RESUMO
Background: Child undernutrition is a major public health concern in Uganda that can lead to increased risks of death with its prevalence higher in rural hard-to-reach areas than in urban areas. While it is assumed that the prevalence will be more concerning in islands with restricted accessibility to healthcare resources, limited research has been conducted on the prevalence and associated factors of stunting and underweight among children in Bussi Islands of Uganda. This study aimed to assess the prevalence and predictors of stunting and underweight among children aged 6 to 59 months in Bussi Islands of Wakiso District in Uganda. Methods: A cross-sectional study was conducted in Bussi Islands of Wakiso District. Sociodemographic and anthropometric measurements were obtained for randomly sampled 409 caretaker-child pairs from 409 households. Data was collected using pre-tested structured electronic questionnaires validated by the Uganda Ministry of Health. Anthropometric indices were calculated using ENA-SMART version 2011 and data analysis was conducted using STATA version 14. Modified Poisson regression was used to generate Unadjusted and Adjusted Prevalence Ratios (APRs) with 95% confidence intervals. Results: Prevalence of stunting and underweight among children in Bussi Islands were 29.8% and 16.1%, respectively. Independent predictors of stunting included: suffering from diarrhea (APR: 1.8; 95% CI: 1.3, 2.5); household food insecurity (APR: 1.7; 95% CI: 1.2, 2.4); and child age of 12 to 23 months and 24 to 35 months (APR: 2.3; 95% CI: 1.3, 4.0 and APR: 2.0; 95% CI: 1.1, 3.6 respectively). Protective factors against stunting were not suffering from measles (APR: 0.62; 95% CI: 0.42, 0.92); receiving deworming tablets every 6 months (APR: 0.58; 95% CI: 0.42, 0.81); and daily household utilization of more than 80 L of water (APR: 0.48; 95% CI: 0.24, 0.95). Predictors of underweight were suffering from diarrhea (APR: 2.2; 95% CI: 1.4, 3.4) and having more than 9 household members (APR: 2.8; 95% CI: 1.1, 7.5). Conclusions: Child stunting and underweight are prevalent public health problems in Bussi Islands of Wakiso District. Therefore, the study suggests that nutrition interventions in the Islands should focus on childhood vaccination, family planning, sufficient safe water coverage, household food security, and health education of child caretakers on optimal infant and young child feeding and development.
RESUMO
The feeding and caring practices of infants and young children are critical to children's nutrition status and development milestones. Most nutrition studies have focused on unfavorable factors that contribute to malnutrition rather than favorable factors that promote good nutrition status among children. This study aimed at identifying predictors of normal nutrition status among children aged 6-24 months in Gulu District, Northern Uganda. A matched case-control study was conducted on a sample of 300 (i.e., 100 cases and 200 controls) purposively selected children during October-December 2021. Controls were children that had normal nutrition status, whereas cases with undernourished children had at least one type of undernutrition. Logistic regression was used to determine the predictors of good nutrition status using odds ratios (ORs). The mean age of the cases and controls was 15 months (SD ± 6) and 13 months (SD ± 5), respectively. At multivariable analysis, breastfeeding in the first hour of the child's life (AOR = 3.31 95% CI. 1.52-7.23), use of family planning (AOR = 2.21 95% CI. 1.25-3.90), number of under-fives in the household (AOR = 0.31 95% CI. 0.13-0.73) and hand washing with soap (AOR = 3.63 95% CI. 1.76-7.49) were significantly independently associated with a child's good nutrition status. Interventions that can improve children's nutrition status include breastfeeding in the first hour of child's life, use of family planning methods, child spacing and hand washing with soap.