Undernutrition and determinants among adolescent street children in DireDawa City, eastern Ethiopia: Vulnerability assessment

• Published in: Nutrition (Burbank, Los Angeles County, Calif.) Los Angeles County, Calif.), 2024-03, Vol.119, p.112307-112307, Article 112307
• Main Authors: Nigatu, Abel, Abdureshid, Neil, Abate, Shambel, Dagne, Imam, Oumer, Abdu
• Format: Article
• Language: English
• Subjects: Adolescents; Age; Body mass index; Body size; Children; Children & youth; Cigarettes; Confidence intervals; COVID-19; Data collection; Drinking behavior; Drinking water; Drug abuse; Drug use; Enumeration; Ethiopia; Heat affected zone; Homeless people; Illnesses; Independent variables; Malnutrition; Meals; Nutritional requirements; Nutritional status; Pandemics; Poverty; Pregnancy; Questionnaires; Risk factors; Sample size; Sociodemographics; Statistical analysis; Street children; Streets; Stunting; Teenagers; Thinness; Undernutrition; Womens health
• ISSN: 0899-9007; 1873-1244
• DOI: 10.1016/j.nut.2023.112307

•A survey of 358 adolescent street children was conducted in parts of Ethiopia.•Thinness (44%; 38.9–49.5) and underweight (56%; 50.8–61.4) were prevalent.•Undernutrition in acute and chronic forms is highly prevalent among street adolescents.•Undernutrition in any form is associated with infrequent meals, poor dietary diversity, substance use, unsafe water sources, and a history of illness.•Multisectoral nutrition interventions targeting these risk factors are needed to achieve global nutrition targets. Adolescents go through rapid development and increased nutritional requirements that can put them at higher risk of undernutrition--a problem that can be highest among orphaned or street children. Evidence on nutritional risk and its contributing factors among this segment is lacking in the city of Dire Dawa, where many children are on the streets with limited access to proper care. The aim of this study was to identify determinants of undernutrition among street adolescents in Ethiopia. A community-based cross-sectional study was conducted with 358 street adolescents 12 to 19 y of age in Dire Dawa from January to February 2022. After conducting a preliminary survey and registering all available street children, a complete enumeration was made. For data collection, an interviewer-administered questionnaire was used along with anthropometric measurements using standard procedures. Height-for-age (HAZ) and body mass index (BMI) for age z scores were computed using World Health Organization (WHO) Anthroplus and statistical analysis was done using SPSS software version 26. Independent variables with P < 0.25 in bivariable analysis were included in multivariable logistic regression, and variables with P < 0.05 were considered statistically significant. A crude and adjusted odds ratio (AOR) with a 95% confidence interval (CI) was reported. Among 358 street adolescents, 44% (38.9–49.5) and 56% (50.8–61.4) were thin and stunted, respectively. Thinness among street children could be associated with a longer stay on the street (AOR, 1.65; 95% CI, 1.40–1.90), infrequent meal frequency (AOR, 1.32; 95% CI, 1.19–1.45), unprotected drinking water sources (AOR, 1.55; 95% CI, 1.40–1.71), alcohol drinking (AOR, 2.92; 95% CI, 1.51–4.32), inadequately diversified diet (AOR, 1.21; 95% CI, 1.06–1.36), and illness history (AOR, 1.34; 95% CI, 1.21–1.47). Moreover, odds of stunting were significantly associated with staying on the street (AOR, 1.32; 1.10–1.54), unsafe drinking wate