Prevalence and Determinants of Double and Triple Burden of Malnutrition Among School Going Children and Adolescents in Zanzibar, 2022

BackgroundMalnutrition stands as a profound global health concern, and its dimensions are evolving. In Zanzibar, the burden of malnutrition especially among school going children is not well unknown, as such, this study was conducted to assess the prevalence and factors associated with double and triple burden of malnutrition among school going children and adolescents in Zanzibar. MethodsThis was a School-based cross-sectional study involving mainly quantitative data collection method. Data was collected as part of the National School Health and Nutrition Survey of 2022, which included primary and secondary school children and adolescents aged 5-19 years, from Zanzibar. Anthropometric measurements and hemoglobin levels of selected students were collected. A multinomial regression model was used to assess factors associated with double burden of malnutrition (DBM) and the triple burden of malnutrition (TBM). Z-scores for weight, height and body mass index for the scholars aged 5-19 years were generated using WHO AnthroPlus and data analysis was done using Stata Version 17. ResultsA total of 2556 primary and secondary school children were enrolled, 51.7% (n= 1,322) were girls. Almost 2 in 5 were individuals with 10-14 years, and most of them were from primary schools. Slightly over 5 in 10 were residing in urban areas. Overall, the prevalence of malnutrition defined as malnutrition of any kind (stunting or underweight/thinness or overweight or anemia) in Zanzibar was 58.4 per cent. The overall prevalence of DBM defined by the coexistence of both undernutrition and over-malnutrition in Zanzibar was 12.0 per cent. Similarly, the overall prevalence of TBM defined as the coexistence of undernutrition, anemia, and overnutrition in Zanzibar was 1.8%. In an adjusted multinomial regression model, the prevalence of DBM was 30% lower if the child was 5 to 9 years 0.7 (95% CI, 0.5-0.9), p = 0.02), and 1.5-fold greater if the student was living in a lowest wealth quantile family (1.5(95%CI, 1.01-2.3), p=0.04). In the contrary, the prevalence of single malnutrition was 1.4-fold greater if the student was a girl (1.4(95%CI,1.2-1.6); p=0.001). Proportion of students with TBM was 2.0-fold greater if there were no school deworming education (2.0(95%CI, 1.0-3.9); p=0.05 ConclusionOver half of the students in Zanzibar are malnourished, with a significant burden of DBM, indicating the need for stringent actions to reduce the prevalence of malnutrition in the country.