title: Risk factors for stunting among under-fives in Libya.
abstract: 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.
authors.affiliation: Hôpital Necker Enfants Malades, 149 rue de Sèvres, F-75743 Paris Cedex 15, France. tajoury@pediatrician.com
authors.forename: Adel
authors.initials: A
authors.lastname: El Taguri
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Betilmal
authors.forename: Salah Murad
authors.initials: SM
authors.lastname: Mahmud
authors.forename: Abdel
authors.initials: A
authors.lastname: Monem Ahmed
authors.forename: Olivier
authors.initials: O
authors.lastname: Goulet
authors.forename: Pilar
authors.initials: P
authors.lastname: Galan
authors.forename: Serge
authors.initials: S
authors.lastname: Hercberg
mesh_terms: 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