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

Abstract

Background: The 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. Method: We used a nationally representative sample of 2902 children aged 6-23 months 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. Result: The 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 12-23 months (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). Conclusion: Among 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.