title: Nutritional and developmental status among 6- to 8-month-old children in southwestern Uganda: a cross-sectional study.
abstract: BACKGROUND
  Undernutrition continues to pose challenges to Uganda's children, but there is limited knowledge on its association with physical and intellectual development.
  
  
  OBJECTIVE
  In this cross-sectional study, we assessed the nutritional status and milestone development of 6- to 8-month-old children and associated factors in two districts of southwestern Uganda.
  
  
  METHODS
  Five hundred and twelve households with mother-infant (6-8 months) pairs were randomly sampled. Data about background variables (e.g. household characteristics, poverty likelihood, and child dietary diversity scores (CDDS)) were collected using questionnaires. Bayley Scales of Infant and Toddler Development (BSID III) and Ages and Stages questionnaires (ASQ) were used to collect data on child development. Anthropometric measures were used to determine z-scores for weight-for-age (WAZ), length-for-age (LAZ), weight-for-length (WLZ), head circumference (HCZ), and mid-upper arm circumference. Chi-square tests, correlation coefficients, and linear regression analyses were used to relate background variables, nutritional status indicators, and infant development.
  
  
  RESULTS
  The prevalence of underweight, stunting, and wasting was 12.1, 24.6, and 4.7%, respectively. Household head education, gender, sanitation, household size, maternal age and education, birth order, poverty likelihood, and CDDS were associated (p<0.05) with WAZ, LAZ, and WLZ. Regression analysis showed that gender, sanitation, CDDS, and likelihood to be below the poverty line were predictors (p<0.05) of undernutrition. BSID III indicated development delay of 1.3% in cognitive and language, and 1.6% in motor development. The ASQ indicated delayed development of 24, 9.1, 25.2, 12.2, and 15.1% in communication, fine motor, gross motor, problem solving, and personal social ability, respectively. All nutritional status indicators except HCZ were positively and significantly associated with development domains. WAZ was the main predictor for all development domains.
  
  
  CONCLUSIONS
  Undernutrition among infants living in impoverished rural Uganda was associated with household sanitation, poverty, and low dietary diversity. Development domains were positively and significantly associated with nutritional status. Nutritional interventions might add value to improvement of child growth and development.
authors.affiliation: Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.|Department of Human Nutrition and Home Economics, Kyambogo University, Kampala, Uganda; g.k.m.muhoozi@studmed.uio.no.
authors.forename: Grace K M
authors.initials: GK
authors.lastname: Muhoozi
authors.affiliation: Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
authors.forename: Prudence
authors.initials: P
authors.lastname: Atukunda
authors.affiliation: School of Food Technology, Nutrition and Bioengineering, Makerere University, Kampala, Uganda.
authors.forename: Robert
authors.initials: R
authors.lastname: Mwadime
authors.affiliation: Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.|Department of Hematology, Oslo University Hospital, Oslo, Norway.
authors.forename: Per Ole
authors.initials: PO
authors.lastname: Iversen
authors.affiliation: Institute of Health Sciences, Kristiania University College, Oslo, Norway.
authors.forename: Ane C
authors.initials: AC
authors.lastname: Westerberg
keywords: Uganda; child development; child growth; undernutrition