Titre : | The impact of environmental factors on child malnutrition in districts and communes of the South of Madagascar: a time series (2015-2022) and stratified analysis (2018 and 2021) |
Auteurs : | Tiphaine Pierre |
Type de document : | Mémoire |
Année de publication : | 2023 |
Description : | 46p. |
Langues: | Anglais |
Classement : | MPH23/ (Master EHESP International master of public health - MPH) |
Mots-clés : | Madagascar ; Précipitation ; Malnutrition ; Enfant ; Végétations ; Climat ; Sécheresse |
Résumé : |
Introduction: Malnutrition is a critical health issue in Madagascar, affecting around 2 million individuals, especially children. This thesis explores the relation between malnutrition forms in relation to precipitation, vegetation, climate, as well as their inter-annual rhythmicity.
Methods: Malnutrition prevalence data was collected for 2018 and 2021 at the commune level and data from 2015-2022 focuses on admissions to CRENAS centers and incidence in Malagasy districts. Descriptive and univariate analyses were performed, in relation to vegetation and precipitation indicators. These were then analyzed via multi-level multivariate zero-inflated beta regression models and multivariate quasi-poisson model considering seasonality, respectively. Results: Commune data shows that communes with semi-arid climate are more likely to develop Severe acute malnutrition(SAM) in 2018 and 2021, while moderate and global acute malnutrition(MAM/GAM) exhibit this relation only for 2021. Vegetation was negatively associated with GAM and MAM in 2021, while no association was found between precipitation and any malnutrition type. Trimesters 2, 3 (dry season), and 4 (start rainy season) were negatively associated with all malnutrition forms, showing the protective effect of the dry season and harvested crops. District-level analysis exhibited contradictory results, with a positive relationship between 1-month-lagged vegetation and malnutrition incidence in Ampanihy and Betioky-Atsimo and not in Amboasary-Atsimo. Once more, precipitation was not associated with malnutrition. Conclusion: While our study is limited by data quality and quantity, it demonstrates the deep impact of semi-arid climate on SAM, MAM and GAM. Vegetation acts as a protective factor of MAM and GAM, and dry and harvest season are protective of all malnutrition forms. Our district-level analysis presents contradicting results, explained by unreliable data. This thesis emphasizes the importance of this topic in Madagascar. Further studies are needed and would allow local public health systems to increase surveillance of environmental predictors of malnutrition to prevent and attend to malnutrition cases. |
Diplôme : | Master MPH of public health |
Plan de classement simplifié : | Master of Public Health - master international de Santé Public (MPH) |
En ligne : | https://documentation.ehesp.fr/memoires/2023/mph/tiphaine_pierre.pdf |
Exemplaires (1)
Code-barres | Cote | Support | Localisation | Section | Disponibilité |
---|---|---|---|---|---|
096518 | MPH23/0004 | Mémoire | Rennes | Salle des Glénan | Empruntable Disponible |