Overweight and/or obesity and its determinants among under-five children in East African countries: A multilevel analysis using Bayesian approach.

Introduction: Childhood overweight and/or obesity become a significant public health problem in the 21 century. It is a double burden next to undernutrition and has a dramatic rise in low- and middle-income countries. This study aimed to determine the prevalence of overweight and/or obesity and its determinants among under-five children in East African Countries.

Methods: Data were retrieved from the recent nationally representative demographic and health survey datasets from eleven East African Countries. A total of 89,091 weighted numbers of under-five children participated. Statistical analysis was performed using the R (Brms R-package) software. Multivariable mixed-effects logistic regression analysis using the Bayesian approach was employed to identify the factors affecting overweight and/or obesity among under-five children.

Results: Overall, 4.59% (95% CI, 4.45-4.73) of under-five children in East African Countries were overweight and/or obese. Under-five children overweight and/or obesity was highest in Comoros and lowest in Burundi. Under-five children aged older than two years (Adjusted odds ratio (AOR) = 0.65, 95% credible interval (CrI), 0.57-0.73), females (AOR = 0.84, 95% CrI:, 0.75-0.94), under-five children live from rich household wealth status (AOR = 1.25, 95% CrI, 1.06-1.49), under-five children living in Malawi (AOR = 2.60, 95% CrI, 1.49-4.51), Mozambique (AOR = 5.26, 95% CrI, 3.52-7.79), Rwanda (AOR = 5.63, 95% CrI, 3.46-9.08), Tanzania (AOR = 2.15, 95% CrI, 1.47-3.12), and Uganda (AOR = 2.62, 95% CrI, 1.71-3.99) were a significant determinant for under-five overweight and/or obesity.

Conclusion: Overweight and/or obesity among under-five children become a problem in low and middle-income countries. Older under-five children, male sex, children who live in rich household wealth, and children who live in a country in Malawi, Mozambique, Ruanda, Tanzania, and Uganda were significantly affected by overweight and/or obesity. Therefore, in these countries, responsible stakeholders shall give primary attention to curve the alarming increase in overweight and/or obesity among under-five children.