Potentially Modifiable Micro-Environmental and Co-Morbid Factors Associated with Severe Wasting and Stunting in Children below 3 Years of Age in Aligarh District

Objective: To estimate the prevalence of wasting and stunting among children under three years of age and study variables associated with their severe forms. Methods: Cross sectional descriptive study done at the field practice areas of the urban and rural health training centres: 468 (245 boys and 223 girls) children aged 0-3 years were included. Height and weight were measured and the indices for wasting (weight for height) and stunting (height for age) calculated using z scores of standard deviation. Socio demographic, child care, feeding and morbidity related factors influencing wasting and stunting were analyzed using binary logistic regression analysis Results: Mean z scores for weight-for-height (WHZ) and heightfor-age (HAZ) were less than the reference (CDC 2000) in both boys as well as girls. The overall age and sex combined prevalence of wasting and stunting were 37.6 % and 59.2 % respectively. Both sexes had comparable rates of wasting (boys=36.7%, girls=38.6%; p>0.05). However, there were significant sex differences in the frequencies of stunting (boys = 68.9%, girls = 48.4%; p<.01). The rates of severe wasting (8.3%) in both boys (9.1%) and girls (7.6%) were not as high as those of severe stunting (29.7%; 32.9% in boys and 26.2% in girls. Among variables in the child’s microenvironment and co-morbidities; a lower socio economic status (Adjusted OR 1.7, 95% CI 1.1-2.6) , history of measles (Adjusted OR 5.2, 95%CI 1.4 to 19.3), inappropriate feeding (Adjusted OR 2.8, 95% CI 1.4 to 5.9) and presence of vitamin D deficiency (Adjusted OR 5.3, 95%CI 1.6 to 17.9) were associated significantly with the presence of severe wasting whereas pallor (Adjusted OR 1.7, 95%CI 1.1 to 2.6) had significant association with severe stunting. Conclusions: Intervention nutritional programmes and better regular immunization rates are needed for the most vulnerable groups to mitigate childhood morbidity and mortality. Contribution: SS and AA are responsible for the concept, data collection, analysis and preparation of the manuscript. SA, ZK and NK were involved in data collection and preparation of manuscript.