Characterizing Undernourished Children Under-Five Years Old with Diarrhoea in Mozambique: A Hospital Based Cross-Sectional Study, 2015–2019

Júlia Sambo; Marta Cassocera; Assucênio Chissaque; Adilson Fernando Loforte Bauhofer; Clémentine Roucher; Jorfélia Chilaúle; Idalécia Cossa-Moiane; Esperança L. Guimarães; Lena Manhique-Coutinho; Elda Anapakala; Diocreciano M. Bero; Jerónimo S. Langa; Katja Polman; Luzia Gonçalves; Nilsa de Deus

doi:10.3390/nu14061164

Characterizing Undernourished Children Under-Five Years Old with Diarrhoea in Mozambique: A Hospital Based Cross-Sectional Study, 2015–2019

Júlia Sambo^*, Marta Cassocera, Assucênio Chissaque, Adilson Fernando Loforte Bauhofer, Clémentine Roucher, Jorfélia Chilaúle, Idalécia Cossa-Moiane, Esperança L. Guimarães, Lena Manhique-Coutinho, Elda Anapakala, Diocreciano M. Bero, Jerónimo S. Langa, Katja Polman, Luzia Gonçalves, Nilsa de Deus

^*Corresponding author for this work

Infectious Diseases

Research output: Contribution to Journal › Article › Academic › peer-review

Abstract

Diarrhoea is associated with undernutrition and this association is related to increased morbidity and mortality in children under-five. In this analysis we aimed to assess the frequency and associated factors of undernutrition in children under-five with diarrhoea. A hospital-based cross-sectional study was conducted from January 2015 to December 2019 through a surveillance system in five sentinel hospitals in Mozambique. Sociodemographic and clinical information was collected, including anthropometry. A total of 963 children were analysed. The overall undernutrition frequency was 54.1% (95% CI: 50.9–57.2), with 32.5% (95% CI: 29.6–35.5) stunting, 26.6% (95% CI: 23.9–29.6) wasting and 24.7% (95% CI: 22.1–27.5) underweight. Children from Nampula province had 4.7 (p = 0.016) higher odds for stunting compared with children from Maputo and Zambézia. Children whose mother was illiterate had higher odds of being underweight 5.4 (p < 0.001). Children born under 2500 g of weight had 2.85 (p = 0.001), 2.97 (p < 0.001) and 2.19 (p = 0.013) higher odds for being underweighted, wasted and stunted, respectively. The HIV positive status of the children was associated with higher odds of being underweight 2.88 (p = 0.005), wasted 2.24 (p = 0.025), and stunted 2.89 (p = 0.004). The province, caregiver education level, child’s birthweight and HIV status were factors associated with undernutrition in children with diarrhoea. These findings emphasise the need for additional caregiver’s education on the child’s nutrition and associated infectious diseases. More studies are needed to better understand the social context in which a child with diarrhoea and undernutrition is inserted.

Original language	English
Article number	1164
Pages (from-to)	1-15
Number of pages	15
Journal	Nutrients
Volume	14
Issue number	6
DOIs	https://doi.org/10.3390/nu14061164
Publication status	Published - 2 Mar 2022

Bibliographical note

Special Issue: Nutrition, Physical Activity Interventions for Children Immunity Development.

Funding Information:
Funding: The National Diarrhoea Surveillance was supported by a Senior Fellowship awarded to Nilsa de Deus by the European Foundation Initiate for African Research into Neglected Tropical Diseases (EFINTD, grant number 98539), World Health Organization (WHO). The World Health Organization: MOZ-19#792. The Global Alliance for Vaccine and Immunization through the Health System Strengthening (HSS) project. The Flandres Government, BICMINS project. The Calouste Gulbenkian Foundation from where Júlia Sambo, Marta Cassocera and Assucênio Chissaque have a PhD fellowship.

