1
|
Vonaesch P, Djorie SG, Kandou KJE, Rakotondrainipiana M, Schaeffer L, Andriatsalama PV, Randriamparany R, Gondje BP, Nigatoloum S, Vondo SS, Etienne A, Robinson A, Hunald FA, Raharimalala L, Giles-Vernick T, Tondeur L, Randrianirina F, Bastaraud A, Gody JC, Sansonetti PJ, Randremanana RV. Factors Associated with Stunted Growth in Children Under Five Years in Antananarivo, Madagascar and Bangui, Central African Republic. Matern Child Health J 2021; 25:1626-1637. [PMID: 34383227 PMCID: PMC8448698 DOI: 10.1007/s10995-021-03201-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2021] [Indexed: 11/29/2022]
Abstract
Objectives With a fourth of all under-five children affected, stunting remains one of the biggest health challenges worldwide. Even though the main underlying factors are known, the exact pathways to stunting varying in affected regions, and interventions thus need to be tailored to the local contexts. This study aimed assessing and comparing factors associated with stunting in two understudied sub-Saharan urban contexts with some of the highest stunting prevalence globally: Bangui, Central African Republic (~ 36%) and Antananarivo, Madagascar (42%). Methods We performed a case–control study on 175 + 194 stunted and 237 + 230 non-stunted control children aged 2–5 years and matched for age, gender and district of residency. Factors associated with stunting were identified using a standardized, paper questionnaire delivered by trained interviewers. Statistical analysis was done using logistic regression modelling. Results In both sites, formal maternal education lowered the risk of being stunted and restricted access to soap, suffering of anaemia and low birth weight were associated with higher risk of stunting. Short maternal stature, household head different from parents, diarrhoea and coughing were associated with an increased risk and continuing breastfeeding was associated with a lower risk of stunting in Antananarivo. Previous severe undernutrition and dermatitis/ fungal skin infections were associated with higher and changes in diet during pregnancy with lower risk of stunting in Bangui. Conclusions Our results suggest maternal education, antenatal care, iron supplementation and simple WASH interventions such as using soap and infection control as general and breastfeeding (Antananarivo) or better nutrition (Bangui) as area-specified interventions. Supplementary Information The online version contains supplementary material available at 10.1007/s10995-021-03201-8.
Collapse
Affiliation(s)
- Pascale Vonaesch
- Unité de Pathogénie Microbienne Moléculaire, Institut Pasteur, 25-28 Rue du Dr Roux, Paris, France. .,Human and Animal Health Unit, Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051, Basel, Switzerland. .,University of Basel, 4051, Basel, Switzerland.
| | - Serge Ghislain Djorie
- Unité D'Epidémiologie, Institut Pasteur de Bangui, Avenue de l'Indépendance, Bangui, Central African Republic
| | - Kaleb Jephté Estimé Kandou
- Unité D'Epidémiologie, Institut Pasteur de Bangui, Avenue de l'Indépendance, Bangui, Central African Republic
| | - Maheninasy Rakotondrainipiana
- Unité Epidémiologie Et de Recherche Clinique, Institut Pasteur de Madagascar-Ambatofotsikely, BP 1274, 101, Antananarivo, Madagascar
| | - Laura Schaeffer
- Unité D'Epidémiologie Des Maladies Emergentes, Institut Pasteur, 28 Rue du Dr. Roux, 75015, Paris, France
| | - Prisca Vega Andriatsalama
- Unité Epidémiologie Et de Recherche Clinique, Institut Pasteur de Madagascar-Ambatofotsikely, BP 1274, 101, Antananarivo, Madagascar
| | - Ravaka Randriamparany
- Unité Epidémiologie Et de Recherche Clinique, Institut Pasteur de Madagascar-Ambatofotsikely, BP 1274, 101, Antananarivo, Madagascar
| | - Bolmbaye Privat Gondje
- Centre Pédiatrique de Bangui, Avenue de l'Indépendance, Bangui, Central African Republic
| | - Synthia Nigatoloum
- Centre Pédiatrique de Bangui, Avenue de l'Indépendance, Bangui, Central African Republic
| | - Sonia Sandrine Vondo
- Centre Pédiatrique de Bangui, Avenue de l'Indépendance, Bangui, Central African Republic
| | - Aurélie Etienne
- Unité Epidémiologie Et de Recherche Clinique, Institut Pasteur de Madagascar-Ambatofotsikely, BP 1274, 101, Antananarivo, Madagascar
| | - Annick Robinson
- Centre Hospitalier Universitaire Mère Enfant de Tsaralalana, Rue Patrice Lumumba, Rue Mabizo S, 101, Antananarivo, Madagascar
| | - Francis Allen Hunald
- Service de Chirurgie Pédiatrique, Centre Hospitalier Universitaire Joseph Ravoahangy Andrianavalona, Ampefiloha, BP 4150, 101, Antananarivo, Madagascar
| | - Lisette Raharimalala
- Centre de Santé Maternelle Et Infantile de Tsaralalana, Lalana Andriantsilavo, 101, Antananarivo, Madagascar
| | - Tamara Giles-Vernick
- Anthropology and Ecology of Disease Emergence Unit, Institut Pasteur, 28 Rue du Dr. Roux, 75015, Paris, France
| | - Laura Tondeur
- Unité D'Epidémiologie Des Maladies Emergentes, Institut Pasteur, 28 Rue du Dr. Roux, 75015, Paris, France
| | - Frédérique Randrianirina
- Centre de Biologie Clinique, Institut Pasteur de Madagascar, BP 1274, 101, Antananarivo, Madagascar
| | - Alexandra Bastaraud
- Laboratoire D'Hygiène Des Aliments Et de L'Environnement (LHAE), Institut Pasteur de Madagascar, BP 1274, 101, Antananarivo, Madagascar
| | - Jean-Chrysostome Gody
- Centre Pédiatrique de Bangui, Avenue de l'Indépendance, Bangui, Central African Republic
| | - Philippe Jean Sansonetti
- Unité de Pathogénie Microbienne Moléculaire, Institut Pasteur, 25-28 Rue du Dr Roux, Paris, France.,The Center for Microbes, Development and Health, Institut Pasteur of Shanghai and Chinese Academy of Sciences, 411 Hefei Rd, Huangpu, Shanghai, China
| | - Rindra Vatosoa Randremanana
- Unité Epidémiologie Et de Recherche Clinique, Institut Pasteur de Madagascar-Ambatofotsikely, BP 1274, 101, Antananarivo, Madagascar.
| | | |
Collapse
|