Determinants of coexistence of undernutrition and anemia among under-five children in Rwanda; evidence from 2019/20 demographic health survey: Application of bivariate binary logistic regression model.

BACKGROUND: Undernutrition and anemia are significant public health issues among under-5 children, with potential long-term consequences for growth, development, and overall health. Thus, this study aims to conduct a bivariate binary logistic regression model by accounting for the possible dependency of childhood undernutrition and anemia. METHODS: The data came from the DHS program's measurement. A total of 3,206 under-five children were involved in this study. A single composite index measure was calculated for stunting, wasting, and underweight using principal component analysis. A bivariate binary logistic regression model is used to assess the association between undernutrition and anemia given the effect of other predictors. RESULTS: Among 3,206 under-five children considered in this study, 1482 (46.2%) and 658 (20.5%) children were agonized by anemia and undernutrition, respectively. In bivariate binary logistic regression model; Urban children [AOR = 0.751, 96% CI: 0.573-0.984; AOR = 0.663, 95% CI: 0.456-0.995] and anemic mothers [AOR = 1.160, 95% CI: 1.104-1.218; AOR = 1.663, 95% CI: 1.242-2.225] were significantly associated with both childhood anemia and undernutrition, respectively. Improved water sources [AOR = 0.681, 95% CI: 0.446-0.996], average-sized children [AOR = 0.567, 95% CI: 0.462-0.696], and diarrhea [AOR = 1.134, 95% CI: 1.120-2.792] were significantly associated with childhood anemia. Large-sized children [AOR = 0.882, 95% CI: 0.791-0.853] and those with fever [AOR = 1.152, 95% CI: 1.312-2.981] were significantly associated with under-five children's undernutrition. CONCLUSION: The prevalence of both undernutrition and anemia among under-five-year-old children was high in Rwanda. The following determinants are statistically associated with both childhood undernutrition and anemia: place of residence; source of drinking water; maternal anemia; being a twin; birth size of children; diarrhea; fever; and child age. Anemia and nutritional deficiencies must be treated concurrently under one program, with evidence-based policies aimed at vulnerable populations.

Multilevel multivariate modeling on the association between undernutrition indices of under-five children in East Africa countries: evidence from recent demographic health survey (DHS) data.

BACKGROUND: Malnutrition is the main cause of illness and death in children under the age of five. It affects millions of children worldwide, putting their health and future in jeopardy. Therefore, this study aimed to identify and estimate the effects of important determinants of anthropometric indicators by taking into account their association and cluster effects. METHOD: The study was carried out in 10 countries in East Africa: Burundi, Ethiopia, Comoros, Uganda, Rwanda, Tanzania, Zimbabwe, Kenya, Zambia, and Malawi. A weighted total sample of 53,322 children under the age of five was included. Given the impact of other predictors such as maternal, child, and socioeconomic variables, a multilevel multivariate binary logistic regression model was employed to analyze the relationship between stunting, wasting, and underweight. RESULT: The study included 53,322 children, and 34.7%, 14.8%, and 5.1% were stunted, underweight, and wasted, respectively. Almost half of the children (49.8%) were female, and 22.0% lived in urban areas. The estimated odds of children from secondary and higher education mothers being stunted and wasted were 0.987; 95% CI: 0.979 - 0.994 and 0.999; 95% CI: 0.995 - 0.999, respectively, times the estimated odds of children from no education mothers. Children from middle-class families were less likely to be underweight than children from poorer families. CONCLUSION: The prevalence of stunting was higher than in the sub-Saharan Africa region, but the prevalence of wasting and underweight was lower. According to the study's findings, undernourishment among young children under the age of five continues to be a significant public health issue in the East African region. Governmental and non-governmental organizations should therefore plan public health participation focusing on paternal education and the poorest households in order to improve the undernutrition status of children under five. Additionally, improving the delivery of healthcare at health facilities, places of residence, children's health education, and drinking water sources are essential for lowering child undernutrition indicators.

Determinants of coexistence of stunting, wasting, and underweight among children under five years in the Gambia; evidence from 2019/20 Gambian demographic health survey: application of multivariate binary logistic regression model.

BACKGROUND: Malnutrition happens when there are insufficient amounts of nutrients and energy consumed improperly. Included are both undernutrition and overnutrition. This study is aimed to evaluate the relationship among undernutrition indicators of stunting, underweight, and wasting among those under 5 years given other predictors. METHODS: The data were obtained from the measure of DHS program. A total of 2399 under-five children were involved in this study. A multivariate binary logistic regression model is used to assess the association between stunting, wasting, and being underweight given the effect of other predictors. RESULTS: Of the 2399 under-five children considered in this study, 13.5, 18.7, and 5.9% of them suffered from stunting, underweight, and wasting, respectively. The majority of children (40.1%) were obtained from the Brikama local government area of Gambia; more than half of the children (52.9%) were male, and 63.3% of children lived in urban areas. The association between stunting and underweight, underweight and wasting, and stunting and wasting was measured by the odds ratio (OR) of 15.87, 46.34, and 1.75, respectively, given the other predictors. The estimated odds ratio for children who had an average birth size to become stunted, underweight, and wasted were 0.965, 0.885, and 0.989 times the estimated odds ratio of children who had a small birth size, respectively. CONCLUSION: The prevalence of stunting and wasting for under-five children in Gambia was lower than the world prevalence, but the prevalence of being underweight was higher. Children who are underweight have a significant association with both stunting and wasting. The age of the child, the child's anemia level, and the birth type of the child are the common important determinants of stunting and underweight. The small birth size of a child was highly associated with a higher risk of stunting, underweight, and wasting among under five-year-olds.