Skip to main content

Advertisement

SpringerLink
Log in

Prevalence and Risk of Moderate Stunting Among a Sample of Children Aged 0–24 Months in Brunei

  • Published:
Maternal and Child Health Journal Aims and scope Submit manuscript

Abstract

Objectives Globally, one-fifth of the world’s children are stunted, however this statistic may be an underestimate as many countries lack comprehensive monitoring of height-for-age. Until a recent national health survey, Negara Brunei Darussalam has lacked the data to offer a comprehensive assessment of height-for-age among children. The aim of this study is to determine the prevalence of and factors associated with stunting among children aged 0–24 months in Negara Brunei Darussalam (Brunei). Methods A cross-sectional analyses of 396 children aged <24 months. Demographic, dietary and anthropometric measurements were recorded. Multivariate logistic regression was used to analyse factors associated with moderate stunting. Results Almost one-quarter of infants (24%) were stunted. Male children and children who were preterm (<37 weeks gestation) were more than twice as likely to be stunted as their counterparts, respectively (OR 2.48; 95% CI 1.49–4.12; OR 2.14; 95% CI 1.06–4.33, respectively). Those who were born low birth weight (<2.5 kg) were three times more likely to be stunted than those born normal birth weight (OR 2.99; 95% CI 1.44–6.17). Conclusions for Practice This study presents data on prevalence of stunting in Brunei based upon the World Health Organization’s growth charts. In addition it is also the first time that the factors associated with stunting among infants aged <24 months have been examined in Brunei. The stunting prevalence in Brunei is of concern due to the reported short and long-term negative impact on health later in life. The authors recommend close monitoring of pregnant women who are at risk of delivering low birth weight infants and frequent monitoring of low birth weight infants in line with World Health Organization nutrition goals. Existing height-for-age data should be integrated into global databases.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Brunei Department of Economic Planning and Development. (2017). Population. Retrieved from http://www.depd.gov.bn/SitePages/Population.aspx.

  • Christian, P., Lee, S. E., Donahue Angel, M., Adair, L. S., Arifeen, S. E., Ashorn, P., et al. (2013). Risk of childhood undernutrition related to small-for-gestational age and preterm birth in low- and middle-income countries. International Journal of Epidemiology, 42(5), 1340–1355.

    Article  PubMed  PubMed Central  Google Scholar 

  • Cogill, B. (2003). Anthropometric indicators measurement guide. Washington, DC: Food and Nutrition Technical Assistance (FANTA) Project, FHI 360.

  • de Onis, M., Dewey K. G., Borghi, E., Onyango A. W., Blossner, M., Daelmans, B. et al. (2013). The World Health Organization’s global target for reducing childhood stunting by 2025: Rationale and proposed actions. Maternal and Child Nutrition, 9(Suppl 2), 6–26.

    Article  PubMed  Google Scholar 

  • de Onis, M., Onyango, A. W., Borghi, E., Garza, C., Yang, H., Borghi, E., Garza, C., & Yang, H. (2006). Comparison of the World Health Organization (WHO) Child Growth Standards and the National Center for Health Statistics/WHO international growth reference: Implications for child health programmes. Public Health Nutrition, 9(7), 942–947.

    PubMed  Google Scholar 

  • del Carmen Casanovas, M., Lutter, C. K., Mangasaryan, N., Mwadime, R., Hajeebhoy, N., Aguilar, A. M., et al. (2013). Multi-sectoral interventions for healthy growth. Maternal & Child Nutrition, 9, 46–57.

    Article  Google Scholar 

  • Dewey, K. G. & Adu-Afarwuah, S. (2008). Systematic review of the efficacy and effectiveness of complementary feeding interventions in developing countries. Maternal and Child Nutrition, 4(Suppl 1), 24–85.

    Article  PubMed  Google Scholar 

  • Fenske, N., Burns, J., Hothorn, T., & Rehfuess, E. A. (2013). Understanding child stunting in India: A comprehensive analysis of socio-economic, nutritional and environmental determinants using additive quantile regression. PLoS ONE, 8(11), e78692.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Gwatkin, D. R., Rutstein, S., Johnson, K., Suliman, E., Wagstaff, A., & Amouzou, A. (2007). Socio-economic differences in health, nutrition, and population within developing countries: An overview. Nigerian Journal of Clinical Practice, 10(4), 272–282.

