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Risk Factors and Nutritional Profiles Associated with Stunting in Children

  • Febriani, Andi Dwi Bahagia (Department of Pediatrics, Hasanuddin University's Faculty of Medicine, DR Wahidin Sudirohusodo Hospital) ;
  • Daud, Dasril (Department of Pediatrics, Hasanuddin University's Faculty of Medicine, DR Wahidin Sudirohusodo Hospital) ;
  • Rauf, Syarifuddin (Department of Pediatrics, Hasanuddin University's Faculty of Medicine, DR Wahidin Sudirohusodo Hospital) ;
  • Nawing, Herry Demokrasi (Department of Pediatrics, Hasanuddin University's Faculty of Medicine, DR Wahidin Sudirohusodo Hospital) ;
  • Ganda, Idham Jaya (Department of Pediatrics, Hasanuddin University's Faculty of Medicine, DR Wahidin Sudirohusodo Hospital) ;
  • Salekede, Setia Budi (Department of Pediatrics, Hasanuddin University's Faculty of Medicine, DR Wahidin Sudirohusodo Hospital) ;
  • Angriani, Hadia (Department of Pediatrics, Hasanuddin University's Faculty of Medicine, DR Wahidin Sudirohusodo Hospital) ;
  • Maddeppungeng, Martira (Department of Pediatrics, Hasanuddin University's Faculty of Medicine, DR Wahidin Sudirohusodo Hospital) ;
  • Juliaty, Aidah (Department of Pediatrics, Hasanuddin University's Faculty of Medicine, DR Wahidin Sudirohusodo Hospital) ;
  • Alasiry, Ema (Department of Pediatrics, Hasanuddin University's Faculty of Medicine, DR Wahidin Sudirohusodo Hospital) ;
  • Artaty, Ratna Dewi (Department of Pediatrics, Hasanuddin University's Faculty of Medicine, DR Wahidin Sudirohusodo Hospital) ;
  • Lawang, St Aizah (Department of Pediatrics, Hasanuddin University's Faculty of Medicine, DR Wahidin Sudirohusodo Hospital) ;
  • Ridha, Nadirah Rasyid (Department of Pediatrics, Hasanuddin University's Faculty of Medicine, DR Wahidin Sudirohusodo Hospital) ;
  • Laompo, Amiruddin (Department of Pediatrics, Hasanuddin University's Faculty of Medicine, DR Wahidin Sudirohusodo Hospital) ;
  • Rahimi, Rahmawaty (Department of Pediatrics, Hasanuddin University's Faculty of Medicine, DR Wahidin Sudirohusodo Hospital) ;
  • Aras, Jusli (Department of Pediatrics, Hasanuddin University's Faculty of Medicine, DR Wahidin Sudirohusodo Hospital) ;
  • Sarmila, Besse (Department of Pediatrics, Hasanuddin University's Faculty of Medicine, DR Wahidin Sudirohusodo Hospital)
  • Received : 2019.11.27
  • Accepted : 2020.05.01
  • Published : 2020.09.30

Abstract

Purpose: To analyze risk factors and various nutrients associated with stunting among children aged 6-60 months. Methods: This is a case-control and cross-sectional study between 40 stunting cases and 40 controls. Data on possible risk factors associated with stunting were obtained through direct interviews and using a questionnaire. Examination of vitamin D, zinc, albumin, and ferritin levels was performed on both groups. Data were analyzed using IBM SPSS Statistics for Windows, Version 23.0 (IBM Co., Armonk, NY, USA) to determine risk factors for stunting and to assess the relationship between nutritional levels and stunting. Results: The incidence of stunting was highest in children aged 12-36 months. Children with low weight and very low weight for age comprised of 55% and 22.5%, respectively, of the study participants. The highest mother's educational level was junior high school (40%). History of low birth weight (LBW) was more commonly observed in the stunting group than that in the control group (25.0% and 7.5%, respectively; p=0.034, odds ratio, 0.310 [95% confidence interval, 0.122-0.789]). Approximately 7.5% of cases had premature birth. Exclusive breast feeding was found to be not correlated with stunting. The mean zinc level in the stunting group was 34.17 ng/mL, which was different from that in the control group (50.83 ng/mL) (p=0.023). Blood ferritin, vitamin D, albumin, and calcium levels were not strongly correlated with stunting. Conclusion: LBW is the main risk factor contributing to stunting and is strongly associated with low zinc level.

