Wasting and its associated factors among under-two years children in Ethiopia: a systematic review and meta-analysis

Abstract<br> Introduction Globally, about 45 million under-five children have suffered from wasting where Asian and African<br> countries have the major share of these wasted children. Despite wasting is affected all types of populations, the long<br> and short term effect is more severe and sensitive in under-two aged children. Hence, this review was intended to<br> assess pooled prevalence and associated factors of wasting among under-two children in Ethiopia.<br> Methods The search was done using electronic data bases (Hinari, PubMed, Google scholar, Scopus) and research<br> repositories from June 19–22/2023. The review included articles published between January 2013 and December<br> 2023.The study included Cross-sectional/case control studies which report the prevalence and associated factors of<br> wasting in under-two aged children. The quality of included studies was assessed using the Joanna Briggs Institute<br> (JBI) quality assessment checklists for observational studies. The presence of heterogeneity between included studies<br> was evaluated using Cochrane Q-test and the I2 statistics. Publication bias was checked through graphical and<br> statistical test. Associated factors were estimated by random effect model using DerSimonian-Laird model weight.<br> Results The pooled prevalence of wasting among under-two children was 10.91% (95% CI: 8.97–12.85; I2 = 86.36%).<br> Absence of maternal antenatal follow up (OR; 3.23: 95%CI: 1.20–5.26), no exclusive breast feeding until six months<br> (OR; 5.30; 95%CI: 1.17–9.43), current illness of the child (OR; 2.58: 95%CI: 1.78–3.37), large family size (OR; 12.38; 95%CI:<br> 1.37–26.13) and low wealth status of the households (OR; 3.91; 95%CI: 1. 54-8.36) were significant factors of wasting<br> among under-two children.<br> Conclusions This study disclosed that the pooled prevalence of wasting among under- two children were high in<br> Ethiopia. Absence of maternal antenatal follow up, no exclusive breast feeding, low wealth status of the households,<br> large family size and current illness of the child were significant factors of wasting. Strictly adherence of maternal<br> antenatal follow up, counsel the parents to feed only breast milk until six months, limit the number of family size to<br> the level of the household income and early treatment of the sick child were recommended. Furthermore, scale up<br> the wealth status and living standard of the family can address the agenda of reducing and eradicating all forms of<br> malnutrition. This review registered at PROSPERO with registration number CRD42023414914.<br>