title: Nutritional status and associated factors in children aged 0-23 months in Granada, Nicaragua.
abstract: OBJECTIVE
  Nicaragua is one of two low-income countries in the Latin Americas. The objectives of this study were to clarify the nutritional status of children aged 0-23 months and to identify the associated factors in rural Nicaragua.
  
  
  METHODS
  This was a cross-sectional study; a questionnaire survey was performed and anthropometric measurements were taken in Granada province, Nicaragua.
  
  
  RESULTS
  Seven hundred and fifty-six mothers with at least one child aged 0-23 months took part in this study. The proportion of underweight children [weight-for-age Z-score <-2 standard deviations (SD)] was 10.3%, while 30.1% of children exhibited stunted growth (height-for-age Z-score <-2 SD) and 5.0% were wasted (weight-for-height Z-score <-2 SD). Mothers' illiteracy or lack of formal education [odds ratio (OR)=3.476, P<0.01], a history of respiratory infection (OR=1.821, P<0.05) and a birth weight below the median (<3000 g; OR=1.704, P<0.05) were identified as risk factors for stunted growth. Breastfeeding for more than 12 months (OR=2.031, P<0.01), absence of participation in child growth monitoring (OR=1.956, P<0.05) and female gender of the child (OR=1.884, P<0.05) were identified as risk factors for underweight.
  
  
  CONCLUSIONS
  Despite the steady economic development in Nicaragua since 1990, child nutritional status has not improved as much as might be expected. The present study revealed that a mother's favourable sociodemographic characteristics and her active participation in health activities, such as child growth monitoring, can protect against child malnutrition, particularly against underweight. More attractive health education or antenatal care programmes might lead to substantial improvements in maternal and child health in this small, poor community.
authors.affiliation: Department of Health Policy and Planning, Graduate School of Medicine, The University of Tokyo, Japan. sakikaya@aol.com
authors.forename: K
authors.initials: K
authors.lastname: Sakisaka
authors.forename: S
authors.initials: S
authors.lastname: Wakai
authors.forename: C
authors.initials: C
authors.lastname: Kuroiwa
authors.forename: L
authors.initials: L
authors.lastname: Cuadra Flores
authors.forename: I
authors.initials: I
authors.lastname: Kai
authors.forename: M
authors.initials: M
authors.lastname: Mercedes Aragón
authors.forename: K
authors.initials: K
authors.lastname: Hanada
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D006128:Growth; D006801:Humans; D007223:Infant; D007224:Infant Care / Q000706:statistics & numerical data; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D008297:Male; D008423:Maternal Age; D008875:Middle Aged; D009527:Nicaragua / Q000453:epidemiology; D009752:Nutritional Status; D011203:Poverty; D012307:Risk Factors; D012737:Sex Factors; D013851:Thinness / Q000453:epidemiology*