Mekonnen Solomon, Birhanu Dereje, Menber Yonatan, Gebreegziabher Zenebe Abebe, Belay Mahider Awoke
North Gondar Zone Health Office, Debark, Ethiopia.
Department of Nutrition and Dietetics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
Front Nutr. 2024 Feb 20;11:1340382. doi: 10.3389/fnut.2024.1340382. eCollection 2024.
The double burden of malnutrition refers to the simultaneous presence of under nutrition and overweight, obesity, or diet-related non-communicable diseases which might occur at the population, household, and individual level. The simultaneous presence of overweight/obese mothers with undernourished children in the same household, as well as overweight children with underweight mothers, holds particular significance. This phenomenon primarily impacts low-income and middle-income countries. The prevalence of double-burden malnutrition at the household level has increased significantly in sub-Saharan African countries. However, there is limited knowledge regarding the extent and factors associated with the double burden of malnutrition among mother-child pairs in Ethiopia. Consequently, the objective of this study was to assess the prevalence and determinants of the double burden of malnutrition among mother-child pairs at the household level in Bahir Dar City, Ethiopia.
In the year 2021, a community-based cross-sectional study design was employed among 702 mother-child pairs in Bahir Dar City from February 28 to March 23. A multistage sampling technique was used to identify study participants who were interviewed using an interviewer-administered questionnaire. The nutritional status of children was evaluated using WHO Anthro Software. To determine the strength of the association, multivariable logistic regression analysis was performed, and adjusted odds ratios with their respective 95% confidence intervals were computed.
The prevalence of the double burden of malnutrition among mother-child pairs was 14.5% (95% CI: 12.8, 15.7%}. Participants who were in the richest wealth index were 2.72 {AOR = 2.72, 95% CI 2.01, 5.63} times more odds of double burden of malnutrition than the poorest. The odds of the double burden of malnutrition among children who had high dietary diversity decreased by 63% {AOR = 0.37, 95% CI 0.22, 0.61} than low dietary diversity. Food secure households were 1.96 {AOR = 1.96, 95% CI 1.13, 3.39} times more likely to have the double burden of malnutrition than food insecure households. The odds of the double burden of malnutrition among mothers who completed college and above decreased by 74% {AOR = 0.26 95% CI 0.121, 0.549} than those unable to read and write.
The magnitude of the double burden of malnutrition was lower than the Ethiopian Demographic and Health Survey. Wealth index, dietary diversity, food security, and educational status were significantly associated with the double burden of malnutrition. Therefore, it is recommended to implement public health interventions that target the identified associated factors in order to reduce the burden of double malnutrition.
营养不良的双重负担是指在人群、家庭和个体层面同时存在营养不足以及超重、肥胖或与饮食相关的非传染性疾病。同一家庭中母亲超重/肥胖但孩子营养不足，以及孩子超重但母亲体重过轻的情况尤其值得关注。这种现象主要影响低收入和中等收入国家。撒哈拉以南非洲国家家庭层面营养不良双重负担的患病率显著上升。然而，关于埃塞俄比亚母婴对中营养不良双重负担的程度及相关因素的了解有限。因此，本研究的目的是评估埃塞俄比亚巴赫达尔市家庭层面母婴对中营养不良双重负担的患病率及决定因素。
2021年2月28日至3月23日，在巴赫达尔市对702对母婴采用基于社区的横断面研究设计。采用多阶段抽样技术确定研究参与者，并使用访谈员管理的问卷进行访谈。使用世界卫生组织儿童生长标准软件评估儿童的营养状况。为确定关联强度，进行多变量逻辑回归分析，并计算调整后的比值比及其各自的95%置信区间。
母婴对中营养不良双重负担的患病率为14.5%（95%置信区间：12.8%，15.7%）。财富指数最高的参与者出现营养不良双重负担的几率是最贫困者的2.72倍（调整后的比值比=2.72，95%置信区间2.01，5.63）。饮食多样性高的儿童出现营养不良双重负担的几率比饮食多样性低的儿童降低了63%（调整后的比值比=0.37，95%置信区间0.22，0.61）。粮食安全家庭出现营养不良双重负担的可能性是粮食不安全家庭的1.96倍（调整后的比值比=1.96，95%置信区间1.13，3.39）。完成大学及以上教育的母亲出现营养不良双重负担的几率比不识字的母亲降低了74%（调整后的比值比=0.26，95%置信区间0.121，0.549）。
营养不良双重负担的程度低于埃塞俄比亚人口与健康调查的结果。财富指数、饮食多样性、粮食安全和教育状况与营养不良双重负担显著相关。因此，建议实施针对已确定相关因素的公共卫生干预措施，以减轻双重营养不良的负担。
