title: Multilevel Analysis of Factors Associated with Wasting and Underweight among Children Under-Five Years in Nigeria.
abstract: Wasting and underweight reflect poor nutrition, which in children leads to retarded growth. The aim of this study is to determine the factors associated with wasting and underweight among children aged 0-59 months in Nigeria. A sample of 24,529 children aged 0-59 months from the 2013 Nigeria Demographic and Health Survey (NDHS) was used. Multilevel logistic regression analysis that adjusted for cluster and survey weights was used to identify significant factors associated with wasting/severe wasting and underweight/severe underweight. The prevalence of wasting was 18% (95% Confidence Interval (CI): 17.1, 19.7) and severe wasting 9% (95% CI: 7.9, 9.8). The prevalence of underweight was 29% (95% CI: 27.1, 30.5) and severe underweight 12% (95% CI: 10.6, 12.9). Multivariable analysis revealed that the most consistent factors associated with wasting/severe wasting and underweight/severe underweight are: geopolitical zone (North East, North West and North Central), perceived birth size (small and average), sex of child (male), place/mode of delivery (home delivery and non-caesarean) and a contraction of fever in the two weeks prior to the survey. In order to meet the WHO's global nutrition target for 2025, interventions aimed at improving maternal health and access to health care services for children especially in the northern geopolitical zones of Nigeria are urgently needed.
authors.affiliation: School of Science and Health, Western Sydney University, Locked Bag 1797, Penrith NSW 2571, Australia. B.Akombi@westernsydney.edu.au.
authors.forename: Blessing J
authors.initials: BJ
authors.lastname: Akombi
authors.affiliation: School of Science and Health, Western Sydney University, Locked Bag 1797, Penrith NSW 2571, Australia. K.Agho@westernsydney.edu.au.
authors.forename: Kingsley E
authors.initials: KE
authors.lastname: Agho
authors.affiliation: School of Science and Health, Western Sydney University, Locked Bag 1797, Penrith NSW 2571, Australia. D.Merom@westernsydney.edu.au.
authors.forename: Dafna
authors.initials: D
authors.lastname: Merom
authors.affiliation: School of Medicine and Public Health, Faculty of Health, University of Newcastle, Callaghan NSW 2308, Australia. John.Hall@newcastle.edu.au.
authors.forename: John J
authors.initials: JJ
authors.lastname: Hall
authors.affiliation: School of Social Sciences and Psychology, Western Sydney University, Locked Bag 1797, Penrith NSW 2751, Australia. Andre.Renzaho@westernsydney.edu.au.
authors.forename: Andre M
authors.initials: AM
authors.lastname: Renzaho
mesh_terms: D015992:Body Mass Index; D002664:Child Nutritional Physiological Phenomena / Q000208:ethnology; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015999:Multivariate Analysis; D009549:Nigeria / Q000453:epidemiology; D009749:Nutrition Surveys; D009752:Nutritional Status / Q000208:ethnology; D011057:Politics; D015995:Prevalence; D012044:Regression Analysis; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D013851:Thinness / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology* / Q000503:physiopathology; D019282:Wasting Syndrome / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology* / Q000503:physiopathology
keywords: Nigeria; malnutrition; multilevel analysis; public health; underweight; wasting