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 6–23\u2009months 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)\u2009=\u20091.19, 95%CI\u2009=\u20091.06–1.33, P\xa0=\u20090.003], consumption of vitamin A rich fruit and vegetables (AOR\u2009=\u20091.15, 95%CI\u2009=\u20091.04–1.27, P\xa0=\u20090.006), meat (AOR\u2009=\u20091.55, 95%CI\u2009=\u20091.17–2.05, P\xa0=\u20090.002), legumes (AOR\u2009=\u20091.38, 95%CI\u2009=\u20091.05–1.81, P\xa0=\u20090.021), and meal frequency\u2009>\u20093 (AOR\u2009=\u20091.22, 95%CI\u2009=\u20091.04–1.37, P\xa0=\u20090.020). The non-dietary household and child factors found significantly linked to higher odds of CAS were rural residence (AOR\u2009=\u20091.29, 95%CI\u2009=\u20091.18–1.41, P\u2009<\u20090.001), low household wealth (AOR\u2009=\u20091.91, 95%CI\u2009=\u20091.53–2.39, P\u2009<\u20090.001), low caregivers’ education level (AOR\u2009=\u20092.14, 95%CI\u2009=\u20091.33–3.44, P\u2009<\u20090.001), male sex (AOR\u2009=\u20091.25, 95%CI\u2009=\u20091.04–1.50, P\xa0=\u20090.015), age 12–23\u2009months (AOR\u2009=\u20091.65, 95%CI\u2009=\u20091.57–1.73, P\u2009<\u20090.001), history of infection (AOR\u2009=\u20091.14, 95%CI\u2009=\u20091.00–1.30, P\xa0=\u20090.048), and small birth size (AOR\u2009=\u20091.99, 95%CI\u2009=\u20091.58–2.51, P\u2009<\u20090.001).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.