title: Prevalence and risk factors of undernutrition among schoolchildren in the Plateau Central and Centre-Ouest regions of Burkina Faso.
abstract: BACKGROUND
  Multiple factors determine children's nutritional status, including energy and nutrient intake, recurrent infectious diseases, access (or lack thereof) to clean water and improved sanitation, and hygiene practices, among others. The "Vegetables go to School: improving nutrition through agricultural diversification" (VgtS) project implements an integrated school garden programme in five countries, including Burkina Faso. The aim of this study was to determine the prevalence of undernutrition and its risk factors among schoolchildren in Burkina Faso before the start of the project.
  
  
  METHODS
  In February 2015, a cross-sectional survey was carried out among 455 randomly selected children, aged 8-14 years, in eight schools in the Plateau Central and Centre-Ouest regions of Burkina Faso. Nutritional status was determined by anthropometric assessment. Helminth and intestinal protozoa infections were assessed using the Kato-Katz and a formalin-ether concentration method. A urine filtration technique was used to identify Schistosoma haematobium eggs. Prevalence of anaemia was determined by measuring haemoglobin levels in finger-prick blood samples. Questionnaires were administered to children to determine their knowledge of nutrition and health and their related attitudes and practices (KAP). Questionnaires were also administered to the children's caregivers to identify basic household socio-demographic and economic characteristics, and water, sanitation and hygiene (WASH) conditions. To determine the factors associated with schoolchildren's nutritional status, mixed logistic regression models were used. Differences and associations were considered statistically significant if P-values were below 0.05.
  
  
  RESULTS
  Complete datasets were available for 385 children. The prevalence of undernutrition, stunting and thinness were 35.1%, 29.4% and 11.2%, respectively. The multivariable analysis revealed that undernutrition was associated with older age (i.e. 12-14 years compared to <12 years; adjusted odds ratio (aOR) = 3.45, 95% confidence interval (CI) 2.12-5.62, P < 0.001), multiple pathogenic parasitic infections (aOR = 1.87, 95% CI 1.02-3.43, P = 0.044) and with moderate and severe anaemia in children (aOR = 2.52, 95% CI 1.25-5.08, P = 0.010).
  
  
  CONCLUSIONS
  We found high prevalence of undernutrition among the children surveyed in the two study regions of Burkina Faso. We further observed that undernutrition, anaemia and parasitic infections were strongly associated. In view of these findings, concerted efforts are needed to address undernutrition and associated risk factors among school-aged children. As part of the VgtS project, WASH, health education and nutritional interventions will be implemented with the goal to improve children's health.
  
  
  BACKGROUND
  ISRCTN17968589 (date assigned: 17 July 2015).
authors.affiliation: Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland.|University of Basel, P.O. Box, CH-4003, Basel, Switzerland.
authors.forename: Séverine
authors.initials: S
authors.lastname: Erismann
authors.affiliation: Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland.|University of Basel, P.O. Box, CH-4003, Basel, Switzerland.
authors.forename: Astrid M
authors.initials: AM
authors.lastname: Knoblauch
authors.affiliation: Institut de Recherches en Sciences de la Santé, P.O. Box 7192, Ouagadougou 03, Burkina Faso.
authors.forename: Serge
authors.initials: S
authors.lastname: Diagbouga
authors.affiliation: Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland.|University of Basel, P.O. Box, CH-4003, Basel, Switzerland.
authors.forename: Peter
authors.initials: P
authors.lastname: Odermatt
authors.affiliation: Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland.|University of Basel, P.O. Box, CH-4003, Basel, Switzerland.
authors.forename: Jana
authors.initials: J
authors.lastname: Gerold
authors.affiliation: Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland.|University of Basel, P.O. Box, CH-4003, Basel, Switzerland.|Kathmandu University, P.O. Box 6250, 45200, Dhulikhel, Nepal.
authors.forename: Akina
authors.initials: A
authors.lastname: Shrestha
authors.affiliation: Institut de Recherches en Sciences de la Santé, P.O. Box 7192, Ouagadougou 03, Burkina Faso.
authors.forename: Grissoum
authors.initials: G
authors.lastname: Tarnagda
authors.affiliation: Institut de Recherches en Sciences de la Santé, P.O. Box 7192, Ouagadougou 03, Burkina Faso.
authors.forename: Boubacar
authors.initials: B
authors.lastname: Savadogo
authors.affiliation: Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland.|University of Basel, P.O. Box, CH-4003, Basel, Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Schindler
authors.affiliation: Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland.|University of Basel, P.O. Box, CH-4003, Basel, Switzerland.
authors.forename: Jürg
authors.initials: J
authors.lastname: Utzinger
authors.affiliation: Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland. gueladio.cisse@unibas.ch.|University of Basel, P.O. Box, CH-4003, Basel, Switzerland. gueladio.cisse@unibas.ch.
authors.forename: Guéladio
authors.initials: G
authors.lastname: Cissé
mesh_terms: D000293:Adolescent; D000740:Anemia / Q000453:epidemiology / Q000209:etiology; D002050:Burkina Faso / Q000453:epidemiology; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000150:complications / Q000453:epidemiology*; D010272:Parasitic Diseases / Q000150:complications / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D013334:Students / Q000706:statistics & numerical data*
keywords: Anaemia; Burkina Faso; Intestinal parasitic infections; School garden; Undernutrition; Water; and hygiene (WASH); sanitation