    CAS  PubMed  Google Scholar 

  • Hammond, K. A. (2002). Dietary and clinical assessment. In: L. K. Mahan, S. Escott-Stump (Eds.), Food nutrition and diet therapy, 10th edn (pp. 353–379). New York: W.B. Saunders.

    Google Scholar 

  • IBM. (2013). IBM SPSS statistics for windows, version 22.0. In. Armonk, NY: BM Corp.

    Google Scholar 

  • International Food Policy Research Institute. (2015). Global nutrition report 2015: Actions and accountability to advance nutrition and sustainable development. Washington, DC. doi:10.2499/9780896298835.

  • Jiang, Y., Su, X., Wang, C., Zhang, L., Zhang, X., Wang, L., et al. (2015). Prevalence and risk factors for stunting and severe stunting among children under three years old in mid-western rural areas of China. Child: Care Health and Development, 41(1), 45–51.

    CAS  Google Scholar 

  • Jones, A. D., Cruz Agudo, Y., Galway, L., Bentley, J., & Pinstrup-Andersen, P. (2012). Heavy agricultural workloads and low crop diversity are strong barriers to improving child feeding practices in the Bolivian Andes. Social Science and Medicine, 75(9), 1673–1684.

    Article  PubMed  PubMed Central  Google Scholar 

  • Khatun, M., Stenlund, H., & Hornell, A. (2004). BRAC initiative towards promoting gender and social equity in health: A longitudinal study of child growth in Matlab, Bangladesh. Public Health Nutrition, 7(8), 1071–1079.

    Article  PubMed  Google Scholar 

  • Kyu, H. H., Georgiades, K., & Boyle, M. H. (2009). Maternal smoking, biofuel smoke exposure and child height-for-age in seven developing countries. International Journal of Epidemiology, 38(5), 1342–1350.

    Article  PubMed  Google Scholar 

  • Lewit, E. M., & Kerrebrock, N. (1997). Population-based growth stunting. The Future of Children, 7(2), 149–156.

    Article  CAS  PubMed  Google Scholar 

  • Martorell, R. & Zongrone, A. (2012). Intergenerational influences on child growth and undernutrition. Paediatric and Perinatal Epidemiology, 26(Suppl 1), 302–314.

    Article  PubMed  Google Scholar 

  • Mc Michael, A. J. (2001). Impact of climatic and other environmental changes on food production and population health in the coming decades. Proceedings of the Nutrition Society, 60(2), 195–201.

    Article  CAS  Google Scholar 

  • Mei, Z., & Grummer-Strawn, L. M. (2007). Standard deviation of anthropometric Z-scores as a data quality assessment tool using the 2006 WHO growth standards: A cross country analysis. Bulletin of the World Health Organization, 85(6), 441–448.

    Article  PubMed  PubMed Central  Google Scholar 

  • Ministry of Health (Brunei Darussalam). (1997). Report 1st national nutritional status survey. Brunei: Ministry of Health (Brunei Darussalam).

  • Ministry of Health (Brunei Darussalam). (2009). Brunei health information booklet. Bandar Seri Begawa, Brunei: Ministry of Health (Brunei Darussalam).

  • Moursi, M. M., Arimond, M., Dewey, K. G., Treche, S., Ruel, M. T., & Delpeuch, F. (2008). Dietary diversity is a good predictor of the micronutrient density of the diet of 6- to 23-month-old children in Madagascar. Journal of Nutrition, 138(12), 2448–2453.

    Article  CAS  PubMed  Google Scholar 

  • National Centre for Health Statistics (NCHS). (1977). NCHS growth curves for children: Birth to 18 years. Series 11. Number 165. Hyattsville, MD: United States Department of Health, Education and Welfare.

