title: Overweight status of the primary caregivers of orphan and vulnerable children in 3 Southern African countries: a cross sectional study.
abstract: BACKGROUND
  Africa is facing a nutritional transition where underweight and overweight coexist. Although the majority of programs for orphan and vulnerable children (OVC) focus on undernourishment, the association between OVC primary caregiving and the caregivers' overweight status remains unclear. We investigated the association between OVC primary caregiving status with women's overweight status in Namibia, Swaziland and Zambia.
  
  
  METHODS
  Demographic Health Survey (DHS) cross-sectional data collected during 2006-2007 were analyzed using weighted marginal means and logistic regressions. We analyzed data from 20-49 year old women in Namibia (N 6638), Swaziland (N 2875), and Zambia (N 4497).
  
  
  RESULTS
  The overweight prevalence of the primary caregivers of OVC ranged from 27.0% (Namibia) to 61.3% (Swaziland). In Namibia, OVC primary caregivers were just as likely or even less likely to be overweight than other primary caregivers. In Swaziland and Zambia, OVC primary caregivers were just as likely or more likely to be overweight than other primary caregivers. In Swaziland and Zambia, OVC primary caregivers were more likely to be overweight than non-primary caregivers living with OVC (Swaziland AOR = 1.56, Zambia AOR = 2.62) and non-primary caregivers not living with OVC (Swaziland AOR = 1.92, Zambia AOR = 1.94). Namibian OVC caregivers were less likely to be overweight than non-caregivers not living with an OVC only in certain age groups (21-29 and 41-49 years old).
  
  
  CONCLUSIONS
  African public health systems/OVC programs may face an overweight epidemic alongside existing HIV/AIDS, tuberculosis and malaria epidemics. Future studies/interventions to curb overweight should consider OVC caregiving status and address country-level differences.
authors.affiliation: Center for Research on U.S. Latino HIV/AIDS and Drug Abuse, Florida International University, 11200 SW 8th Street. AHC5 422, Miami, FL, 33199, USA. mkanamor@fiu.edu.
authors.forename: Mariano
authors.initials: M
authors.lastname: Kanamori
authors.affiliation: Department of Epidemiology and Biostatistics, University of Maryland College Park School of Public Health, 2234G SPH Bldg, College Park, MD, 20742, USA. opokras@umd.edu.
authors.forename: Olivia
authors.initials: O
authors.lastname: Carter-Pokras
authors.affiliation: African American Studies Department, 1119 Taliaferro Hall, College Park, MD, 20742, USA. smadhava@umd.edu.
authors.forename: Sangeetha
authors.initials: S
authors.lastname: Madhavan
authors.affiliation: Department of Behavioral and Community Health, School of Public Health University of Maryland, College Park, MD, 20742, USA. rfeldman@umd.edu.
authors.forename: Robert
authors.initials: R
authors.lastname: Feldman
authors.affiliation: Department of Epidemiology and Biostatistics, University of Maryland College Park School of Public Health, 2234G SPH Bldg, College Park, MD, 20742, USA. xinhe@umd.edu.
authors.forename: Xin
authors.initials: X
authors.lastname: He
authors.affiliation: Department of Epidemiology and Biostatistics, University of Maryland College Park School of Public Health, 2234G SPH Bldg, College Park, MD, 20742, USA. sunmin@umd.edu.
authors.forename: Sunmin
authors.initials: S
authors.lastname: Lee
mesh_terms: D000328:Adult; D017954:Africa South of the Sahara / Q000453:epidemiology; D001294:Attitude to Health; D017028:Caregivers / Q000706:statistics & numerical data*; D002648:Child; D002669:Child Welfare / Q000706:statistics & numerical data; D054540:Child, Orphaned / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008297:Male; D050177:Overweight / Q000453:epidemiology* / Q000517:prevention & control; D015995:Prevalence; D055815:Young Adult