Composite index anthropometric failures and associated factors among school adolescent girls in Debre Berhan city, central Ethiopia.

Background: Composite Index of Anthropometric Failures (CIAF) summarizes anthropometric failure, including both deficiency and excess weight, by combining multiple indicators. However, most studies in some parts of Ethiopia still rely on conventional single anthropometric indices, which underestimate the extent of the problem.

Objectives: The primary objective of this study was to assess the prevalence and associated factors of composite index anthropometric failures (CIAF) among school adolescent girls in Debre Berhan City, central Ethiopia in 2023.

Methods: A school-based cross-sectional study was conducted from April 29 to May 30, 2023. The sample included 623 adolescent girls selected using a multistage sampling technique. Data were collected through interviewer-administered questionnaires and anthropometric measurements. Data were analyzed using SPSS, and anthropometric status indices were generated using WHO Anthroplus software. Bivariate and multivariable logistic regression analyses were used to examine associations between independent and dependent variables, with statistical significance declared at p < 0.05.

Results: The prevalence of composite index anthropometric failure was 30.2% (95% CI: 26.6-33.9%), comprising undernutrition (22.5%, 95% CI: 19.1-26.0%) and over nutrition (7.7%, 95% CI: 5.8-10.0%). Multivariable logistic regression analysis identified several factors associated with undernutrition, including family size ≥ 5, low wealth index tertile, inadequate meal frequency (< 3 per day), poor dietary diversity practice, and recent illness. Overweight/obesity was significantly associated with factors such as consuming fast foods, lacking nutrition information, and not engaging in moderate-intensity activities.

Conclusion: The study revealed a higher prevalence of overall malnutrition (30.2%) when considering composite index anthropometric failure compared to single indices. Approximately one-third of the study participants experienced some form of anthropometric failure.

Policy and practical implications: The findings underscore the need for integrated school based nutrition programs targeting dietary diversity, meal frequency, and physical activity, as well as community level strategies to address socioeconomic disparities.