Epidemiology of Underweight among Infants in Rural Burkina Faso

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  • 1 Centre de Recherche en Santé de Nouna, Burkina Faso;
  • | 2 Francis I Proctor Foundation, University of California, San Francisco, California;
  • | 3 Division of Epidemiology and Biostatistics, University of California, Berkeley, California;
  • | 4 Department of Ophthalmology, University of California, San Francisco, California;
  • | 5 Department of Epidemiology and Biostatistics, University of California, San Francisco, California

Infant undernutrition is thought to contribute to growth failure and mortality. We evaluated the patterns in underweight in a population-based sample of children aged 1–11 months in rural northwestern Burkina Faso. Data were collected during the baseline assessment of a community-randomized trial evaluating mass azithromycin distribution in Nouna District, Burkina Faso. A door-to-door census was undertaken for all households in all communities. Infants aged 1–11 months were weighed for weight-based dosing in the trial and their weights were used to calculate weight-for-age Z-scores (WAZ). Underweight was defined as WAZ ≤ 2. We evaluated the age patterns in WAZ and underweight by demographic, seasonal, and geographic characteristics. Of 7,109 infants, 6,077 had accurate weight and global positioning system (GPS) coordinate data (85.5%). Infants were a median of 6 months old (interquartile range [IQR] 3–8) and 48.4% were female. Mean WAZ was −0.68 (SD 1.6) and 19.0% were underweight. The WAZ decreased with increasing age, and the prevalence of underweight increased from 2.5% among 1-month-olds to 27.6% among 11-month-olds. Underweight was more common among boys than girls (22.1% among boys versus 15.6% among girls). Improved latrine use by the household was associated with increased WAZ, and this effect was stronger in male compared with female infants. Given the large burden of underweight among infants, interventions addressing undernutrition should specifically include infants.

Author Notes

Address correspondence to Catherine E. Oldenburg, Francis I Proctor Foundation, University of California, 513 Parnassus Ave., San Francisco, CA 94143. E-mail: catherine.oldenburg@ucsf.edu

Financial support: The Community Health with Azithromycin Trial is funded by the Bill and Melinda Gates Foundation (OPP1187628). Azithromycin and matching placebo were donated by Pfizer.

Authors’ addresses: Ali Sié, Mamadou Ouattara, Mamadou Bountogo, Clarisse Dah, and Guillaume Compaore, Centre de Recherche en Santé de Nouna, Burkina Faso, E-mails: sieali@yahoo.fr, md.ouattara@yahoo.fr, drbountogo@yahoo.fr, n.clarissedah@yahoo.fr, and guidedeo@yahoo.fr. Elodie Lebas, Jessica M. Brogdon, Ying Lin, and William W. Godwin, Francis I Proctor Foundation, University of California, San Francisco, CA, E-mails: elodie.lebas@ucsf.edu, jessica.brogdon@ucsf.edu, ying.lin@ucsf.edu, and william.godwin@ucsf.edu. Kieran S. O’Brien, Francis I Proctor Foundation, University of California, San Francisco, CA, and Division of Epidemiology and Biostatistics, University of California, Berkeley, CA, E-mail: kieran.obrien@ucsf.edu. Benjamin F. Arnold, Francis I Proctor Foundation, University of California, San Francisco, CA, and Department of Ophthalmology, University of California, San Francisco, CA, E-mail: ben.arnold@ucsf.edu. Thomas M. Lietman and Catherine E. Oldenburg, Francis I Proctor Foundation, University of California, San Francisco, CA, Department of Ophthalmology, University of California, San Francisco, CA, and Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, E-mails: tom.lietman@ucsf.edu and catherine.oldenburg@ucsf.edu.

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