Factors Associated with Stunted Growth in Children Under Five Years in Antananarivo, Madagascar and Bangui, Central African Republic

Pascale Vonaesch (1) , Serge Ghislain Djorie (2) , Kaleb Jephté Estimé Kandou (2) , Maheninasy Rakotondrainipiana (3) , Laura Schaeffer (4) , Prisca Vega Andriatsalama (3) , Ravaka Randriamparany (3) , Bolmbaye Privat Gondje (5) , Synthia Nigatoloum (5) , Sonia Sandrine Vondo (5) , Aurélie Etienne (3) , Annick Robinson (6) , Francis Allen Hunald (7) , Lisette Raharimalala (6) , Tamara Giles-Vernick (8) , Laura Tondeur (4) , Frédérique Randrianirina (9) , Alexandra Bastaraud (10) , Jean-Chrysostome Gody (5) , Philippe Jean Sansonetti (1) , Rindra Vatosoa Randremanana (11) , The Afribiota Investigators

1 Pathogénie microbienne moléculaire
2 Institut Pasteur de Bangui
3 IPM - Unité d'Epidémiologie [Antananarivo, Madagascar]
4 Epidémiologie des Maladies Emergentes - Emerging Diseases Epidemiology
5 Centre pédiatrique de Bangui
6 CHUMET - Centre Hospitalier Universitaire Mère-Enfant de Tsaralalàna
7 CHUJRA - Centre Hospitalier Universitaire Joseph Ravoahangy Andrianavalona
8 Anthropologie et écologie de l’émergence des maladies - Anthropology and Ecology of Disease Emergence
9 IPM - Centre de Biologie Clinique [Antananarivo]
10 IPM - Laboratoire d'hygiène des aliments et de l'environnement [Antananarivo, Madagascar]
11 Unité d’Épidémiologie et de Recherche clinique [Antananarivo, Madagascar]

Objectives With a fourth of all under-five children affected, stunting remains one of the biggest health challenges worldwide. Even though the main underlying factors are known, the exact pathways to stunting varying in affected regions, and interventions thus need to be tailored to the local contexts. This study aimed assessing and comparing factors associated with stunting in two understudied sub-Saharan urban contexts with some of the highest stunting prevalence globally: Bangui, Central African Republic (~ 36%) and Antananarivo, Madagascar (42%). Methods We performed a case–control study on 175 + 194 stunted and 237 + 230 non-stunted control children aged 2–5 years and matched for age, gender and district of residency. Factors associated with stunting were identified using a standardized, paper questionnaire delivered by trained interviewers. Statistical analysis was done using logistic regression modelling. Results In both sites, formal maternal education lowered the risk of being stunted and restricted access to soap, suffering of anaemia and low birth weight were associated with higher risk of stunting. Short maternal stature, household head different from parents, diarrhoea and coughing were associated with an increased risk and continuing breastfeeding was associated with a lower risk of stunting in Antananarivo. Previous severe undernutrition and dermatitis/ fungal skin infections were associated with higher and changes in diet during pregnancy with lower risk of stunting in Bangui. Conclusions Our results suggest maternal education, antenatal care, iron supplementation and simple WASH interventions such as using soap and infection control as general and breastfeeding (Antananarivo) or better nutrition (Bangui) as area-specified interventions.

Mots clés: Stunted growth; Risk factors; Central African Republic; Madagascar; Children; Undernutrition

Domaines: Microbiologie et Parasitologie; Immunologie; Biologie cellulaire; Biologie moléculaire; Santé publique et épidémiologie

Pascale Vonaesch, Serge Ghislain Djorie, Kaleb Jephté Estimé Kandou, Maheninasy Rakotondrainipiana, Laura Schaeffer, et al.. Factors Associated with Stunted Growth in Children Under Five Years in Antananarivo, Madagascar and Bangui, Central African Republic. Maternal and Child Health Journal, 2021, 25 (10), pp.1626-1637. ⟨10.1007/s10995-021-03201-8⟩. ⟨pasteur-03506434⟩