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Article

Double Burden of Malnutrition in Rural Madagascar: A Study on Infant Health in Ampefy

by
Rosita Rotella
1,2,
Jose M. Soriano
3,4,
Agustin Llopis-Gonzalez
1,5 and
María Morales-Suarez-Varela
1,5,*
1
Research Group in Social and Nutritional Epidemiology, Pharmacoepidemiology and Public Health, Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine, Faculty of Pharmacy, Universitat de València, Av. Vicent Andrés Estelles s/n, 46100 Burjassot, Valencia, Spain
2
Centro Medico-Chirurgico Saint Paul (Change ONG), Andasibe, Ampefy 118, District of Soavinandriana, Itasy Province, Madagascar
3
Observatory of Nutrition and Food Safety for Developing Countries, Food & Health Lab, Institute of Materials Science, University of Valencia, Carrer Catedrático Agustín Escardino, 9, 46980 Paterna, Spain
4
Joint Research Unit on Endocrinology, Nutrition and Clinical Dietetics, University of Valencia-Health Research Institute La Fe, Avda. Fernando Abril Martorell, 106, 46026 Valencia, Spain
5
Biomedical Research Center in Epidemiology and Public Health Network (CIBERESP), Carlos III Health Institute, Av. Monforte de Lemos 3-5. Pabellón 11, Planta 0, 28029 Madrid, Spain
*
Author to whom correspondence should be addressed.
Nutrients 2025, 17(11), 1756; https://doi.org/10.3390/nu17111756
Submission received: 6 May 2025 / Revised: 16 May 2025 / Accepted: 21 May 2025 / Published: 22 May 2025
(This article belongs to the Special Issue Perinatal Outcomes and Early-Life Nutrition)

Highlights

  1. Almost half of all deaths worldwide in children under five are related to malnutrition.
  2. Nutrimetry, which integrates height-for-age and BMI-for-age, provides a comprehensive assessment of nutritional status, especially in low-resource settings.
  3. This study revealed a double burden of malnutrition in children under two years in rural Madagascar, with high rates of both stunting (57.6%) and overweight/obesity (21.3%).
  4. A significant proportion of overweight or obese children (61.03%) were also stunted, highlighting the coexistence of under- and overnutrition.
  5. Socioeconomic constraints, poor dietary diversity, maternal nutritional status, and breastfeeding practices were key determinants of child malnutrition.

Abstract

Background/Objectives: This study investigates the prevalence and impact of the double burden of malnutrition (DBM), malnutrition and overnutrition, in infants aged 0–24 months in the rural municipality of Ampefy, Itasy region, Madagascar. The Global Nutrition Report 2022 highlights the widespread issue of malnutrition, affecting 2 billion adults and 38 million children under five. Madagascar, characterized by severe poverty and high malnutrition rates, serves as a critical case study. Methods: A structured questionnaire was administered to 437 mother–child pairs from November 2022 to March 2023, collecting data on maternal education, dietary habits, and socio-economic status. Anthropometric measurements were taken using either a stadiometer or UNICEF length charts to assess height/length and an electronic scale to determine weight. Results: Findings reveal a high prevalence of malnutrition, with 29.7% of children affected by either wasting, stunting, and/or underweight, and 13.3% classified as overweight or obese. This study identifies significant age-related differences, with younger children more likely to be overweight and older children more likely to suffer from stunting or wasting. Maternal nutritional status, breastfeeding practices, and socio-economic conditions are strongly associated with child malnutrition outcomes. Lower dietary diversity among mothers and insufficient antenatal care are significant risk factors. Households with lower incomes and limited access to water and transport face higher malnutrition risks. Conclusions: This study underscores the critical need for targeted nutritional interventions and education to address DBM in Madagascar, highlighting the importance of maternal health and dietary diversity in early childhood development. Further longitudinal research is recommended to establish causality and develop comprehensive public health strategies.
Keywords: malnutrition; infant; Madagascar malnutrition; infant; Madagascar

Share and Cite

MDPI and ACS Style

Rotella, R.; Soriano, J.M.; Llopis-Gonzalez, A.; Morales-Suarez-Varela, M. Double Burden of Malnutrition in Rural Madagascar: A Study on Infant Health in Ampefy. Nutrients 2025, 17, 1756. https://doi.org/10.3390/nu17111756

AMA Style

Rotella R, Soriano JM, Llopis-Gonzalez A, Morales-Suarez-Varela M. Double Burden of Malnutrition in Rural Madagascar: A Study on Infant Health in Ampefy. Nutrients. 2025; 17(11):1756. https://doi.org/10.3390/nu17111756

Chicago/Turabian Style

Rotella, Rosita, Jose M. Soriano, Agustin Llopis-Gonzalez, and María Morales-Suarez-Varela. 2025. "Double Burden of Malnutrition in Rural Madagascar: A Study on Infant Health in Ampefy" Nutrients 17, no. 11: 1756. https://doi.org/10.3390/nu17111756

APA Style

Rotella, R., Soriano, J. M., Llopis-Gonzalez, A., & Morales-Suarez-Varela, M. (2025). Double Burden of Malnutrition in Rural Madagascar: A Study on Infant Health in Ampefy. Nutrients, 17(11), 1756. https://doi.org/10.3390/nu17111756

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