  • Oken, E., Kleinman, K. P., Rich-Edwards, J., & Gillman, M. W. (2003). A nearly continuous measure of birth weight for gestational age using a United States national reference. BMC Pediatrics, 3, 6.

    Article  PubMed  PubMed Central  Google Scholar 

  • Prendergast, A. J., & Humphrey, J. H. (2014). The stunting syndrome in developing countries. Paediatrics and International Child Health, 34(4), 250–265.

    Article  PubMed  PubMed Central  Google Scholar 

  • Ruel, M. T., & Alderman, H. (2013). Nutrition-sensitive interventions and programmes: How can they help to accelerate progress in improving maternal and child nutrition? Lancet, 382(9891), 536–551.

    Article  PubMed  Google Scholar 

  • Ruel, M. T., & Menon, P. (2002). Child feeding practices are associated with child nutritional status in Latin America: Innovative uses of the demographic and health surveys. Journal of Nutrition, 132(6), 1180–1187.

    CAS  PubMed  Google Scholar 

  • Sguassero, Y., de Onis, M., Bonotti, A. M., & Carroli, G. (2012). Community-based supplementary feeding for promoting the growth of children under five years of age in low and middle income countries. Cochrane Database of Systematic Reviews, 6, Cd005039.

    Google Scholar 

  • The World Bank Group. (2014). GDP per capita PPP (current international $). http://data.worldbank.org/indicator/NY.GDP.PCAP.PP.CD. Accessed 31 July 2017.

  • United Nations Development Program. (2014). Human development report 2014: Sustaining human progress: Reducing vulnerabilities and building resilience. New York: United Nations Development Program.

    Google Scholar 

  • United Nations Inter-agency Group for Child Mortality Estimation. (2015). Levels and trends in child mortality: Estimates developed by the UN Inter-agency Group for Child Mortality Estimation (IGME). New York: United Nations Children’s Fund.

    Google Scholar 

  • United States Agency for International Development (USAID). (2013). Standard recode manual: Demographic and health surveys methodology. Washington, DC: USAID.

    Google Scholar 

  • Vella, V., Tomkins, A., Borgesi, A., Migliori, G. B., Oryem, V. Y., Borgesi, A., Migliori, G. B., & Oryem, V. Y. (1994). Determinants of stunting and recovery from stunting in Northwest Uganda. International Journal of Epidemiology, 23(4), 782–786.

    Article  CAS  PubMed  Google Scholar 

  • Victora, C. G., Adair, L., Fall, C., Hallal, P. C., Martorell, R., Richter, L., et al. (2008). Maternal and child undernutrition: Consequences for adult health and human capital. Lancet, 371(9609), 340–357.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Victora, C. G., de Onis, M., Hallal, P. C., Blossner, M., & Shrimpton, R. (2010). Worldwide timing of growth faltering: Revisiting implications for interventions. Pediatrics, 125(3), e473–e480.

    Article  PubMed  Google Scholar 

  • Wamani, H., Åstrøm, A. N., Peterson, S., Tumwine, J. K., Tylleskär, T., Peterson, S., Tumwine, J. K., & Tylleskär, T. (2007). Boys are more stunted than girls in Sub-Saharan Africa: A meta-analysis of 16 demographic and health surveys. BMC Pediatrics, 7, 17–17.

    Article  PubMed  PubMed Central  Google Scholar 

  • Wamani, H., Tylleskär, T., Åstrøm, A. N., Tumwine, J. K., Peterson, S., Åstrøm, A. N., Tumwine, J. K., & Peterson, S. (2004). Mothers’ education but not fathers’ education, household assets or land ownership is the best predictor of child health inequalities in rural Uganda. International Journal for Equity in Health, 3, 9–9.

    Article  PubMed  PubMed Central  Google Scholar 

  • Webb, K., Marks, G. C., Lund-Adams, M., Rutishauser, I. H. E., & Abraham, B. (2001). Towards a national system for monitoring breastfeeding in Australia: Recommendations for population indicators, definitions and next steps. Canberra: National Food and Nutrition Monitoring and Surveillance Project. Commonwealth Department of Health and Aged Care.

