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Environmental determinants of underweight among pre-schoolchildren: A case control study

Arun Sugumaran, Anil J Purty, Stalin P, Zile Singh.




Abstract

Background: Underweight is a predisposing factor and a leading cause of mortality among pre-schoolchildren in low and middle income countries worldwide. Pre-schoolchildren require relatively higher nutritional requirements for their body weight compared to older children and adults which makes them vulnerable for underweight. According to the third National Family Health Survey-3 in which 42.5% of under 5 children are underweight.

Objective: This study aims to study the selected environmental factors associated with underweight among pre-schoolchildren in a rural area.

Materials and Methods: A community-based case control study was conducted in 10 villages of Kancheepuram District, Tamil Nadu. Sample size was calculated with two-sided confidence interval of 95%, power 90%, and ratio of cases to controls of 1. Taking the percent of exposure (lower socioeconomic status) in controls and cases as 22% and 43%, respectively, and an odds ratio of 2.6. The sample size calculated was 112 (cases-112 and controls 112). Chi-square test was applied to test the statistical difference in proportion and odds ratio was calculated.

Results: The significant risk factors on univariate analysis for underweight were socioeconomic status (OR=5.16), inadequate ventilation (OR=1.8), presence of indoor pollution (OR=2.8), firewood used as fuel for cooking (OR=1.8), practice of open air defecation (OR=2.06). After adjusting for confounders using multivariate analysis the significant risk factors were socioeconomic status (OR=5.75), inadequate ventilation (OR=3.2).

Conclusion: Poor socioeconomic status and inadequate ventilation were found to be associated with malnutrition in our study population.

Key words: Determinants, underweight, pre-school children






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