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The Interaction between Morbidity and Nutritional Status among Children under Five Years Old in Cambodia: A Longitudinal Study

1
Reproductive and Child Health Alliance, No. 160 Street 71, Tonle Bassac, Chamkar Mon, P.O.Box 2471, Phnom Penh 12100, Cambodia
2
UMR-204 Nutripass, Institut de Recherche pour le Développement, IRD/UM/SupAgro, 34390 Montpellier, France
3
United Nations Children’s Fund (UNICEF), Integrated Early Childhood Development, Exchange Square, 5th Floor, No. 19&20, Street 106, Sangkat Wat Phnom, Khan Daun Penh, Phnom Penh 12100, Cambodia
*
Author to whom correspondence should be addressed.
Nutrients 2019, 11(7), 1527; https://doi.org/10.3390/nu11071527
Received: 15 May 2019 / Revised: 19 June 2019 / Accepted: 23 June 2019 / Published: 5 July 2019
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Abstract

Even though limited evidence is available, the relationship between morbidity and under-nutrition among children under-five is likely to be a strong two-way association. This study aims to explore this vicious cycle by employing longitudinal data of four periods within a 24 month follow-up, whereby morbidity was captured between two subsequent anthropometric measures. Malnutrition was classified according to z-scores of anthropometric measures and morbidity by number of sick days experienced in between. Mixed-effects models were used to assess this relation, where dependency of morbidity and nutritional status were interchanged; models were adjusted for province, age, gender, wealth index score, maternal education level, diet, and Water, Sanitation, and Hygiene indicators. Stunting and wasting prevalence were 29.9% and 8.9%, respectively, where 21.3% of the children had multiple anthropometric failures. Children identified as wasted were 35% more likely to experience prolonged illness periods (OR: 1.35, 95% CI: 1.02–1.56). Those experiencing high proportion of sick days were found to be 64% more likely to become stunted (OR: 1.64, 95% CI: 1.18–2.29). This study suggests that the link between wasting and stunting could be partly explained by acute illness, where wasting increases the likelihood of prolonged episodes of illness, which increases the risk of stunting. View Full-Text
Keywords: stunting; wasting; anthropometric failure; morbidity; children under five; acute illness stunting; wasting; anthropometric failure; morbidity; children under five; acute illness
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Hondru, G.; Wieringa, F.T.; Poirot, E.; Berger, J.; Som, S.V.; Theary, C.; Laillou, A. The Interaction between Morbidity and Nutritional Status among Children under Five Years Old in Cambodia: A Longitudinal Study. Nutrients 2019, 11, 1527.

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