The interaction between morbidity and nutritional status among children under five years old in cambodia: A longitudinal study

Gabriela Hondru*, Frank T. Wieringa, Etienne Poirot, Jacques Berger, Somphos V. Som, Chan Theary, Arnaud Laillou

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review


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 inbetween. 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, andWater, Sanitation, and Hygiene indicators. Stunting and wasting prevalences were 29.9% and 8.9%, respectively, where 21.3% of the children hadmultiple 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 epiosed of illness, which increases the risk of stunting.

Original languageEnglish
Article number1527
Pages (from-to)1-12
Number of pages12
Issue number7
Early online date5 Jul 2019
Publication statusPublished - Jul 2019
Externally publishedYes


The study, shortly named MyHealth, received ethical approval under the name of “The Cambodian Health and Nutrition Monitoring Study” with file number 117/NECHR from the Cambodian National Ethical Committee for Health Research, National Institute of Public Health, Ministry of Health, Cambodia. Funding: The MyHealth project is supported by the UNICEF National Committees of Australia, Korea, and Canada and the French National Research Institute for Sustainable Development (IRD).

FundersFunder number
French National Research Institute for Sustainable Development
UNICEF National Committees of Australia
Institut de recherche pour le développement


    • Acute illness
    • Anthropometric failure
    • Children under five
    • Morbidity
    • Stunting
    • Wasting


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