Concurrent anemia and stunting in young children: prevalence, dietary and non-dietary associated factors

Abstract

BackgroundThe existing evidence is limited and contradicting on the co-occurrence of anemia and stunting (CAS) at individual level, despite a great overlap in their risk factors. We aimed to determine the prevalence of CAS, and the dietary and non-dietary factors associated with it, among infants and young children in Ethiopia.MethodWe used a nationally representative sample of 2902 children aged 6-23months from the Ethiopian demographic and health survey, conducted in 2016. The study was cross-sectional in design. Samples were selected by two-stage clustering sampling method. CAS prevalence was estimated by various sociodemographic factors. To identify the dietary and non-dietary factors associated with CAS, we conducted hierarchical logistic regression analyses.ResultThe overall prevalence of CAS was 23.9. The dietary factors found significantly linked to lower odds of CAS were use of vitamin A supplement adjusted odds ratio (AOR)=1.19, 95%CI=1.06-1.33, P=0.003, consumption of vitamin A rich fruit and vegetables (AOR=1.15, 95%CI=1.04-1.27, P=0.006), meat (AOR=1.55, 95%CI=1.17-2.05, P=0.002), legumes (AOR=1.38, 95%CI=1.05-1.81, P=0.021), and meal frequency>3 (AOR=1.22, 95%CI=1.04-1.37, P=0.020). The non-dietary household and child factors found significantly linked to higher odds of CAS were rural residence (AOR=1.29, 95%CI=1.18-1.41, P<0.001), low household wealth (AOR=1.91, 95%CI=1.53-2.39, P<0.001), low caregivers' education level (AOR=2.14, 95%CI=1.33-3.44, P<0.001), male sex (AOR=1.25, 95%CI=1.04-1.50, P=0.015), age 12-23months (AOR=1.65, 95%CI=1.57-1.73, P<0.001), history of infection (AOR=1.14, 95%CI=1.00-1.30, P=0.048), and small birth size (AOR=1.99, 95%CI=1.58-2.51, P<0.001).ConclusionAmong infants and young children in Ethiopia, there was a concerning high level of CAS, which was associated with various dietary and non-dietary factors. Enhanced public health/nutrition interventions, with due emphasis on the multifactorial nature of CAS, might stand an important consideration to reduce the burden of CAS in Ethiopia and beyond.