Determinants of child malnutrition in rural and urban Ecuadorian highlands.
OBJECTIVE
To identify and compare the sociodemographic determinants of stunting, wasting and overweight among infants of urban and rural areas in the Ecuadorian highlands.


METHODS
Cross-sectional study.


METHODS
Nabon (rural) and Cuenca (urban) cantons, Azuay Province, Ecuador.


METHODS
A total of 703 children aged 0-24 months and their caregivers (227 rural and 476 urban) recruited during the period from June to September 2008.


RESULTS
Stunting prevalence was significantly higher in the rural area (37·4 % v. 17·7 %; P < 0·001) while wasting (7·1 %) and overweight (17·1 %) prevalence were more similar between areas. Determinants of stunting for the pooled sample were male gender (OR = 1·43; 95 % CI 1·06, 1·92; P = 0·02), preterm delivery (OR = 1·65; 95 % CI 1·14, 2·38; P = 0·008), child's age (OR = 1·04; 95 % CI 1·01, 1·07; P = 0·011), maternal education (OR = 0·95; 95 % CI 0·92, 0·99; P = 0·025) and facility-based delivery (OR = 0·57; 95 % CI 0·45, 0·74; P < 0·001). The latter was also a determinant of overweight (OR = 0·39; 95 % CI 0·25, 0·62; P < 0·001). Rural determinants of stunting were maternal height (OR = 0·004; 95 % CI 0·00004, 0·39; P = 0·018), diarrhoea prevalence (OR = 2·18; 95 % CI 1·13, 4·21; P = 0·02), socio-economic status (OR = 0·79; 95 % CI 0·64, 0·98; P = 0·030) and child's age (OR = 1·07; 95 % CI 1·02, 1·11; P = 0·005). Urban determinants were: maternal BMI for stunting (OR = 0·91; 95 % CI 0·84, 0·99; P = 0·027), cough prevalence (OR = 0·57; 95 % CI 0·34, 0·96; P = 0·036) and facility-based delivery (OR = 0·25; 95 % CI 0·09, 0·73; P = 0·011) for overweight, and hygiene for wasting (OR = 0·57; 95 % CI 0·36, 0·89; P = 0·013).


CONCLUSIONS
Infant malnutrition was associated with different sociodemographic determinants between urban and rural areas in the Ecuadorian highlands, a finding which contributes to prioritize the determinants to be assessed in nutritional interventions.
1Department of Food Safety and Food Quality,Faculty of Bioscience Engineering,Ghent University,Coupure Links 653,B-9000 Ghent,Belgium.
Johana
J
Ortiz
1Department of Food Safety and Food Quality,Faculty of Bioscience Engineering,Ghent University,Coupure Links 653,B-9000 Ghent,Belgium.
John
J
Van Camp
1Department of Food Safety and Food Quality,Faculty of Bioscience Engineering,Ghent University,Coupure Links 653,B-9000 Ghent,Belgium.
Sylviana
S
Wijaya
2Faculty of Chemical Sciences,Cuenca University,Cuenca,Ecuador.
Silvana
S
Donoso
1Department of Food Safety and Food Quality,Faculty of Bioscience Engineering,Ghent University,Coupure Links 653,B-9000 Ghent,Belgium.
Lieven
L
Huybregts
D000531:Altitude; D002657:Child Development; D003430:Cross-Sectional Studies; D004484:Ecuador / Q000453:epidemiology; D005260:Female; D006130:Growth Disorders / Q000209:etiology*; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena / Q000191:economics / Q000208:ethnology; D007231:Infant, Newborn; D008297:Male; D044342:Malnutrition / Q000191:economics / Q000453:epidemiology* / Q000208:ethnology / Q000503:physiopathology; D009749:Nutrition Surveys; D050177:Overweight / Q000191:economics / Q000453:epidemiology / Q000208:ethnology; D015995:Prevalence; D012423:Rural Health / Q000191:economics / Q000208:ethnology; D012737:Sex Factors; D012959:Socioeconomic Factors; D013851:Thinness / Q000209:etiology*; D014504:Urban Health / Q000191:economics / Q000208:ethnology