Predictors of Undernutrition and Stunting Among Adolescents in Tanzania: a Rural/Urban Comparison

Adolescents remain one of the world's most neglected, difficult to measure, and hard to reach populations. Sub‐Saharan Africa is the only region in the world where the adolescent population continues to grow relative to the total population, and where prevalence rates of malnutrition remain stagnant. This cross‐sectional study examined data on adolescents (10‐14 yrs; n=1125) in Tanzania. Undernutrition was classified as BMI for age <‐2SD and stunting was classified as height‐for‐age <‐2SD using WHO 2007 reference. Multivariate linear regression analysis tested associations between urban/rural residence and BMIZ, as well as HAZ. Prevalence of undernutrition was 10.9% among rural and 6.2% among urban adolescents (p<0.05). Stunting was prevalent in 64.2% of rural and 3.9% of urban adolescents (p<0.05). Significant predictors of BMIZ were gender, child age, urban/rural status, and number of assets owned (p<0.001). Significant predictors of HAZ were identical but included ownership of a modern floor (p<0.001). BMIZ was 0.41 units lower in rural adolescents (p<0.001), and HAZ was 2.025 units lower in rural adolescents (p<0.001), when all other covariates were identical. Our findings suggest that adolescents in rural settings experience higher rates of undernutrition and stunting than urban youth. Longitudinal studies are needed to determine whether adolescent nutritional status in developing countries has a physiological explanation and whether growth trajectories differ across urban/rural settings. Policies directed at improving the nutritional status and health of adolescents should be concurrent with those directed at improving morbidity and mortality outcomes in children under five years.