Prevalence Of Undernutrition And Its Associated Factors Among Children Under Five Years Of Age In Ambo Town, West Shoa, Ethiopia, 2025: By Using A Composite Index Of Anthropometric Failure

Abstract

Background: Undernutrition is the global issue due to its high prevalence. Different aspects of nutritional status are reflected in the determination of undernutrition status utilizing conventional indicators such as weight-for-age, height for-age, and weight-for-height. Conventional measures, either alone or in combination, are unable to capture the full extent of undernutrition in the population. Another classification scheme that aims to close this gap is the Composite Index of Anthropometric Failure. So knowing the real prevalence of undernutrition by using the composite index of anthropometric failure is crucial to working on the eradication of undernutrition, which is one of the sustainable development goals of the world by 2030. Objective: To determine the prevalence of undernutrition and its associated factors using a composite index of anthropometric failure among children under five years of age in Ambo town, West Shoa, Ethiopia, 2025 Method and Materials: A community-based cross-sectional study was conducted among systematic randomly selected 423 under five year children paired with their mothers/caregivers in Ambo town, West Shoa, Ethiopia, from January 3, 2025 to April 3, 2025. Data were collected using structured interviewer-administered questionnaires and nutritional status of the children were assessed using anthropometric measurements. A combination of conventional index measurements was used to determine the composite index of anthropometric failure. The collected data were checked, coded, and entered into Epi data versions 3.1 and exported to the statistical package for Social Science (SPSS) version 27 for further analysis. Descriptive statistics like frequency and percentage for categorical variables and mean with standard deviation for continuous variables was used to describe the study population. Binary logistic regression model was used to analysis the data, and the variables with p-value < 0.25 in bi-variable logistic regression analysis was selected to fit multivariate logistic regression analysis. The strength of association was estimated using an adjusted odds ratio with a 95% confidence interval. Statistical significance was declared at p-value < 0.05 on the final model. Results: The mean age of the under-5 children in the study was 29.82 ± 14.16 months. The overall prevalence of undernutrition using composite index of anthropometric failure was, 218(51.5%) (95% CI [48.7-54.3%]) which is high. Colostrum feeding [AOR =0.416, 95%CI (256-3675)], maternal age 18-24 years [AOR =1.968,95% CI (1.152-3.362)] and 25-34 years [AOR=2.666, 95%CI (1.24-5.733)], and child age 6-24 months [AOR =0.566, 95% CI (0.352-0.910)], presence of under-five sibling [AOR=2.004, 95% CI (1.062-3.784)], history of upper respiratory tract infection in the last two weeks [AOR=1.763. 95% CI (01.131-2.749)], and history of diarrhoea diseases in the last two weeks [AOR=1.701, 95% CI (1.021-2.834)] have an association with undernutrition in ender five children. Conclusion: This study demonstrated that composite index of anthropometric failure gives an overall and more accurate estimate of undernutrition. In addition to identifying more children with multiple anthropometric failures and providing a more comprehensive picture of the extent and pattern of undernutrition among children residing in communities with low resources, composite index of anthropometric failure provides a more accurate assessment of undernutrition than commonly employed traditional indices. Avoiding colostrum, both maternal and child age, presence of under five siblings, having history of upper respiratory tract infection and diarrhoea disease in the last two weeks are strongly associated with composite index of anthropometric failure.