Funding Information:
The National Diarrhoea Surveillance was supported by a Senior Fellowship awarded to Nilsa de Deus by the European Foundation Initiate for African Research into Neglected Tropical Diseases (EFINTD, grant number 98539), World Health Organization (WHO). The World Health Organization: MOZ-19#792. The Global Alliance for Vaccine and Immunization through the Health System Strengthening (HSS) project. The Flandres Government, BICMINS project. The Calouste Gulbenkian Foundation from where J?lia Sambo, Marta Cassocera and Assuc?nio Chissaque have a PhD fellowship. Acknowledgments: We would like to thank the parents or guardians who consented for their children to be enrolled in the surveillance and all ViNaDia team for their dedication and effort with recruitment, data collection and shipment of specimens to the central laboratory in Maputo: Miguel Bambo, Carlos Guilamba, Celina Nhamuave, M?rcia Nhaca, Judite Sal?ncia, Herm?nio Cossa, F?lix Gundane, Aun?sia Marurele, Angelina Pereira, Mulaja Kabeya ?tienne, Celso Gabriel, Titos Maulate, Julieta Ernesto, Siasa Mendes, H?rcio Simbine, Susete de Carvalho, Marcos Joaquim, Elvira Sarguene, Fernando Vilanculos, Felicidade Martins, Dulce Gra?a, Edma Samuel, Vivaldo Pedro, L?cia Matabel, Aida Junta, Gilda Maria Safrina, Nat?rcia Abreu, Vanessa da Silva, Nazareth Mabutana, Delcio Muteto, Benilde Munlela and Carolina Conjo. A special thank you also to Timothy Kellogg for all the guidance during the initial data analysis process.

Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.

Funding

Funding: The National Diarrhoea Surveillance was supported by a Senior Fellowship awarded to Nilsa de Deus by the European Foundation Initiate for African Research into Neglected Tropical Diseases (EFINTD, grant number 98539), World Health Organization (WHO). The World Health Organization: MOZ-19#792. The Global Alliance for Vaccine and Immunization through the Health System Strengthening (HSS) project. The Flandres Government, BICMINS project. The Calouste Gulbenkian Foundation from where Júlia Sambo, Marta Cassocera and Assucênio Chissaque have a PhD fellowship. The National Diarrhoea Surveillance was supported by a Senior Fellowship awarded to Nilsa de Deus by the European Foundation Initiate for African Research into Neglected Tropical Diseases (EFINTD, grant number 98539), World Health Organization (WHO). The World Health Organization: MOZ-19#792. The Global Alliance for Vaccine and Immunization through the Health System Strengthening (HSS) project. The Flandres Government, BICMINS project. The Calouste Gulbenkian Foundation from where J?lia Sambo, Marta Cassocera and Assuc?nio Chissaque have a PhD fellowship. Acknowledgments: We would like to thank the parents or guardians who consented for their children to be enrolled in the surveillance and all ViNaDia team for their dedication and effort with recruitment, data collection and shipment of specimens to the central laboratory in Maputo: Miguel Bambo, Carlos Guilamba, Celina Nhamuave, M?rcia Nhaca, Judite Sal?ncia, Herm?nio Cossa, F?lix Gundane, Aun?sia Marurele, Angelina Pereira, Mulaja Kabeya ?tienne, Celso Gabriel, Titos Maulate, Julieta Ernesto, Siasa Mendes, H?rcio Simbine, Susete de Carvalho, Marcos Joaquim, Elvira Sarguene, Fernando Vilanculos, Felicidade Martins, Dulce Gra?a, Edma Samuel, Vivaldo Pedro, L?cia Matabel, Aida Junta, Gilda Maria Safrina, Nat?rcia Abreu, Vanessa da Silva, Nazareth Mabutana, Delcio Muteto, Benilde Munlela and Carolina Conjo. A special thank you also to Timothy Kellogg for all the guidance during the initial data analysis process.

Funders	Funder number
European Foundation Initiate for African Research into Neglected Tropical Diseases	98539
Flandres Government
World Health Organization	MOZ-19#792
World Health Organization

Keywords

Associated factors
Children
Diarrhoea
Mozambique
Undernutrition

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.3390/nu14061164

Persistent URL (handle)

Persistent link

Cite this

Sambo, J., Cassocera, M., Chissaque, A., Bauhofer, A. F. L., Roucher, C., Chilaúle, J., Cossa-Moiane, I., Guimarães, E. L., Manhique-Coutinho, L., Anapakala, E., Bero, D. M., Langa, J. S., Polman, K., Gonçalves, L., & de Deus, N. (2022). Characterizing Undernourished Children Under-Five Years Old with Diarrhoea in Mozambique: A Hospital Based Cross-Sectional Study, 2015–2019. Nutrients, 14(6), 1-15. Article 1164. https://doi.org/10.3390/nu14061164

