The rise in stunting in relation to avian influenza and food consumption patterns in Lower Egypt in comparison to Upper Egypt: Results from 2005 and 2008 Demographic and Health Surveys

Background: A 2006 avian influenza (AI) outbreak resulted in mass removal of chickens in Lower Egypt, which decreased the household supply of poultry. Poultry, a key animal-source food, contains nutrients critical for child growth. This paper examines determinants of stunting between 2006 and 2008 in children 6 to 59 months of age within the context of the AI outbreak. Methods: The 2005 and 2008 nationally representative Egypt Demographic and Health Surveys (EDHS) were used to analyse anthropometric data from 7,794 children in 2005 and 6,091 children in 2008. Children, 6-59 months of age, with length for age Z-score∈<∈-2 S.D. were categorized as stunted. Predictors of stunting were examined by bivariate and multivariable analyses, focusing on Lower Egypt, where a rise in stunting occurred, and Upper Egypt, where stunting declined. Results: Between 2005 and 2008, Upper Egypt experienced a significant decline in stunting (28.8 to 21.8%, P∈<∈0.001). Lower Egypt experienced a significant rise in stunting (16.6 to 31.5%, P∈<∈0.001), coinciding with the 2006 AI outbreak. In Lower Egypt (2008), households owning poultry were 41.7% less likely to have a stunted child [aOR 0.58; 95% CI (0.42, 0.81) P∈=∈0.002], and 12-47 month old children were 2.12-2.34 times [95% CI (1.39 - 3.63) P.