Prevalence and risk factors for underweight, wasting, stunting among children (5 years) in Jhangara Twon & Villages (Rural Sindh)

Date of Award


Document Type


Degree Name

Master of Science in Epidemiology & Biostatistics (MSc Epidemiology & Biostats)


Community Health Sciences


Project Summary: Malnutrition is a common problem worldwide, especially in developing countries including Pakistan. About 12 million of children under five who die each year in the developed countries mainly from preventable causes, the death of about 55% are either directly or indirectly attributable to malnutrition. Pakistan Demographic and Health Survey 199O/91 (PDHS) showed that 5O% of the children under five years were stunted while 40% of children were underweight and 9% were labeled as wasted. The main objectives of this cross sectional study conducted during July-September 1991 were to assess the prevalence and the associated risk factors for underweight, stunting and wasting. Apart from the already documented risk factors for malnutrition, present study came up with two new suggested factors i.e. the effect of consanguineous marriages and prolonged breast feeding on child nutritional status; consanguinity was identified as a risk factor for underweight while prolonged breast feeding (>12 months) demonstrated a protective effect for wasting. The study was conducted in Jhangara Town and adjoining villages within 20 km area around Jhangara Town (rural Sindh). Only the last born child was enrolled, the questionnaire was administered to eligible respondent and anthropometric measurements of the child were noted. We did census in the study area and ended up with the enrollment of 800 children. The whole analysis was carried out in CHS department, Aga Khan University Karachi. Epi Info version 6.04 was used to calculate Z-Scores, simple frequencies and bivariate analyses, while SPSS package (7.5) was used to run multivariate models. This study revealed that the overall prevalence was, for underweight 54.3Vo, for wasting 21.57o and for stunting 6IVo in the study population, which was higher than the prevalence reported by PDHS 199O/91. Since underweight, wasting and stunting signifies three different categories of malnutrition, it is expected that their risk factors should be different. In multivariate analysis various risk factor for underweight were, consanguinity (OR = 1.5, 95% CI 1.08- 2.01), birth weight (OR=1.6, 95% CI 1.08 - 2.16), breast-feeding (OR =2.7, 95% CI 1.19 - 6.17). For wasting, area of residence (OR = 1.8, 95% CI 1.17-2.69) was identified as risk factors while prolonged breast feeding > 12 months (OR = 0.6, 95% C 10.43-0.98) was identified as a protective factor. For stunting, ethnicity (OR = 2.1, 95% CI 1.21- 3.57) and birth interval (OR = 1.5, 95Vo CI 1.09 - 1.99) were identified as risk factors in multivariate analysis. Malnutrition is a silent emergency in rural areas with a number of risk factor involved. There is a clear and urgent need to formulate policies within our resources to address this issue. Effective strategies to discourage consanguineous marriages between first cousins are required. Birth interval of more than two years and breast feeding of more than one year are other factors that should be incorporated while designing control strategies to reduce morbidity and mortality due to malnutrition in children (< 5 years).

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