Determinants and morbidities of multiple anthropometric deficits in southwest rural Ethiopia

• A composite index of anthropometrical failure estimated a higher proportion of undernutrition in the population than conventional indices over time.
• Children were more likely to develop multiple anthropometrical failures rather than stunting or wasting.
• Shared determinants of multiple anthropometrical failures, stunting, and wasting were the age of the child, being female, and the reporting that the child did not eat special foods during illness and they are stable over time.
• Children with multiple anthropometrical failures were more likely to report any morbidity.
• The conventional indices such as stunting, wasting, and underweight were not associated with any of the child morbidities.

ObjectiveThe aim of this study was to compare undernutrition with child morbidity and their determinants according to a composite index of anthropometrical failures and conventional indices.MethodsWe used data generated from three rounds of a longitudinal panel survey conducted in nine districts in Oromiya Region and the Southern Nations, Nationality and Peoples Region of Ethiopia. We estimated undernutrition using conventional indices and composite index of anthropometrical failures. Included in this analysis were 579, 674, and 674 children age <5 y in rounds 1, 2, and 3, respectively. The households were recruited using the expanded program on immunization sampling method. The hierarchical nature of the data Applied nutritional investigation was taken into account during the statistical analysis using a two-level mixed-effects logistic regression model.ResultsA composite index of anthropological failure, estimated 45.1%, 42.4%, and 46.4% of the children were undernourished in round 1, 2, and 3, respectively. The conventional indices estimated 24.4%, 24.2%, and 30.4% underweight in round 1, 2, and 3, respectively. Being female (odds ratio [OR], 7.4; 95% confidence interval [CI], 3.9–14.0); low dietary diversity (OR, 3.1; 95% CI, 1.6–5.9); medium dietary diversity (OR, 1.9; 95% CI, 1.1–3.3), and no special foods during illness (OR, 1.8; 95% CI, 1.2–2.8) were determinant of multiple anthropometrical failures. Children with multiple anthropometric failures were 2.6 times more likely to report child morbidities (OR, 2.6; 95% CI, 1.1–5.9). However, none of the conventional indices were associated with any of the reported child morbidities, such as stunting (OR, 1.1; 95% CI, 0.8–1.4), wasting (OR, 0.9; 95% CI, 0.5–1.6), or underweight (OR, 1.4; 95% CI, 1.0–2.0).ConclusionThe conventional indices underestimated the prevalence of undernutrition by 20.7%. Children with multiple anthropometric failures are at high risk for developing child morbidities and should benefit from nutrition intervention to reduce child morbidities.