Prevalence, Trends, and Associated Factors of Malnutrition Among Under Six‐Month‐Old Infants in Bangladesh: A Pooled Analysis of DHS Data (2011–2022)

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Abstract
Malnutrition among infants aged under 6 months (u6m) is a global public health problem. As countries begin implementing 2023 WHO malnutrition guidelines, local prevalence and epidemiology must be well understood. We analysed Bangladesh Demographic Health Survey data (2011–2022), describing the prevalence and time trends of infant u6m wasting (weight‐for‐length z‐score [WLZ] < −2), stunting (length‐for‐age z‐score [LAZ] < −2), and underweight (weight‐for‐age z‐score [WAZ] < −2). In bivariate and multivariate analyses, we tested the association between wasting and underweight and established risk factors for malnutrition. Over the last 10 years, Bangladesh has seen some reduction in stunting and underweight, while wasting has remained relatively stable. In 2022, out of 440 infants u6m, 10.2% were wasted, 11.2% stunted, 11.3% underweight, 0.2% concurrently wasted/stunted. This translates to 178,394 infants u6m being wasted, 195,884 stunted, and 197,633 underweight, in 2022. Between the years 2011 and 2022, 30.3% of participants had at least one form of anthropometric deficit. Length (171) had more missing values than weight (79). WAZ had the lowest percentage of flagged data (0.5%) compared to WLZ (6.1%) and LAZ (2.5%). Underweight was associated with residence, wealth status, maternal age at delivery, maternal BMI, maternal height, maternal level of education, exclusive breastfeeding status and fever in the past 2 weeks. Factors associated with wasting were survey year, the sex of the household head, wealth status, maternal educational level, maternal age at delivery, infant age, and place of delivery. Our findings support the urgent need to roll out the 2023 WHO Guidelines in Bangladesh. They are also consistent with other recent literature highlighting potential advantages of weight‐for‐age (WAZ) as a measure of undernutrition. Given multiple associated factors, packages of care tackling a wide range of potential underlying causes are important for effective local interventions tailored to this age group.

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