Child malnutrition and recurrent flooding in rural eastern India: a community-based survey

Objectives: This study aims to improve the understanding of the relationship between exposure to floods and malnutrition in children aged 6-59 months in rural India. Research has focused exclusively on Bangladeshi children, and few controlled epidemiological studies are available. Method: A community-based cross-sectional study of child nutritional status was carried out in 14 flooded and 18 non-flooded villages of Jagatsinghpur district (Orissa) within one month of the September 2008 floods, and similarly affected by flooding in August 2006. Face-to-face interviews were conducted in 757 households in the flooded villages and 816 in the non-flooded communities. Data used in this study were from those households with children aged 6-59 months. In total, 191 and 161 children were measured, respectively. The association between various malnutrition indicators and the exposure to floods was assessed by univariate and multivariate logistic regression. Results: Adjusted analyses revealed that children in flooded households were more likely stunted compared with those in non-flooded ones (adjusted prevalence ratio 1.60; 95% CI 1.05 to 2.44). The prevalence of underweight was also higher in children living in the flooded communities (adjusted prevalence ratio 1.86; 95% CI 1.04 to 3.30). Further analyses found that the 26-36-month flooded cohort, thus those children younger than 1 year during the precedent flood in August 2006, attained the largest difference in levels of stunting compared with the unexposed group of the same age. Conclusion: Exposure to floods is associated with long-term malnutrition in these rural communities of Orissa, India. Children exposed to floods during their first year of life presented higher levels of chronic malnutrition. Long-term malnutrition prevention programmes after floods should be implemented in flood-prone areas.

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