Addae Hammond Yaw, Tahiru Rafatu, Alhassan Afizu, Fuseini Abdul-Ganiyu, Iddrisu Mohammed, Mensah Wilhelmina, Azupogo Fusta, Adokiya Martin Nyaaba
Department of Biochemistry, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Nursing and Midwifery Training College, Salaga, Ghana.
PLOS Glob Public Health. 2025 Sep 12;5(9):e0005078. doi: 10.1371/journal.pgph.0005078. eCollection 2025.
Anaemia, undernutrition and obesity remain complex public health challenges. Their coexistence among households, commonly known as the triple burden of malnutrition (TBM) is a new concept that lacks scholarship within the maternal and child nutrition discourse in Ghana. This study therefore aimed to evaluate the trends and factors associated with TBM among mothers and their children aged 0-59 months in Ghana. This study combined and analysed datasets from the Ghana Demographic and Health Survey from 2003 to 2022. Prevalence and multivariable logistic regression were used to evaluate the trends and determinants of TBM among 11,925 mother-child pairs using complex sample procedures. The pooled prevalence of TBM was 6.7% (5.7 - 6.7). This reduced from 7.6% (6.6 - 8.7) in 2003 to 5.0% (4.1-6.2) in 2022. Male children [AOR 2.23, 95% CI:1.33 - 3.74, p = 0.002] were more likely to suffer TBM than female children. Large birth size [AOR 0.30, 95% CI: 0.17 - 0.54, p < 0.001] and breastfed children [AOR 0.13, 95% CI:0.05 - 0.34, p < 0.001] were less likely to suffer TBM. Women with no education [AOR 5.14, 95% CI:1.16 - 22.75, p < 0.031] and those with inadequate dietary diversity [AOR 2.53, 95% CI:1.50 - 4.26, p < 0.001] were more likely to suffer TBM. Also, high-wealth [AOR 0.13, 95% CI:0.05 - 0.33, p < 0.001] and rural households [AOR 0.34, 95% CI: 0.05 - 0.33, p < 0.001] were less likely to suffer TBM. Although the prevalence of TBM reduced over the past two decades, the pooled estimate remains high in Ghana. The associated factors include breastfeeding, childbirth size, maternal education, dietary diversity, wealth and urbanicity. Strategies that promote breastfeeding, improve dietary diversity and ensure equitable distribution of resources are urgently needed to mitigate the TBM.
贫血、营养不良和肥胖仍然是复杂的公共卫生挑战。它们在家庭中的共存，通常被称为营养不良三重负担（TBM），是一个新的概念，在加纳母婴营养领域缺乏相关学术研究。因此，本研究旨在评估加纳0至59个月母亲及其子女中TBM的趋势和相关因素。本研究合并并分析了2003年至2022年加纳人口与健康调查的数据集。使用复杂抽样程序，采用患病率和多变量逻辑回归来评估11925对母婴中TBM的趋势和决定因素。TBM的合并患病率为6.7%（5.7 - 6.7）。这一比例从2003年的7.6%（6.6 - 8.7）降至2022年的5.0%（4.1 - 6.2）。男童患TBM的可能性高于女童[AOR 2.23，95%CI：1.33 - 3.74，p = 0.002]。出生时体重较大的婴儿[AOR 0.30，95%CI：0.17 - 0.54，p < 0.001]和母乳喂养的儿童[AOR 0.13，95%CI：0.05 - 0.34，p < 0.001]患TBM的可能性较小。未受过教育的女性[AOR 5.14，95%CI：1.16 - 22.75，p < 0.031]以及饮食多样性不足的女性[AOR 2.53，95%CI：1.50 - 4.26，p < 0.001]患TBM的可能性更大。此外，高财富家庭[AOR 0.13，95%CI：0.05 - 0.33，p < 0.001]和农村家庭[AOR 0.34，95%CI：0.05 - 0.33，p < 0.001]患TBM的可能性较小。尽管在过去二十年中TBM的患病率有所下降，但加纳的合并估计值仍然很高。相关因素包括母乳喂养、出生时体重、母亲教育程度、饮食多样性、财富和城市化程度。迫切需要采取促进母乳喂养、改善饮食多样性并确保资源公平分配的策略来减轻TBM。
