Co-occurrence of Overweight, Stunting, and Anemia among Adolescents (10-19 Years) in Tanzania Mainland: A School-Based Cross-Sectional Study

Geofrey Mchau; Erick Killel; Kaunara Azizi; Stanslaus Henry; Samafilan Ainan; Theresia Jumbe; Nyamizi Bundara; Wiggins Kystikila; Felista Mwingira; Pendael Machafuko; Bwire Wilson; Heavenlight A Paulo; Sauli Epimack; Hoyce Mshinda; Frank Chacky; Ramadhani Noor; Ray Masumo; Germana Leyna

doi:10.1016/j.cdnut.2023.102016

Co-occurrence of Overweight, Stunting, and Anemia among Adolescents (10-19 Years) in Tanzania Mainland: A School-Based Cross-Sectional Study

Curr Dev Nutr. 2023 Oct 14;8(1):102016. doi: 10.1016/j.cdnut.2023.102016. eCollection 2024 Jan.

Authors

Geofrey Mchau^{1

2}, Erick Killel¹, Kaunara Azizi³, Stanslaus Henry¹, Samafilan Ainan⁴, Theresia Jumbe^{5

6}, Nyamizi Bundara⁷, Wiggins Kystikila⁸, Felista Mwingira⁹, Pendael Machafuko¹⁰, Bwire Wilson⁸, Heavenlight A Paulo², Sauli Epimack¹, Hoyce Mshinda¹, Frank Chacky¹¹, Ramadhani Noor¹², Ray Masumo¹, Germana Leyna^{1

2}

Affiliations

¹ Department of Community Health and Nutrition, Tanzania Food Nutrition Centre (TFNC), Dar es Salaam, Tanzania.
² Department of Epidemiology and Biostatistics, Muhimbili University of Health Allied Sciences (MUHAS), Dar es Salaam, Tanzania.
³ Department of Food Sciences and Nutrition, Tanzania Food Nutrition Centre (TFNC), Dar es Salaam, Tanzania.
⁴ Department of Pediatric and Child Health, Muhimbili University of Health Allied Sciences (MUHAS), Dar es Salaam, Tanzania.
⁵ Hellen Keller International (HKI), Tanzania.
⁶ Department of Human Nutrition and Consumer Studies, Sokoine University of Agriculture (SUA), Tanzania.
⁷ Ministry of Livestock and Fisheries.
⁸ Department of Statistics, University of Dar es Salaam (UDSM), Dar es Salaam, Tanzania.
⁹ Dar es Salaam University College of Education.
¹⁰ National Institute for Medical Research, Muheza Branch.
¹¹ National Malaria Control Program, Ministry of Health (MoH), Tanzania.
¹² United Nations Children's Fund (UNICEF), Ethiopia.

Abstract

Background: Evidence on double and triple burdens of malnutrition among adolescents is an essential key to informing policy design, implementation, and tracking progress of adolescent nutritional programs. Tanzania has a scarcity of studies on the double and triple burden of malnutrition among adolescents.

Objective: The aim of this study was to assess the co-occurrence of malnutrition (overweight, stunting, and anemia) among adolescents (10-19 y) in mainland Tanzania.

Methods: A school-based cross-sectional study was conducted among 44,120 primary school adolescents aged 10 to 19 y in mainland Tanzania. Anthropometric assessments (weight, height, and body mass index), dietary assessments, and hemoglobin levels were used to calculate the single, double, and triple burden of malnutrition. Data were analyzed using Stata software 15. The chi-square test was used to test the association between the nutrition condition and social demographic variables, physical activity, and dietary quality. Log-binomial models were used to determine factors associated with stunting, overweight, and anemia. Multivariable log-binomial models were used to control confounders. All analyses were 2-tailed, and the significance level was set at 5%.

Results: The prevalence of anemia was 34.1%, while stunting and overweight had a prevalence of 32% and 4.2%, respectively. Approximately 41.7%, 13.5%, and 0.3% had single, double, and triple burden malnutrition-related conditions, respectively. Females were found to have a higher risk of being overweight compared with males (relative risk [RR]: 1.33; 95% confidence interval [CI]: 1.21, 1.45), while engaging in moderate to low levels of physical activity was associated with a decreased risk of being overweight. Additionally, residing in urban areas was linked to a decreased risk of stunting (RR: 0.78; 95% CI: 0.75, 0.80) and a 27% lower risk of anemia when compared with participants from rural areas.

Conclusion: The findings from this study suggest that the complex nature of malnutrition among school adolescents warrants consideration when designing policies and interventions to reduce the burden of malnutrition.

Keywords: Tanzania; anemia; double burden; overweight; stunting; triple burden.