Gender and age disparities in adult undernutrition in northern Uganda: high-risk groups not targeted by food aid programmes.
To determine the prevalence of adult malnutrition and associated risk factors in a post-conflict area of northern Uganda.



A cross-sectional community survey was performed from September 2011 to June 2013. All registered residents in Gulu Health and Demographic Surveillance System aged 15 years and older were considered eligible. Trained field assistants collected anthropometric measurements (weight and height) and administered questionnaires with information on sociodemographic characteristics, food security, smoking and alcohol. Nutritional status was classified by body mass index.



In total, 2062 men and 2924 women participated and were included in the analyses. The prevalence of underweight was 22.3% for men and 16.0% for women, whereas the prevalence of overweight was 1.5% for men and 7.6% for women. In men, underweight was associated with younger (15-19 years) and older age (>55 years) (P < 0.001), being divorced/separated [odds ratio (OR) = 1.91 (95% confidence interval (CI): 1.21-2.99] and smoking (OR = 2.13, 95% CI: 1.67-2.73). For women, underweight was associated with older age (P < 0.001) and hungry-gap rainy season (May-July) (OR = 1.33, 95% CI: 1.04-1.69). Widowed or divorced/separated women were not more likely to be underweight. No association was found between education, alcohol consumption or food security score and underweight.



Our findings are not in line with the conventional target groups in nutritional programmes and highlight the importance of continuous health and nutritional assessments of all population groups that reflect local social determinants and family structures.
Centre for Global Health, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
Stine
S
Schramm
Department of Public Health, Faculty of Medicine, Gulu University, Gulu, Uganda.
Felix Ocaka
FO
Kaducu
Centre for Global Health, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
Siri Aas
SA
Smedemark
Department of Mental Health, Faculty of Medicine, Gulu University, Gulu, Uganda.
Emilio
E
Ovuga
Centre for Global Health, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.|Department of Infectious Diseases, Odense University Hospital, Odense, Denmark.
Morten
M
Sodemann
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D063105:Food Assistance; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000453:epidemiology*; D017533:Marital Status; D008875:Middle Aged; D009752:Nutritional Status; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors; D012621:Seasons; D012737:Sex Factors; D012907:Smoking; D013851:Thinness / Q000453:epidemiology*; D014454:Uganda; D055815:Young Adult
anthropometry; anthropométrie; antropometría; community study; estatus nutricional; estudio comunitario; gender; género; nutritional status; post-conflict; post-conflicto; post-conflit; sexe; état nutritionnel; étude communautaire