Factors associated with stunting in healthy children aged 5 years and less living in Bangui (RCA)

PLoS One. 2017 Aug 10;12(8):e0182363. doi: 10.1371/journal.pone.0182363. eCollection 2017.

Abstract

Stunting remains a major public health concern worldwide. Although its global prevalence is slowly decreasing, the actual number of affected children is still rising in Sub-Saharan Africa. In the Central African Republic (CAR), about one third of all children below the age of five are stunted. Stunting is correlated with many long-term consequences, including poor cognitive development and a higher rate of morbidity and mortality, making stunting a major contributor to poverty. In CAR, little is known about the factors that contribute to stunting. This study aimed at analysing, in a cross-sectional study, the main factors associated with stunting in a group of 414 children recruited between December 2011 and November 2013, aged five years or less and living in Bangui. For all children, demographic, socio-economic and anthropometric data were recorded and asymptomatic enteropathogen carriage was assessed in stool samples using classical microbiological assays. The study group had a mean age of 14.2±10 months. Fifty-eight percent (292/414) were boys, and 36 percent (148/414) exhibited stunted growth. Of the stunted children, 51% (75/148) showed a moderate delay in linear growth for their age group [height-for-age z-score (HAZ) between -2 and -3 SD] while 49% (73/148) presented a severe delay (HAZ < -3). Factors significantly associated with stunting included gender (aOR: 1.67; 95% CI: 1.07; 2.62 for boys compared to girls) and age (aOR of 3.98 (95% CI: 2.45; 6.46) for toddlers and aOR 4.42 (95% CI: 2.36; 8.28) for children compared to infants). Most importantly, we identified being overweight [weight-for-height z-score (WHZ) > 2 SD; aOR: 3.21; 95% CI: 1.50; 6.90 of overweight compared to normal weight] as also being significantly associated with stunting. This is the first study showing that even in the poorest countries of the world there is an association of stunting with being overweight.

MeSH terms

  • Body Height
  • Body Weight
  • Central African Republic
  • Child Nutrition Disorders / complications*
  • Child Nutrition Disorders / epidemiology
  • Child, Preschool
  • Cross-Sectional Studies
  • Female
  • Growth Disorders / epidemiology
  • Growth Disorders / etiology*
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Overweight / epidemiology
  • Overweight / etiology
  • Prevalence
  • Risk Factors

Grants and funding

The original study was funded by the Total Foundation. Pascale Vonaesch is the recipient of a SNF Early. Postdoc Mobility Fellowship as well as a Roux Cantarini Postdoctoral Fellowship. The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.