TY - JOUR
T1 - Trends and Determinants of Children’s Wasting and Women’s Thinness in Chad, 2015 to 2021
AU - Adler, Sarah
AU - Zavala, Eleonor
AU - Wabyona, Edgar
AU - Ahimbisibwe, Martin
AU - Haisset, Fanga
AU - Doocy, Shannon
N1 - Publisher Copyright:
© The Author(s) 2021.
PY - 2023/9
Y1 - 2023/9
N2 - Background: Cross-sectional surveys using the Standardized Monitoring and Assessment of Relief and Transitions methodology have been conducted annually in Chad since 2015 to evaluate population-level nutritional status. Objective: This analysis characterizes national and subnational trends in child wasting and women’s thinness from 2015 to 2021 in Chad and identifies risk factors during the COVID-19 pandemic. Methods: Annual survey data with 12,000 to 15,000 households were included. Wasting was estimated for children 6 to 59 months using the WHO child growth standards, and among women 15 to 49 years, thinness was defined as mid-upper arm circumference <23 cm. Trends were stratified by agroecological zone, and chi-square tests used to assess statistical significance. Simple and multivariate logistic regression models were conducted for 2020 and 2021 to identify risk factors of wasting and thinness. Results: About 11,958 to 17,897 children and 9883 to 15,535 women contributed values each year. National wasting and thinness rates did not significantly decrease over the 7-year period (wasting: 14.1% to 12.1%, P =.43; thinness: 15.2% to 13.4%, P =.51) and wasting rose from 2020 to 2021. The Saharan and Sahelian zones had consistently higher rates compared to the Sudanian zone. Younger age, male sex, inadequate infant and young child feeding practices, and poorer household socio-economic factors were associated with greater odds of child wasting. For women, younger age, lack of nutrition knowledge, and poorer household socio-economic factors increased the odds of thinness. Conclusions: Undernutrition in Chad has not improved since 2015, and the COVID-19 pandemic likely exacerbated the crisis among children nationally and among women subnationally. Multisectoral approaches and regional targeting of interventions are recommended.
AB - Background: Cross-sectional surveys using the Standardized Monitoring and Assessment of Relief and Transitions methodology have been conducted annually in Chad since 2015 to evaluate population-level nutritional status. Objective: This analysis characterizes national and subnational trends in child wasting and women’s thinness from 2015 to 2021 in Chad and identifies risk factors during the COVID-19 pandemic. Methods: Annual survey data with 12,000 to 15,000 households were included. Wasting was estimated for children 6 to 59 months using the WHO child growth standards, and among women 15 to 49 years, thinness was defined as mid-upper arm circumference <23 cm. Trends were stratified by agroecological zone, and chi-square tests used to assess statistical significance. Simple and multivariate logistic regression models were conducted for 2020 and 2021 to identify risk factors of wasting and thinness. Results: About 11,958 to 17,897 children and 9883 to 15,535 women contributed values each year. National wasting and thinness rates did not significantly decrease over the 7-year period (wasting: 14.1% to 12.1%, P =.43; thinness: 15.2% to 13.4%, P =.51) and wasting rose from 2020 to 2021. The Saharan and Sahelian zones had consistently higher rates compared to the Sudanian zone. Younger age, male sex, inadequate infant and young child feeding practices, and poorer household socio-economic factors were associated with greater odds of child wasting. For women, younger age, lack of nutrition knowledge, and poorer household socio-economic factors increased the odds of thinness. Conclusions: Undernutrition in Chad has not improved since 2015, and the COVID-19 pandemic likely exacerbated the crisis among children nationally and among women subnationally. Multisectoral approaches and regional targeting of interventions are recommended.
KW - anthropometry
KW - Chad
KW - COVID-19
KW - severe acute malnutrition
KW - thinness
KW - undernutrition
KW - wasting
UR - http://www.scopus.com/inward/record.url?scp=85171901109&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85171901109&partnerID=8YFLogxK
U2 - 10.1177/03795721231190203
DO - 10.1177/03795721231190203
M3 - Article
C2 - 37728128
AN - SCOPUS:85171901109
SN - 0379-5721
VL - 44
SP - 172
EP - 182
JO - Food and nutrition bulletin
JF - Food and nutrition bulletin
IS - 3
ER -