2017 Articles

Prevalence and determinants of stunting in a conflict-ridden border region in Armenia - a cross-sectional study

Balalian, Arin; Simonyan, Hambardzum; Hekimian, Kim; Deckelbaum, Richard Joseph; Sargsyan, Aelita

Background
Despite global efforts, stunting remains a public health problem in several developing countries. The prevalence of stunting among 0- to 5-year-old children in Armenia has increased from 17% in 2000 to 19% in 2010. A baseline study was conducted among preschool children in Berd, a region near the northeastern border of Armenia that has experienced intermittent military tension for over 20 years.

Methods
We conducted a cross-sectional study including 594 children aged 6-month- 6 years old and their caregivers in our analysis, to assess the prevalence and determinants of stunting. We calculated the anthropometric measurements and hemoglobin levels of children; analyzed children’s stool and conducted a survey with children’s caregivers. We employed the hierarchical logistic regression model to explore the predictors of stunting among 25–72 months old children and multivariable logistic regression models to investigate the predictors of stunting among 6–24 months old children. Individual and residence level variables were included in the models including anemia, minimum dietary diversity, mothers’ height, the overall duration of breastfeeding, birthweight, child’s history of diarrhea and mean socio-economic score.

Results
The prevalence of stunting was significantly higher among the 6–24 months old children (13.3%) compared to the children aged 25–72 months old (7.8%). We did not find any differences in the prevalence of stunting by place of residence in either age group. The 6–24 months old children who consumed at least four food groups during the previous day (minimum dietary diversity) had 72% lower odds of being stunted (p < 0.05). Each kilogram increase in birthweight was associated with 76% lower odds of being stunted (OR = 0.24, p < 0.01). Mother’s height significantly decreased the odds of stunting among the children 25–72- months old (OR = 0.86, p < 0.001). BMI was also a significant predictor of stunting among both age-groups.

Conclusions
The study results highlight the significance of mother’s height, birthweight, and adequate complementary feeding to reduce stunting. Further studies are needed to determine the possible association of anemia and stunting with the ongoing conflict in the region, as well as socioeconomic conditions and food insecurity in the region.