228 - Patterns of Childhood Growth in Amhara, Ethiopia: Prevalence, Incidence and Reversal of Underweight and Wasting from Birth to 2 years

Publication Number: 2219.228

Kathleen M. Kurowski, Childrens Hospital of Philadelphia, Philadelphia, PA, United States; Grace Chan, Childrens Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, United States; Bezawit Mesfin Hunegnaw, JSI Ethiopia, Addis Ababa, MA, Ethiopia; Yahya Mohammed, HaSET, Addis Ababa, Adis Abeba, Ethiopia; Chalachew Bekele. Shiferaw, HaSET Maternal and Children Research Program, Addis Ababa, Adis Abeba, Ethiopia

Background: Undernutrition and growth continue to be a problem in many low- and middle-income countries, with a high burden in sub-Saharan Africa. In Ethiopia, the prevalence of malnutrition is high and understanding growth patterns and estimates of underweight and wasting is essential in improving recovery.

Objective: To characterize growth trajectories and estimate prevalence and incidence of underweight and wasting among children aged 0 to 24 months.

Design/Methods: This prospective cohort study of the participants in the Birhan Maternal and Child Health living in North Shewa Zone, Amhara Ethiopia was conducted between December 2018 to November 2020. Eligible participants were children aged 0 to 24 months who were enrolled in the Birhan cohort and had their length and weight measured at least once. The primary outcomes of this study are underweight, defined as weight-for-age z score (WAZ) at least 2 standard deviations (SDs) below the mean, and wasting, defined as weight-for-height z score (WHZ) at least 2 SDs below the mean. Secondary outcomes include reversal of underweight and wasting.

Results: Out of 4354 enrolled children, 3674 (84.4%) had at least one height measured and 3800 (87.3%) had at least one weight measured. Among the 3674 children included in analysis, 48.7% (1786/2670) were female and 51.3% (1884/3670) were male. Children who had at least one visit with a height and weight measurement (n=3674) were included in the study. The incidence of underweight fluctuates over time, with a low of 6.2% (95% CI: 4.7% - 8.2%) at 6 months and a high of 15.7% (95% CI: 12.5% - 19.4%) at 24 months. The incidence of wasting decreases over time, from 21.7% (95% CI: 19/6% - 23.9%) at birth to 5.3% (95% CI: 3.5% = 7.8%) at 24 months. Prevalence of underweight and wasting follow similar trends to incidence. Reversal patterns will be investigated.

Conclusion(s): The incidence and prevalence of wasting decreased over time, suggesting that there could be factors that are affecting the weight of children in the cohort. Understanding what factors may be helpful in lowering the prevalence of wasting in this cohort and protective against wasting as age increases could be informative for future interventions.