title: Poorer health and nutritional outcomes in orphans and vulnerable young children not explained by greater exposure to extreme poverty in Zimbabwe.
abstract: OBJECTIVE
  To describe patterns of association between different groups of young orphans and vulnerable children (OVC) and their nutritional and health outcomes; and to develop a theoretical framework to analyse the determinants of child malnutrition and ill-health, and identify the different mechanisms which contribute to these outcomes in such children.
  
  
  METHODS
  We developed and tested a theoretical framework to explain why orphans and vulnerable children experience more ill-health and malnutrition based on statistical analysis of data on 31 672 children aged 0-17 years (6753 aged under 5 years) selected from the Zimbabwe OVC Baseline Survey 2004.
  
  
  RESULTS
  28% of children aged 0-4 years at last birthday were either orphans or vulnerable children. They were more likely than non-vulnerable children to have suffered recently from diarrhoeal illness (age- and sex-adjusted odds ratio, AOR, 1.27; 95% CI 1.09-1.48) and acute respiratory infection (1.27; 1.01-1.59) and to be stunted (1.24; 1.09-1.41) and underweight (1.18; 1.02-1.36). After further adjustment for exposure to extreme poverty, OVC remained at greater risk of diarrhoeal disease (AOR 1.25; 1.07-1.46) and chronic malnutrition (1.21; 1.07-1.38). In 0-17-year-olds, OVC with acute respiratory infection were more likely not to have received any treatment even after adjusting for poverty (AOR 1.29; 95% CI 1.16-1.43).
  
  
  CONCLUSIONS
  Differences in exposure to extreme poverty among young children by OVC status were relatively small and did not explain the greater malnutrition and ill-health seen in OVC.
authors: Department of Infectious Disease Eidemiology, Imperial College London, St Mary's Campus, UK. h.watts@imperial.ac.uk
authors: Helen
authors: H
authors: Watts
authors: Simon
authors: S
authors: Gregson
authors: Suzue
authors: S
authors: Saito
authors: Ben
authors: B
authors: Lopman
authors: Michael
authors: M
authors: Beasley
authors: Roeland
authors: R
authors: Monasch
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D017677:Age Distribution; D002648:Child; D015362:Child Nutrition Disorders / Q000453:epidemiology*; D002675:Child, Preschool; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003967:Diarrhea / Q000453:epidemiology; D005260:Female; D005581:Foster Home Care; D006130:Growth Disorders / Q000453:epidemiology; D006304:Health Status; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011203:Poverty; D015995:Prevalence; D012141:Respiratory Tract Infections / Q000453:epidemiology; D012307:Risk Factors; D013851:Thinness / Q000453:epidemiology; D035862:Vulnerable Populations; D015030:Zimbabwe / Q000453:epidemiology