Risk factors for stunting among under-fives in Libya.
OBJECTIVE
Stunting is a chronic condition reflecting poor nutrition and health. Our aim was to ascertain major predictors of stunting in children <5 years old in Libya.


METHODS
A nationally representative, cross-sectional, two-stage stratified cluster sample survey enrolled 4549 under-fives from 6707 households. Logistic regression was used to determine individual risk factors in bivariate and multivariate analyses.


RESULTS
Anthropometric measurements were available for 4498 children. Among the 929 stunted children (20.7 %), 495 were boys (53.3 %) and 434 were girls (46.5 %). In multivariate analysis, risk factors were young age (1-2 years: OR = 2.32, 95 % CI 1.67, 3.22; 2-3 years: OR = 1.64, 95 % CI 1.22, 2.21), resident of Al-Akhdar (OR = 1.67, 95 % CI 1.08, 2.58), being a boy (OR = 1.28, 95 % CI 1.05, 1.55), having a less educated father (illiterate: OR = 2.10, 95 % CI 1.17, 3.77; preparatory school: OR = 1.71, 95 % CI 1.11, 2.65), poor psychosocial stimulation (no family visits or trips: OR = 1.52, 95 % CI 1.07, 2.16; father rarely/never plays with child: OR = 2.24, 95 % CI 1.20, 4.16), filtered water (OR = 8.45, 95 % CI 2.31, 30.95), throwing garbage in the street (OR = 13.81, 95 % CI 2.33, 81.72), diarrhoea (OR = 1.58, 95 % CI 1.09, 2.29) and low birth weight (OR = 1.8, 95 % CI 1.17, 2.40). Protective factors were older age of father (OR = 0.53, 95 % CI 0.32, 0.90) and water storage (OR = 0.70, 95 % CI 0.54, 0.90). These variables only explained 20 % of cases of stunting.


CONCLUSIONS
Various multilevel actions are needed to improve nutritional status of under-fives in Libya. At risk-groups include those with young age (1-3 years), resident of Al-Akhdar region, boys, father's low educational level, poor psychosocial stimulation, poor housing environment, diarrhoea and low birth weight.
El Taguri
Adel
A
Hôpital Necker Enfants Malades, 149 rue de Sèvres, F-75743 Paris Cedex 15, France. tajoury@pediatrician.com
Betilmal
Ibrahim
I
Mahmud
Salah Murad
SM
Monem Ahmed
Abdel
A
Goulet
Olivier
O
Galan
Pilar
P
Hercberg
Serge
S
D000367:Age Factors; D001827:Body Height; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005190:Family; D005219:Father-Child Relations; D005260:Female; D006130:Growth Disorders / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D007223:Infant; D008002:Libya / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D044342:Malnutrition / Q000150:complications* / Q000453:epidemiology; D015999:Multivariate Analysis; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors; D014881:Water Supply