title: Cross-sectional study of malnutrition and associated factors among school aged children in rural and urban settings of Fogera and Libo Kemkem districts, Ethiopia.
abstract: BACKGROUND
  Little information is available on malnutrition-related factors among school-aged children ≥5 years in Ethiopia. This study describes the prevalence of stunting and thinness and their related factors in Libo Kemkem and Fogera, Amhara Regional State and assesses differences between urban and rural areas.
  
  
  METHODS
  In this cross-sectional study, anthropometrics and individual and household characteristics data were collected from 886 children. Height-for-age z-score for stunting and body-mass-index-for-age z-score for thinness were computed. Dietary data were collected through a 24-hour recall. Bivariate and backward stepwise multivariable statistical methods were employed to assess malnutrition-associated factors in rural and urban communities.
  
  
  RESULTS
  The prevalence of stunting among school-aged children was 42.7% in rural areas and 29.2% in urban areas, while the corresponding figures for thinness were 21.6% and 20.8%. Age differences were significant in both strata. In the rural setting, fever in the previous 2 weeks (OR: 1.62; 95% CI: 1.23-2.32), consumption of food from animal sources (OR: 0.51; 95% CI: 0.29-0.91) and consumption of the family's own cattle products (OR: 0.50; 95% CI: 0.27-0.93), among others factors were significantly associated with stunting, while in the urban setting, only age (OR: 4.62; 95% CI: 2.09-10.21) and years of schooling of the person in charge of food preparation were significant (OR: 0.88; 95% CI: 0.79-0.97). Thinness was statistically associated with number of children living in the house (OR: 1.28; 95% CI: 1.03-1.60) and family rice cultivation (OR: 0.64; 95% CI: 0.41-0.99) in the rural setting, and with consumption of food from animal sources (OR: 0.26; 95% CI: 0.10-0.67) and literacy of head of household (OR: 0.24; 95% CI: 0.09-0.65) in the urban setting.
  
  
  CONCLUSIONS
  The prevalence of stunting was significantly higher in rural areas, whereas no significant differences were observed for thinness. Various factors were associated with one or both types of malnutrition, and varied by type of setting. To effectively tackle malnutrition, nutritional programs should be oriented to local needs.
authors.affiliation: National Centre of Tropical Medicine, Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Tropical Diseases Research Network (RICET in Spanish), Madrid, Spain.
authors.forename: Zaida
authors.initials: Z
authors.lastname: Herrador
authors.affiliation: National Centre of Epidemiology, ISCIII, Madrid, Spain; Department of Preventive Medicine and Public Health, Faculty of Medicine, Complutense University, Madrid, Spain; Network Biomedical Research Centers, Epidemiology and Public Health (CIBERESP in Spanish), Madrid, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Sordo
authors.affiliation: Armauer Hansen Research Institute, Addis Ababa, Ethiopia.
authors.forename: Endalamaw
authors.initials: E
authors.lastname: Gadisa
authors.affiliation: National Centre of Microbiology, ISCIII, Madrid, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Moreno
authors.affiliation: National Centre of Microbiology, ISCIII, Madrid, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Nieto
authors.affiliation: National Centre of Tropical Medicine, Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Tropical Diseases Research Network (RICET in Spanish), Madrid, Spain.
authors.forename: Agustín
authors.initials: A
authors.lastname: Benito
authors.affiliation: Armauer Hansen Research Institute, Addis Ababa, Ethiopia.
authors.forename: Abraham
authors.initials: A
authors.lastname: Aseffa
authors.affiliation: National Centre of Microbiology, ISCIII, Madrid, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Cañavate
authors.affiliation: National Centre of Tropical Medicine, Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Tropical Diseases Research Network (RICET in Spanish), Madrid, Spain.
authors.forename: Estefania
authors.initials: E
authors.lastname: Custodio
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005002:Ethiopia / Q000453:epidemiology; D006801:Humans; D044342:Malnutrition / Q000150:complications / Q000453:epidemiology*; D012424:Rural Population; D014505:Urban Population