The prevalence and socio-demographic risk factors of coexistence of stunting, wasting and underweight among children under five years in Bangladesh

Abstract Background Childhood malnutrition in all its forms is a significant public health challenge for developing countries like Bangladesh. There is a gap in knowledge of the coexistence of various forms of malnutrition among children under five years (under-5) in Bangladesh. This study aims (i) describe prevalence and risk factors for the coexistence of stunting, wasting and underweight among children under-5 in Bangladesh. Methods This study included 6,610 and 7,357 under-5 children from Bangladesh Demographic Health Surveys (BDHS) 2014 and 2017/18 respectively. Associations between coexistence stunting, wasting and underweight and socio-demographic factors were assessed by the Chi-square test and negative binomial regression. Results The prevalence of coexistence of stunting, wasting and underweight gradually declined from 5.2% in 2014 to 2.7% in 2017/18. Children of uneducated mothers ((Adjused incidence rate ratio (aIRR) 5.0, 95% CI 2.3, 11.0)); with low birth weights (aIRR 2.7, 95% CI 1.4, 5.1); children of age group 36–47 months (aIRR 2.5, 95% CI 1.5, 4.1); and children of underweight mothers (aIRR 1.9, 95% CI 1.4, 2.7) were the most important risk factors. However, maternal educational status was not associated with coexistence of stunting, wasting and underweight among children under-5 in 2014 whereas in 2017/18 it was the most influential risk factor. Moreover, watching television less than once a week increased the risk of coexistence of stunting, wasting and underweight by 54% (aIRR 1.54, 95% CI 1.0, 2.4). Conclusions one out of thirty-five under-5 children were identified to have coexistence of stunting, wasting and underweight in Bangladesh. The burden of malnutrition was disproportionate among uneducated mother, underweight mother, low birth weight and socio-economically poorest household. Our study indicates that there is a need for multi-level interventions from household level to societal level to reduce consequences of childhood malnutrition.