Keywords

References

  1. United Nations Children's Fund (UNICEF), World Health Organization, International Bank for Reconstruction and Development/The World Bank. Levels and trends in child malnutrition: key findings of the 2019 Edition of the Joint Child Malnutrition Estimates. Geneva: World Health Organization, 2019.
  2. Kesehatan K. Profil Kesehatan Indonesia Tahun 2015. Jakarta: Kementerian Kesehatan, 2016:169.
  3. Scaling Up Nutrition. Scaling Up Nutrition (SUN) movement strategy [2012-2015]. SUN Movement, 2012:3.
  4. Anugraheni HS, Kartasurya MI. [Faktor risiko kejadian stunting pada anak usia 12-36 bulan di kecamatan Pati, kabupaten Pati]. J Nutr Coll 2012;1:30-7. Indonesia. https://doi.org/10.14710/jnc.v1i1.725
  5. Ramli , Agho KE, Inder KJ, Bowe SJ, Jacobs J, Dibley MJ. Prevalence and risk factors for stunting and severe stunting among under-fives in North Maluku province of Indonesia. BMC Pediatr 2009;9:64. https://doi.org/10.1186/1471-2431-9-64
  6. Fikadu T, Assegid S, Dube L. Factors associated with stunting among children of age 24 to 59 months in Meskan district, Gurage Zone, South Ethiopia: a case-control study. BMC Public Health 2014;14:1-7. https://doi.org/10.1186/1471-2458-14-1
  7. Sari EM, Juffrie M, Nurani N, Sitaresmi MN. [Protein, calcium and phosphorus intake of stunting and non stunting children aged 24-59 months]. J Gizi Klin Indones 2016;12:152-9. Indonesia. https://doi.org/10.22146/ijcn.23111
  8. van Stuijvenberg ME, Nel J, Schoeman SE, Lombard CJ, du Plessis LM, Dhansay MA. Low intake of calcium and vitamin D, but not zinc, iron or vitamin A, is associated with stunting in 2- to 5-year-old children. Nutrition 2015;31:841-6. https://doi.org/10.1016/j.nut.2014.12.011
  9. Paudel R, Pradhan B, Wagle RR, Pahari DP, Onta SR. Risk factors for stunting among children: a community based case control study in Nepal. Kathmandu Univ Med J (KUMJ) 2012;10:18-24.
  10. Arif GM. Child health and poverty in Pakistan. Pak Dev Rev 2004;43:211-38. https://doi.org/10.30541/v43i3pp.211-238
  11. National Institute of Population Research and Training (NIPORT), Mitra and Associates, ICF International. Bangladesh demographic and health survey 2014. Dhaka, Rockville: NIPORT, Mitra and Associates, ICF International, 2016.
  12. International Institute for Population Sciences (IIPS). ICF. National family health survey (NFHS-4) [Internet]. Mumbai: IIPS; 2017 [cited 2019 Sep 7]. Available from: https://dhsprogram.com/pubs/pdf/FR339/FR339.pdf
  13. Candra A, Puruhita N, Susanto JC. Risk factors of stunting among 1-2 years old children in Semarang city. Media Med Indones 2011;45:206-12.
  14. El Taguri A, Betilmal I, Mahmud SM, Monem Ahmed A, Goulet O, Galan P, et al. Risk factors for stunting among under-fives in Libya. Public Health Nutr 2009;12:1141-9. https://doi.org/10.1017/s1368980008003716
  15. Peacock M. Calcium metabolism in health and disease. Clin J Am Soc Nephrol 2010;5 Suppl 1:S23-30. https://doi.org/10.2215/CJN.05910809
  16. Meilyasari F, Isnawati M. [Faktor risiko kejadian stunting pada balita usia 12 bulan di Desa Purwokerto Kecamatan Patebon, Kabupaten Kendal]. J Nutr Coll 2014;3:303-9. Indonesia. https://doi.org/10.14710/jnc.v3i2.5437
  17. Gibson RS, Manger MS, Krittaphol W, Pongcharoen T, Gowachirapant S, Bailey KB, et al. Does zinc deficiency play a role in stunting among primary school children in NE Thailand? Br J Nutr 2007;97:167-75. https://doi.org/10.1017/S0007114507250445
  18. Dewi IAKC, Adhi KT. [Pengaruh konsumsi protein dan seng serta riwayat penyakit infeksi terhadap kejadian stunting pada anak balita umur 24-59 bulan di wilayah kerja Puskesmas Nusa Penida III]. Arc Com Health 2016;3:36-46. Indonesia.
  19. Hidayati L, Hadi H, Kumara A. Kekurangan energi dan zat gizi merupakan faktor risiko kejadian stunted pada anak usia 1-3 tahun yang tinggal di wilayah kumuh perkotaan Surakarta. J Kesehat 2010;3:89-104.