title: Prevalence and predictors of undernutrition among infants aged six and twelve months in Butajira, Ethiopia: the P-MaMiE Birth Cohort.
abstract: BACKGROUND
  Child undernutrition is a major public health problem in low income countries. Prospective studies of predictors of infant growth in rural low-income country settings are relatively scarce but vital to guide intervention efforts.
  
  
  METHODS
  A population-based sample of 1065 women in the third trimester of pregnancy was recruited from the demographic surveillance site (DSS) in Butajira, south-central Ethiopia, and followed up until the infants were one year of age. After standardising infant weight and length using the 2006 WHO child growth standard, a cut-off of two standard deviations below the mean defined the prevalence of stunting (length-for-age <-2), underweight (weight-for-age <-2) and wasting (weight-for-length <-2).
  
  
  RESULTS
  The prevalence of infant undernutrition was high at 6 months (21.7% underweight, 26.7% stunted and 16.7% wasted) and at 12 months of age (21.2% underweight, 48.1% stunted, and 8.4% wasted). Significant and consistent predictors of infant undernutrition in both logistic and linear multiple regression models were male gender, low birth weight, poor maternal nutritional status, poor household sanitary facilities and living in a rural residence. Compared to girls, boys had twice the odds of being underweight (OR = 2.00; 95%CI: 1.39, 2.86) at 6 months, and being stunted at 6 months (OR = 2.38, 95%CI: 1.69, 3.33) and at 12 months of age (OR = 2.08, 95%CI: 1.59, 2.89). Infant undernutrition at 6 and 12 months of age was not associated with infant feeding practices in the first two months of life.
  
  
  CONCLUSIONS
  There was a high prevalence of undernutrition in the first year of infancy in this rural Ethiopia population, with significant gender imbalance. Our prospective study highlighted the importance of prenatal maternal nutritional status and household sanitary facilities as potential targets for intervention.
authors.affiliation: Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia. gtmedhin@yahoo.com
authors.forename: Girmay
authors.initials: G
authors.lastname: Medhin
authors.forename: Charlotte
authors.initials: C
authors.lastname: Hanlon
authors.forename: Michael
authors.initials: M
authors.lastname: Dewey
authors.forename: Atalay
authors.initials: A
authors.lastname: Alem
authors.forename: Fikru
authors.initials: F
authors.lastname: Tesfaye
authors.forename: Bogale
authors.initials: B
authors.lastname: Worku
authors.forename: Mark
authors.initials: M
authors.lastname: Tomlinson
authors.forename: Martin
authors.initials: M
authors.lastname: Prince
mesh_terms: D000367:Age Factors; D001835:Body Weight / Q000502:physiology; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D048788:Growth and Development / Q000502:physiology; D006801:Humans; D007223:Infant; D008297:Male; D044342:Malnutrition / Q000453:epidemiology*; D039382:Maternal Nutritional Physiological Phenomena; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors