Malnutrition, morbidity and infection in the informal settlements of Nairobi, Kenya: An epidemiological study

Maria Vittoria De Vita, Carlo Scolfaro, Bruna Santini, Antonella Lezo, Federico Gobbi, Dora Buonfrate, Elizabeth W. Kimani-Murage, Teresiah Macharia, Milka Wanjohi, Jacopo Mattia Rovarini, Gianfranco Morino

Research output: Contribution to journalArticle

Abstract

Background: Malnutrition constitutes one of the major public health challenges throughout the developing world. Urban poverty and malnutrition have been on the rise, with an increased rate of morbidity. We herein explore the relationship between infections and nutritional status and the related association with hygienic conditions as risk of infection in children residing in the slums of Nairobi. Methods: Case-control study based on a secondary analysis of quantitative data collected from a cluster randomized trial carried out in two slums of Nairobi. The following information about resident children were selected: babies' anthropometric measurements, related life conditions, data on infant-feeding practices, food security, hygiene, immunization coverage and morbidity were collected and updated with structured questionnaires until 12 months of life. Prevalence of malnutrition was calculated, then both bivariate and multivariate analysis were used to explore the relationship between malnutrition and its determinants. Results: The study involved a total of 1119 babies registered at birth (51.28% male and 48.03% female infants). Overall the prevalence of malnutrition was high, with 26.3% of the children being stunted, 6.3% wasted and 13.16% underweight. Prevalence of wasting was higher in the first months of life, while in older children more case of stunting and underweight were captured. Wasted infants were significantly associated with common childhood illnesses: with cough and rapid breathing as well as with diarrhea (p-value< 0.05). Stunting was associated with hygienic conditions (p-value< 0.05 in households that did not perform any water treatment and for children that had a toilet within the house compound), immunization program and low-birth-weight. Moreover, regression analysis showed that significant determinants of stunting were sex and feeding practices. Underweight was significantly associated with socio-demographic factors. Conclusions: In the specific environment where the study was conducted acute malnutrition is correlated with acute infections, while chronic malnutrition is more influenced by WASH conditions. Therefore, our findings suggest that one cannot separate infection and its risk factors as determinants of the whole malnutrition burden.

Original languageEnglish
Article number12
JournalItalian Journal of Pediatrics
Volume45
Issue number1
DOIs
Publication statusPublished - Jan 14 2019

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Kenya
Malnutrition
Epidemiologic Studies
Morbidity
Growth Disorders
Infection
Thinness
Poverty Areas
Immunization Programs
Food Supply
Water Purification
Low Birth Weight Infant
Poverty
Nutritional Status
Hygiene
Cough
Case-Control Studies
Diarrhea
Immunization
Respiration

Keywords

  • Infection
  • Informal settlements
  • Kenya
  • Malnutrition
  • WASH

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Malnutrition, morbidity and infection in the informal settlements of Nairobi, Kenya : An epidemiological study. / De Vita, Maria Vittoria; Scolfaro, Carlo; Santini, Bruna; Lezo, Antonella; Gobbi, Federico; Buonfrate, Dora; Kimani-Murage, Elizabeth W.; Macharia, Teresiah; Wanjohi, Milka; Rovarini, Jacopo Mattia; Morino, Gianfranco.

In: Italian Journal of Pediatrics, Vol. 45, No. 1, 12, 14.01.2019.

Research output: Contribution to journalArticle

De Vita, MV, Scolfaro, C, Santini, B, Lezo, A, Gobbi, F, Buonfrate, D, Kimani-Murage, EW, Macharia, T, Wanjohi, M, Rovarini, JM & Morino, G 2019, 'Malnutrition, morbidity and infection in the informal settlements of Nairobi, Kenya: An epidemiological study', Italian Journal of Pediatrics, vol. 45, no. 1, 12. https://doi.org/10.1186/s13052-019-0607-0
De Vita, Maria Vittoria ; Scolfaro, Carlo ; Santini, Bruna ; Lezo, Antonella ; Gobbi, Federico ; Buonfrate, Dora ; Kimani-Murage, Elizabeth W. ; Macharia, Teresiah ; Wanjohi, Milka ; Rovarini, Jacopo Mattia ; Morino, Gianfranco. / Malnutrition, morbidity and infection in the informal settlements of Nairobi, Kenya : An epidemiological study. In: Italian Journal of Pediatrics. 2019 ; Vol. 45, No. 1.
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T2 - An epidemiological study

AU - De Vita, Maria Vittoria

AU - Scolfaro, Carlo

AU - Santini, Bruna

AU - Lezo, Antonella

AU - Gobbi, Federico

AU - Buonfrate, Dora

AU - Kimani-Murage, Elizabeth W.

AU - Macharia, Teresiah

AU - Wanjohi, Milka

AU - Rovarini, Jacopo Mattia

AU - Morino, Gianfranco

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N2 - Background: Malnutrition constitutes one of the major public health challenges throughout the developing world. Urban poverty and malnutrition have been on the rise, with an increased rate of morbidity. We herein explore the relationship between infections and nutritional status and the related association with hygienic conditions as risk of infection in children residing in the slums of Nairobi. Methods: Case-control study based on a secondary analysis of quantitative data collected from a cluster randomized trial carried out in two slums of Nairobi. The following information about resident children were selected: babies' anthropometric measurements, related life conditions, data on infant-feeding practices, food security, hygiene, immunization coverage and morbidity were collected and updated with structured questionnaires until 12 months of life. Prevalence of malnutrition was calculated, then both bivariate and multivariate analysis were used to explore the relationship between malnutrition and its determinants. Results: The study involved a total of 1119 babies registered at birth (51.28% male and 48.03% female infants). Overall the prevalence of malnutrition was high, with 26.3% of the children being stunted, 6.3% wasted and 13.16% underweight. Prevalence of wasting was higher in the first months of life, while in older children more case of stunting and underweight were captured. Wasted infants were significantly associated with common childhood illnesses: with cough and rapid breathing as well as with diarrhea (p-value< 0.05). Stunting was associated with hygienic conditions (p-value< 0.05 in households that did not perform any water treatment and for children that had a toilet within the house compound), immunization program and low-birth-weight. Moreover, regression analysis showed that significant determinants of stunting were sex and feeding practices. Underweight was significantly associated with socio-demographic factors. Conclusions: In the specific environment where the study was conducted acute malnutrition is correlated with acute infections, while chronic malnutrition is more influenced by WASH conditions. Therefore, our findings suggest that one cannot separate infection and its risk factors as determinants of the whole malnutrition burden.

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