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abstract = "Diarrhoea is associated with undernutrition and this association is related to increased morbidity and mortality in children under-five. In this analysis we aimed to assess the frequency and associated factors of undernutrition in children under-five with diarrhoea. A hospital-based cross-sectional study was conducted from January 2015 to December 2019 through a surveillance system in five sentinel hospitals in Mozambique. Sociodemographic and clinical information was collected, including anthropometry. A total of 963 children were analysed. The overall undernutrition frequency was 54.1% (95% CI: 50.9–57.2), with 32.5% (95% CI: 29.6–35.5) stunting, 26.6% (95% CI: 23.9–29.6) wasting and 24.7% (95% CI: 22.1–27.5) underweight. Children from Nampula province had 4.7 (p = 0.016) higher odds for stunting compared with children from Maputo and Zamb{\'e}zia. Children whose mother was illiterate had higher odds of being underweight 5.4 (p < 0.001). Children born under 2500 g of weight had 2.85 (p = 0.001), 2.97 (p < 0.001) and 2.19 (p = 0.013) higher odds for being underweighted, wasted and stunted, respectively. The HIV positive status of the children was associated with higher odds of being underweight 2.88 (p = 0.005), wasted 2.24 (p = 0.025), and stunted 2.89 (p = 0.004). The province, caregiver education level, child{\textquoteright}s birthweight and HIV status were factors associated with undernutrition in children with diarrhoea. These findings emphasise the need for additional caregiver{\textquoteright}s education on the child{\textquoteright}s nutrition and associated infectious diseases. More studies are needed to better understand the social context in which a child with diarrhoea and undernutrition is inserted.",

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author = "J{\'u}lia Sambo and Marta Cassocera and Assuc{\^e}nio Chissaque and Bauhofer, {Adilson Fernando Loforte} and Cl{\'e}mentine Roucher and Jorf{\'e}lia Chila{\'u}le and Idal{\'e}cia Cossa-Moiane and Guimar{\~a}es, {Esperan{\c c}a L.} and Lena Manhique-Coutinho and Elda Anapakala and Bero, {Diocreciano M.} and Langa, {Jer{\'o}nimo S.} and Katja Polman and Luzia Gon{\c c}alves and {de Deus}, Nilsa",

note = "Special Issue: Nutrition, Physical Activity Interventions for Children Immunity Development. Funding Information: Funding: The National Diarrhoea Surveillance was supported by a Senior Fellowship awarded to Nilsa de Deus by the European Foundation Initiate for African Research into Neglected Tropical Diseases (EFINTD, grant number 98539), World Health Organization (WHO). The World Health Organization: MOZ-19#792. The Global Alliance for Vaccine and Immunization through the Health System Strengthening (HSS) project. The Flandres Government, BICMINS project. The Calouste Gulbenkian Foundation from where J{\'u}lia Sambo, Marta Cassocera and Assuc{\^e}nio Chissaque have a PhD fellowship. Funding Information: The National Diarrhoea Surveillance was supported by a Senior Fellowship awarded to Nilsa de Deus by the European Foundation Initiate for African Research into Neglected Tropical Diseases (EFINTD, grant number 98539), World Health Organization (WHO). The World Health Organization: MOZ-19#792. The Global Alliance for Vaccine and Immunization through the Health System Strengthening (HSS) project. The Flandres Government, BICMINS project. The Calouste Gulbenkian Foundation from where J?lia Sambo, Marta Cassocera and Assuc?nio Chissaque have a PhD fellowship. Acknowledgments: We would like to thank the parents or guardians who consented for their children to be enrolled in the surveillance and all ViNaDia team for their dedication and effort with recruitment, data collection and shipment of specimens to the central laboratory in Maputo: Miguel Bambo, Carlos Guilamba, Celina Nhamuave, M?rcia Nhaca, Judite Sal?ncia, Herm?nio Cossa, F?lix Gundane, Aun?sia Marurele, Angelina Pereira, Mulaja Kabeya ?tienne, Celso Gabriel, Titos Maulate, Julieta Ernesto, Siasa Mendes, H?rcio Simbine, Susete de Carvalho, Marcos Joaquim, Elvira Sarguene, Fernando Vilanculos, Felicidade Martins, Dulce Gra?a, Edma Samuel, Vivaldo Pedro, L?cia Matabel, Aida Junta, Gilda Maria Safrina, Nat?rcia Abreu, Vanessa da Silva, Nazareth Mabutana, Delcio Muteto, Benilde Munlela and Carolina Conjo. A special thank you also to Timothy Kellogg for all the guidance during the initial data analysis process. Publisher Copyright: {\textcopyright} 2022 by the authors. Licensee MDPI, Basel, Switzerland.",

