Little information is known about the influence of altitude on child growth in Ethiopia, where most people live in highlands. We investigated the relation of residential altitude with growth faltering (stunting) of infants and young children in Ethiopia. We also examined whether the altitude–growth relationship was independent of the influence of the dietary and non-dietary determinants of growth. We used the data of 26 976 under-5-year-old children included in the Ethiopian Demographic and Health Surveys, conducted from 2005 to 2016. The samples were recruited following a two-stage cluster sampling strategy. Stunting was defined by height-for-age <−2 z-scores. The relationship between residential altitude and stunting was examined by running multiple logistic regression analysis, controlling the effect of covariate dietary and non-dietary variables. The residential altitude of the study participants ranged from −116 to 4500 m above sea level (masl). There was a significant and progressive increase in the prevalence and odds of stunting with increasing altitude (P < 0·001), irrespective of the dietary and non-dietary predictors of stunting. The prevalence of stunting was lowest in lowlands (39 %) and highest in highlands (47 %). Compared with altitude <1000 masl, the odds of stunting was 1·41 times higher at altitude ≥2500 masl (OR 1·41, 95 % CI 1·16, 1·71) and 1·29 times higher at altitude 2000–2499 masl (OR 1·29, 95 % CI 1·11, 1·49). Children living in highlands might be at a higher risk of poor growth. Further studies are warranted to understand the mechanism behind the observed altitude–stunting link and identify strategies to compensate for the growth-faltering effect of living in highlands.

中文翻译：

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居住海拔和发育迟缓之间的关系：来自埃塞俄比亚高地和低地超过 26 000 名儿童的证据

关于海拔对埃塞俄比亚儿童成长的影响的信息知之甚少，那里的大多数人都生活在高地。我们调查了居住海拔与埃塞俄比亚婴幼儿生长迟缓（发育迟缓）的关系。我们还检查了海拔 - 生长关系是否独立于饮食和非饮食决定因素的影响。我们使用了 2005 年至 2016 年进行的埃塞俄比亚人口和健康调查中包含的 26 976 名 5 岁以下儿童的数据。样本是按照两阶段整群抽样策略招募的。发育迟缓由年龄别身高 <-2 定义z-分数。通过运行多元逻辑回归分析检查居住海拔和发育迟缓之间的关系，控制协变量饮食和非饮食变量的影响。研究参与者的居住海拔范围为海拔 -116 至 4500 m (masl)。随着海拔的升高，发育迟缓的患病率和几率显着且逐渐增加（磷< 0·001)，与发育迟缓的饮食和非饮食预测因素无关。低地发育迟缓的发生率最低（39%），高地最高（47%）。与海拔 <1000 masl 相比，在海拔 ≥2500 masl 时发育迟缓的几率高 1·41 倍（OR 1·41, 95 % CI 1·16, 1·71），在海拔 2000–2499 时高出 1·29 倍masl (OR 1·29, 95 % CI 1·11, 1·49)。生活在高地的儿童生长不良的风险可能更高。有必要进行进一步的研究，以了解观察到的海拔 - 发育迟缓联系背后的机制，并确定补偿生活在高地的生长迟缓效应的策略。