    Google Scholar 

  • WHO Multicentre Growth Reference Study Group. (2006). WHO child growth standards: Length/height-for-age, weight-for-age, weight-for-length, weight for-height and body mass index-for-age. Methods and development. Geneva: World Health Organisation.

    Google Scholar 

  • World Health Organisation. Cut-off points and summary statistics: ‘Trigger-levels’ as a basis of public health decisions. Retrieved from http://www.who.int/nutgrowthdb/about/introduction/en/index5.html.

  • World Health Organisation (2006). WHO Child Growth Standards based on length/height, weight and age. Acta Paediatrica Supplement, 450, 76–85.

    Google Scholar 

  • World Health Organisation. (2008). Indicators for assessing infant and young child feeding practices. Part 1 definitions: Conclusions of a consensus meeting held 6–8 November 2007 in Washington DC, USA. Geneva: World Health Organisation.

  • World Health Organisation. (2012). Maternal, infant and young child nutrition. Resolution WHA656. Geneva: World Health Organisation.

  • World Health Organisation. (2015). WHA global nutrition targets 2025: Stunting policy brief. Geneva: World Health Organisation.

Download references

Acknowledgements

The authors would like to acknowledge all of the project staff from the Community Nutrition Division and Community Nursing Division, Department of Health Services at the Brunei Ministry of Health. The survey, conducted as a national project would also not have materialized without the contributions from the following sectors of the Ministry of Health: Directorate and Administration of Department of Health Services; Directorate of Department of Environmental Health Services, Disease Control Division; Division of Estate Management and Development; Department of Health Care and Technology; Department of Administration and Finance; Department of Policy and Planning, Public Relation Division; the Health Promotion Centre; members of staff of Health Centres and District Health Offices throughout the country and the Dietetic Unit, Department of Medical Services. The authors would also like to extend their acknowledgment to others at The University of Sydney who provided advice on survey design -Professor Ian Caterson, Professor Stephen Colagiuri, Professor Adrian Bauman, Dr. Vicki Flood, and Dr. Debra Hector.

Funding

The NHANSS was funded by The Brunei Ministry of Health in collaboration with The Department of Economic Planning and Development of The Prime Minister’s Office under the 9th National Development Plan.

Author information

Authors and Affiliations

  1. Prevention Research Collaboration, School of Public Health, Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2050, Australia

    Sinead Boylan & Seema Mihrshahi

  2. School of Molecular Bioscience, Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2050, Australia

    Jimmy Chun Yu Louie & Anna Rangan

  3. Community Nutrition Division and Community Nursing Division, Department of Health Services, Brunei Ministry of Health, Jalan Pelumpong, Muara, Brunei

    Hj Norsal Salleh, Hj Ilham Md Ali & Hjh Roseyati Dato Paduka

  4. School of Public Health, Charles Perkins Centre, Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, The University of Sydney, Sydney, NSW, 2050, Australia

    Timothy Gill

Authors
  1. Sinead Boylan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Seema Mihrshahi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jimmy Chun Yu Louie
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Anna Rangan
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hj Norsal Salleh
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hj Ilham Md Ali
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hjh Roseyati Dato Paduka
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Timothy Gill
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

SB, JL, AR, TG acted as consultants for the design and monitoring of the NHANSS 2011–2012 data collection. SB conducted the statistical analyses and drafted the manuscript. SM, JL, AR and TG provided advice regarding the statistical analyses. NS, IA and RY were involved with data collection. All authors read the final manuscript and provided comments.

Corresponding author

Correspondence to Sinead Boylan.

Ethics declarations

Conflict of interest

None declared.

Ethical Approval

This study was conducted according to the guidelines laid down in the Declaration of Helsinki and all procedures involving human subjects were approved by the Ministry of Health, Brunei Darussalam.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Boylan, S., Mihrshahi, S., Louie, J.C.Y. et al. Prevalence and Risk of Moderate Stunting Among a Sample of Children Aged 0–24 Months in Brunei. Matern Child Health J 21, 2256–2266 (2017). https://doi.org/10.1007/s10995-017-2348-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10995-017-2348-2

Keywords

Search

Navigation