Open Access Research article

Prevalence and predictors of undernutrition among infants aged six and twelve months in Butajira, Ethiopia: The P-MaMiE Birth Cohort

Girmay Medhin1*, Charlotte Hanlon23, Michael Dewey3, Atalay Alem2, Fikru Tesfaye4, Bogale Worku5, Mark Tomlinson6 and Martin Prince3

Author Affiliations

1 Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia

2 Department of Psychiatry, Faculty of Medicine, Addis Ababa University, Addis Ababa, Ethiopia

3 King's College London (Institute of Psychiatry), Health Service and Population Research Department, London, UK

4 Department of Reproductive Health and Nutrition, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia

5 Department of Paediatrics and Child Health, Faculty of Medicine, Addis Ababa University, Addis Ababa, Ethiopia

6 Department of Psychology, Stellenbosch University, Matieland, South Africa

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BMC Public Health 2010, 10:27  doi:10.1186/1471-2458-10-27

Published: 20 January 2010



Child undernutrition is a major public health problem in low income countries. Prospective studies of predictors of infant growth in rural low-income country settings are relatively scarce but vital to guide intervention efforts.


A population-based sample of 1065 women in the third trimester of pregnancy was recruited from the demographic surveillance site (DSS) in Butajira, south-central Ethiopia, and followed up until the infants were one year of age. After standardising infant weight and length using the 2006 WHO child growth standard, a cut-off of two standard deviations below the mean defined the prevalence of stunting (length-for-age <-2), underweight (weight-for-age <-2) and wasting (weight-for-length <-2).


The prevalence of infant undernutrition was high at 6 months (21.7% underweight, 26.7% stunted and 16.7% wasted) and at 12 months of age (21.2% underweight, 48.1% stunted, and 8.4% wasted). Significant and consistent predictors of infant undernutrition in both logistic and linear multiple regression models were male gender, low birth weight, poor maternal nutritional status, poor household sanitary facilities and living in a rural residence. Compared to girls, boys had twice the odds of being underweight (OR = 2.00; 95%CI: 1.39, 2.86) at 6 months, and being stunted at 6 months (OR = 2.38, 95%CI: 1.69, 3.33) and at 12 months of age (OR = 2.08, 95%CI: 1.59, 2.89). Infant undernutrition at 6 and 12 months of age was not associated with infant feeding practices in the first two months of life.


There was a high prevalence of undernutrition in the first year of infancy in this rural Ethiopia population, with significant gender imbalance. Our prospective study highlighted the importance of prenatal maternal nutritional status and household sanitary facilities as potential targets for intervention.