Determinants of child malnutrition in rural and urban Ecuadorian highlands

Objective: To identify and compare the sociodemographic determinants of stunting, wasting and overweight among infants of urban and rural areas in the Ecuadorian highlands. Design: Cross-sectional study. Setting: Nabon (rural) and Cuenca (urban) cantons, Azuay Province, Ecuador. Subjects: A total of 703 children aged 0-24 months and their caregivers (227 rural and 476 urban) recruited during the period from June to September 2008. Results: Stunting prevalence was significantly higher in the rural area (37.4% v. 17.7%; P < 0.001) while wasting (7.1%) and overweight (17.1%) prevalence were more similar between areas. Determinants of stunting for the pooled sample were male gender (OR=1.43; 95% CI 1.06, 1.92; P=0.02), preterm delivery (OR=1.65; 95% CI 1.14, 2.38; P=0.008), child's age (OR=1.04; 95% CI 1.01, 1.07; P=0.011), maternal education (OR=0.95; 95% CI 0.92, 0.99; P=0.025) and facility-based delivery (OR=0.57; 95% CI 0.45, 0.74; P=0.001). The latter was also a determinant of overweight (OR=0.39; 95% CI 0.25, 0.62; P