year = "2022",

month = mar,

day = "2",

doi = "10.3390/nu14061164",

language = "English",

volume = "14",

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Sambo, J, Cassocera, M, Chissaque, A, Bauhofer, AFL, Roucher, C, Chilaúle, J, Cossa-Moiane, I, Guimarães, EL, Manhique-Coutinho, L, Anapakala, E, Bero, DM, Langa, JS, Polman, K, Gonçalves, L & de Deus, N 2022, 'Characterizing Undernourished Children Under-Five Years Old with Diarrhoea in Mozambique: A Hospital Based Cross-Sectional Study, 2015–2019', Nutrients, vol. 14, no. 6, 1164, pp. 1-15. https://doi.org/10.3390/nu14061164

TY - JOUR

T1 - Characterizing Undernourished Children Under-Five Years Old with Diarrhoea in Mozambique: A Hospital Based Cross-Sectional Study, 2015–2019

AU - Sambo, Júlia

AU - Cassocera, Marta

AU - Chissaque, Assucênio

AU - Bauhofer, Adilson Fernando Loforte

AU - Roucher, Clémentine

AU - Chilaúle, Jorfélia

AU - Cossa-Moiane, Idalécia

AU - Guimarães, Esperança L.

AU - Manhique-Coutinho, Lena

AU - Anapakala, Elda

AU - Bero, Diocreciano M.

AU - Langa, Jerónimo S.

AU - Polman, Katja

AU - Gonçalves, Luzia

AU - de Deus, Nilsa

N1 - Special Issue: Nutrition, Physical Activity Interventions for Children Immunity Development. Funding Information: Funding: The National Diarrhoea Surveillance was supported by a Senior Fellowship awarded to Nilsa de Deus by the European Foundation Initiate for African Research into Neglected Tropical Diseases (EFINTD, grant number 98539), World Health Organization (WHO). The World Health Organization: MOZ-19#792. The Global Alliance for Vaccine and Immunization through the Health System Strengthening (HSS) project. The Flandres Government, BICMINS project. The Calouste Gulbenkian Foundation from where Júlia Sambo, Marta Cassocera and Assucênio Chissaque have a PhD fellowship. Funding Information: The National Diarrhoea Surveillance was supported by a Senior Fellowship awarded to Nilsa de Deus by the European Foundation Initiate for African Research into Neglected Tropical Diseases (EFINTD, grant number 98539), World Health Organization (WHO). The World Health Organization: MOZ-19#792. The Global Alliance for Vaccine and Immunization through the Health System Strengthening (HSS) project. The Flandres Government, BICMINS project. The Calouste Gulbenkian Foundation from where J?lia Sambo, Marta Cassocera and Assuc?nio Chissaque have a PhD fellowship. Acknowledgments: We would like to thank the parents or guardians who consented for their children to be enrolled in the surveillance and all ViNaDia team for their dedication and effort with recruitment, data collection and shipment of specimens to the central laboratory in Maputo: Miguel Bambo, Carlos Guilamba, Celina Nhamuave, M?rcia Nhaca, Judite Sal?ncia, Herm?nio Cossa, F?lix Gundane, Aun?sia Marurele, Angelina Pereira, Mulaja Kabeya ?tienne, Celso Gabriel, Titos Maulate, Julieta Ernesto, Siasa Mendes, H?rcio Simbine, Susete de Carvalho, Marcos Joaquim, Elvira Sarguene, Fernando Vilanculos, Felicidade Martins, Dulce Gra?a, Edma Samuel, Vivaldo Pedro, L?cia Matabel, Aida Junta, Gilda Maria Safrina, Nat?rcia Abreu, Vanessa da Silva, Nazareth Mabutana, Delcio Muteto, Benilde Munlela and Carolina Conjo. A special thank you also to Timothy Kellogg for all the guidance during the initial data analysis process. Publisher Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland.

