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Local spatial clustering of stunting and wasting among children under the age of 5 years: implications for intervention strategies

  • Seifu Hagos Gebreyesus (a1) (a2), Damen H. Mariam (a1), Tasew Woldehanna (a3) and Bernt Lindtjørn (a2)
Abstract
AbstractObjective

The present study aimed to evaluate the clustering of undernutrition indicators of children under the age of 5 years in relation to different scales.

Design

A community-based cross-sectional study design was employed. We collected anthropometric data, geographic locations/elevations of households and other data from visited households. We used a retrospective purely spatial Poisson probability model to identify and locate clusters (high rates) of stunting and wasting using the software SaTScan™ version 9·1·1. We ran a logistic regression model to help evaluate the causes of clustering.

Settings

Six villages in the Meskane Mareko District (38·45763°E, 8·042144°N) of southern Ethiopia.

Subjects

We surveyed 2371 children aged <5 years, who were found in 1744 households.

Results

We found a micro-level variation in the risk of stunting and wasting within the studied district. We found the most likely significant clusters for wasting and severe wasting in two of the six villages. For stunting, a single large cluster size of 390 cases (304·19 expected) in 756 households was identified (relative risk=1·48, P<0·01). For severe stunting, a single cluster size of 106 cases (69·39 expected) in 364 households was identified (relative risk=1·69, P=0·035).

Conclusions

We conclude that the distribution of wasting and stunting was partly spatially structured. We identified distinct areas within and between villages that have a higher risk than the underlying at-risk population. Our analysis identified the spatial locations of high-risk areas for stunting that could be an input for geographically targeting and optimizing nutritional interventions.

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Copyright
Corresponding author
*Corresponding author: Email seif_h23@yahoo.com
Linked references
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This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

1. RE Black , CG Victora , SP Walker et al. (2013) Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet 382, 427451.

7. MT Ruel & H Alderman (2013) Nutrition-sensitive interventions and programmes: how can they help to accelerate progress in improving maternal and child nutrition? Lancet 382, 536551.

9. RA Ashton , T Kefyalew , G Tesfaye et al. (2011) School-based surveys of malaria in Oromia Regional State, Ethiopia: a rapid survey method for malaria in low transmission settings. Malaria J 10, 25.

10. S Brooker , S Clarke , JK Njagi et al. (2004) Spatial clustering of malaria and associated risk factors during an epidemic in a highland area of western Kenya. Trop Med Int Health 9, 757766.

11. RJS Magalhaes & ACA Clements (2011) Mapping the risk of anaemia in preschool-age children: the contribution of malnutrition, malaria, and helminth infections in West Africa. PLoS Med 8, e1000438.

12. M Ombok , K Adazu , F Odhiambo et al. (2010) Geospatial distribution and determinants of child mortality in rural western Kenya 2002–2005. Trop Med Int Health 15, 423433.

13. N Schur , E Hurlimann , A Garba et al. (2011) Geostatistical model-based estimates of schistosomiasis prevalence among individuals aged ≤20 years in West Africa. PLoS Negl Trop Dis 5, e1194.

14. T Bousema , C Drakeley , S Gesase et al. (2010) Identification of hot spots of malaria transmission for targeted malaria control. J Infect Dis 201, 17641774.

15. M Coleman , M Coleman , AM Mabuza et al. (2009) Using the SaTScan method to detect local malaria clusters for guiding malaria control programmes. Malar J 8, 68.

17. NJ Madise , Z Matthews & B Margetts (1999) Heterogeneity of child nutritional status between households: a comparison of six sub-Saharan African countries. Popul Stud A J Demogr 53, 331343.

19. NB Kandala , TP Madungu , JB Emina et al. (2011) Malnutrition among children under the age of five in the Democratic Republic of Congo (DRC): does geographic location matter? BMC Public Health 11, 261.

20. SS Morris (2001) Targeting urban malnutrition: a multi-city analysis of the spatial distribution of childhood nutritional status. Food Policy 26, 4964.

21. B Fenn , SS Morris & C Frost (2004) Do childhood growth indicators in developing countries cluster? Implications for intervention strategies. Public Health Nutr 7, 829834.

25. M Sicotte , M Ledoux , MV Zunzunegui et al. (2010) Reliability of anthropometric measures in a longitudinal cohort of patients initiating ART in West Africa. BMC Med Res Methodol 10, 102.

26. B Ayele , A Aemere , T Gebre et al. (2012) Reliability of measurements performed by community-drawn anthropometrists from rural Ethiopia. PLoS One 7, e30345.

31. W Tobler (1970) A computer movie simulating urban growth in the Detroit region. Econ Geogr 46, 234240.

33. S Hagos , T Lunde , DH Mariam et al. (2014) Climate change, crop production and child under nutrition in Ethiopia; a longitudinal panel study. BMC Public Health 14, 884.

35. JL Baker & ME Grosh (1994) Poverty reduction through geographic targeting – how well does it work? World Dev 22, 983995.

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Public Health Nutrition
  • ISSN: 1368-9800
  • EISSN: 1475-2727
  • URL: /core/journals/public-health-nutrition
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Supplementary Materials

Gebreyesus supplementary material
Supplemental file S2

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Supplementary Materials

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Supplemental file S1

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