Lowest wealth quintiles predispose under-five children to stunting in Ethiopia: Updates of systematic review and meta-analysis

Abstract Background: Malnutrition remains as a major public health problem in the world, particularly in developing countries such as Ethiopia. The prevalence of stunting in Ethiopia has been decreased considerably from 58% in 2000 to 44% in 2011 and 38% in 2016. The aim of this systematic review and meta-analysis is to assess the prevalence of stunting and its associations with wealth index among under-five children in Ethiopia. Methodology: The databases screened were PubMed/MEDLINE, Scopus, HINARI and grey literatures. The studies’ qualities were assessed by two reviewers independently, and any controversy was handled by other reviewers using the JBI critical appraisal checklist. In the statistical analysis, the funnel plot, Egger’s test, and Begg’s test were used to assess publication bias. The I2 statistic, forest plot, and Cochran’s Q test were used to deal with heterogeneity. Results: The pooled prevalence of stunting was 41.5% among under-five children, despite its considerable heterogeneity (I2=97.6%, p<0.001). However, the included studies had no publication bias in calculating the pooled prevalence (Egger’s test p=0.26; Begg’s test p=0.87). Children from households with a medium or low/poor wealth index had higher odds of stunting (AOR 1.33, 95% CI: 1.07, 1.65 or AOR 1.92, 95% CI: 1.46, 2.54, respectively) compared to children from households with a high/rich wealth index. Conclusions: The pooled prevalence of stunting is great. In the subgroup analysis, the Amhara region, followed by the Oromia region and then the Tigray region had the highest prevalence of stunting