PY - 2022/3/2

Y1 - 2022/3/2

N2 - Diarrhoea is associated with undernutrition and this association is related to increased morbidity and mortality in children under-five. In this analysis we aimed to assess the frequency and associated factors of undernutrition in children under-five with diarrhoea. A hospital-based cross-sectional study was conducted from January 2015 to December 2019 through a surveillance system in five sentinel hospitals in Mozambique. Sociodemographic and clinical information was collected, including anthropometry. A total of 963 children were analysed. The overall undernutrition frequency was 54.1% (95% CI: 50.9–57.2), with 32.5% (95% CI: 29.6–35.5) stunting, 26.6% (95% CI: 23.9–29.6) wasting and 24.7% (95% CI: 22.1–27.5) underweight. Children from Nampula province had 4.7 (p = 0.016) higher odds for stunting compared with children from Maputo and Zambézia. Children whose mother was illiterate had higher odds of being underweight 5.4 (p < 0.001). Children born under 2500 g of weight had 2.85 (p = 0.001), 2.97 (p < 0.001) and 2.19 (p = 0.013) higher odds for being underweighted, wasted and stunted, respectively. The HIV positive status of the children was associated with higher odds of being underweight 2.88 (p = 0.005), wasted 2.24 (p = 0.025), and stunted 2.89 (p = 0.004). The province, caregiver education level, child’s birthweight and HIV status were factors associated with undernutrition in children with diarrhoea. These findings emphasise the need for additional caregiver’s education on the child’s nutrition and associated infectious diseases. More studies are needed to better understand the social context in which a child with diarrhoea and undernutrition is inserted.

AB - Diarrhoea is associated with undernutrition and this association is related to increased morbidity and mortality in children under-five. In this analysis we aimed to assess the frequency and associated factors of undernutrition in children under-five with diarrhoea. A hospital-based cross-sectional study was conducted from January 2015 to December 2019 through a surveillance system in five sentinel hospitals in Mozambique. Sociodemographic and clinical information was collected, including anthropometry. A total of 963 children were analysed. The overall undernutrition frequency was 54.1% (95% CI: 50.9–57.2), with 32.5% (95% CI: 29.6–35.5) stunting, 26.6% (95% CI: 23.9–29.6) wasting and 24.7% (95% CI: 22.1–27.5) underweight. Children from Nampula province had 4.7 (p = 0.016) higher odds for stunting compared with children from Maputo and Zambézia. Children whose mother was illiterate had higher odds of being underweight 5.4 (p < 0.001). Children born under 2500 g of weight had 2.85 (p = 0.001), 2.97 (p < 0.001) and 2.19 (p = 0.013) higher odds for being underweighted, wasted and stunted, respectively. The HIV positive status of the children was associated with higher odds of being underweight 2.88 (p = 0.005), wasted 2.24 (p = 0.025), and stunted 2.89 (p = 0.004). The province, caregiver education level, child’s birthweight and HIV status were factors associated with undernutrition in children with diarrhoea. These findings emphasise the need for additional caregiver’s education on the child’s nutrition and associated infectious diseases. More studies are needed to better understand the social context in which a child with diarrhoea and undernutrition is inserted.

KW - Associated factors

KW - Children

KW - Diarrhoea

KW - Mozambique

KW - Undernutrition

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U2 - 10.3390/nu14061164

DO - 10.3390/nu14061164

M3 - Article

AN - SCOPUS:85125886595

SN - 2072-6643

VL - 14

SP - 1

EP - 15

JO - Nutrients

JF - Nutrients

IS - 6

M1 - 1164

ER -

Characterizing Undernourished Children Under-Five Years Old with Diarrhoea in Mozambique: A Hospital Based Cross-Sectional Study, 2015–2019

Abstract

Bibliographical note

Funding

Keywords

UN SDGs

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