p = 0.044) were most likely to have anthropometric failure. However, consumption of diversified diet was not found to be associated with anthropometric failure (p > 0.05). (Continued on next page)
* Correspondence: [email protected] 1 Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the
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