Malnutrition among Children under Age Five in Panama: Results of the ENSPA 2019

Background: Malnutrition has important short- and long-term consequences in children under age five. Malnutrition encompasses undernutrition, overnutrition, and the coexistence of both of them, known as the double burden of malnutrition (DBM). Objective: The aim of this study was to estimate the prevalence of undernutrition, overnutrition, and the DBM among these children at the national level and by living area in Panama. Methods: Data from the National Health Survey of Panama (ENSPA, Spanish acronym), a population-based, cross-sectional study carried out in 2019 were used. Stunting, wasting, overweight, and obesity were defined according to the cut-off points of the World Health Organization Growth Standards. Undernutrition was defined as being stunted only, wasted only or both; overnutrition was defined as being overweight only or obese only; and the DBM was defined as the co-occurence of stunting and overweight/obesity in the same child. Prevalence and general characteristics at the national level and by living area were weighted. Findings: The prevalence of undernutrition was 15.3% (95% confidence interval (CI) 13.4- 17.3) at the national level and 36.6% (CI: 30.1-43.5) in indigenous areas. The prevalence of overnutrition was 10.2% (8.2-12.6) at the national level and 11.9% (CI: 8.5-16.3), 8.4% (CI: 6.5-10.7) and 8.7% (CI: 5.2-14.3) in urban, rural and indigenous areas, respectively. The DBM prevalence was 1.4% (CI: 1.0-2.1) at the national level and 2.7% (CI: 1.4-5.1) in indigenous areas. Conclusions: Undernutrition is still the most prevalent malnutrition condition in our country. Panama has the highest prevalence of overnutrition in Central America. The highest prevalence of undernutrition and DBM was found among children living in indigenous areas.