Child, maternal and household-level correlates of nutritional status: a cross-sectional study among young Samoan children

Objective Young children are particularly vulnerable to malnutrition as nutrition transition progresses. The present study aimed to document the prevalence, coexistence and correlates of nutritional status (stunting, overweight/obesity and anaemia) in Samoan children aged 24-59 months. Design A cross-sectional community-based survey. Height and weight were used to determine prevalence of stunting (height-for-age Z-score < -2) and overweight/obesity (BMI-for-age Z-score > +2) based on WHO growth standards. Anaemia was determined using an AimStrip Hemoglobin test system (Hb < 110 g/l). Setting Ten villages on the Samoan island of Upolu. Subjects Mother-child pairs (n 305) recruited using convenience sampling. Results Moderate or severe stunting was apparent in 20·3 % of children, 16·1 % were overweight/obese and 34·1 % were anaemic. Among the overweight/obese children, 28·6 % were also stunted and 42·9 % anaemic, indicating dual burden of malnutrition. Stunting was significantly less likely among girls (OR=0·41; 95 % CI 0·21, 0·79, P < 0·01) than boys. Overweight/obesity was associated with higher family socio-economic status and decreased sugar intake (OR per 10 g/d=0·89, 95 % CI 0·80, 0·99, P=0·032). The odds of anaemia decreased with age and anaemia was more likely in children with an anaemic mother (OR=2·20; 95 % CI 1·22, 3·98, P=0·007). No child, maternal or household characteristic was associated with more than one of the nutritional status outcomes, highlighting the need for condition-specific interventions in this age group. Conclusions The observed prevalences of stunting, overweight/obesity and anaemia suggest that it is critical to invest in nutrition and develop health programmes targeting early childhood growth and development in Samoa.