Intestinal helminth infections and dietary diversity score predict nutritional status of urban schoolchildren from southern Ethiopia

Abstract

Background: Undernutrition is a major public health problem in developing countries like Ethiopia where schoolchildren are among the vulnerable groups. However, limited attention has been given for the nutritional status of schoolchildren including the lack of available evidence on the magnitude and modifiable risk factors in different parts of the country. Thus, we aimed at determining the magnitude and predictors of undernutrition among schoolchildren in Arba Minch town, southern Ethiopia. Methods: A school-based cross-sectional study was conducted in March and April, 2014 involving 532 schoolchildren aged 7 to 14 years. A two-stage probability sampling procedure was applied to select study schools and subjects. Anthropometry measurements were taken using standardized techniques and calibrated equipment. Intestinal parasite infections were determined from stool samples using direct saline method and formal ether concentration technique; whereas data on demographic and relevant risk factors were gathered through structured interview of caretakers. Bivariate and multivariable logistic regressions were used to identify predictors of stunting and wasting in the study population. Results: The prevalence of stunting and wasting were 26.0% (95% CI: 22.3, 30.1%) and 11.7% (95% CI: 9.1, 14.9%), respectively. In multivariable model, poor household wealth [AOR (95% CI) = 3.2 (1.2, 8.5)], living in large family [AOR (95% CI) = 2.3 (1.0, 5.1)], lack of maternal formal education [AOR (95% CI) = 4.1 (1.8, 9.4)], low Dietary Diversity Score [AOR (95% CI) = 2.3 (1.2, 4.7)], A. lumbricoides [AOR (95% CI) = 5.0 (2.7, 9.4)], hookworm [AOR (95% CI) = 8.0 (4.0, 15.8)] and T. trichuria [AOR (95% CI) = 6.3 (2.8, 14.1)] infections were associated with stunting. Wasting status was independently associated with not living with both parents [AOR (95% CI) = 2.0 (1.0, 4.1)], poor household wealth [AOR (95% CI) = 8.9 (2.0, 39.2)], and recent illnesses [AOR (95% CI) = 6.3 (3.1, 12.6)]. Conclusions: Both acute and chronic malnutrition are prevalent among schoolchildren in the study area where intestinal parasite infections, poor dietary quality and common illnesses are important modifiable risk factors. A comprehensive school-based health and nutrition intervention involving parents may help to alleviate the problem including regular deworming and promotion of personal hygiene and balanced diet.