Estimated timing of the first menstrual period and dietary and nutritional correlates of menarche among urban school‐going adolescents in four sub‐Saharan African sites

Bibliographic Data

ID15535986
AuthorsJanaína Calu Costa (0000-0002-7912-8685, Harvard University, corresponding author), Anne Marie Darling (0000-0002-2282-7696, Harvard University), Sanjyot Shinde (0000-0001-6369-4212, Harvard University), Amare Worku Tadesse (0000-0002-7805-3191, Addis Continental Institute of Public Health), Huda Sherfi (Ahfad University for Women), Mary Mwanyika‐Sando (0000-0002-8079-5960, Africa Academy for Public Health), Amani Tinkasimile (0000-0002-9401-0060, Africa Academy for Public Health), Deepika Sharma (0000-0002-6641-173X, United Nations Children's Fund), Till Baernighausen (Harvard University), Wafaie W Fawzi (0000-0002-2908-600X, Harvard University, corresponding author)
Year2024
Volume21
IssueS1
Pagese13583-e13583
Publication date2024-08-02
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueMaternal and Child Nutrition (JOURNAL)
Journal identifiersISSN: 1740-8695 • E-ISSN: 1740-8709
PublisherWiley (PUBLISHER • GB)
DOI10.1111/mcn.13583
PMID39094055
OpenAlexW4401244447
LanguageEN
References cited43

Characterizing the timing of menarche and the factors that are associated with it is important for understanding a population's reproductive health needs and long-term health trajectories. We estimated the age at the menstrual onset among adolescent girls and the association between dietary and nutritional factors and menarche in four sub-Saharan African urban sites. We used cross-sectional school-based data from 2307 female adolescents aged 10-14 years collected by the Africa Research, Implementation Science, and Education (ARISE) Network in Ouagadougou, Burkina Faso; Addis Ababa, Ethiopia; Khartoum, Sudan; and Dar es Salaam, Tanzania. Logit models were used to estimate the median age at menarche at each site. Associations between menarche and BMI-for-age, stunting, dietary quality and food insecurity across settings were assessed using Poisson regression models adjusted for country and school levels. The estimated median age at menarche was 13.1 years (95% confidence interval: 12.7, 13.5) in Ouagadougou; 12.9 (12.6, 13.2) in Addis Ababa; 13.3 (12.7, 13.6) in Khartoum; and 13.2 (12.3, 14.0) in Dar es Salaam. Between 18% and 49% of the girls in each setting had already menstruated. Based on the pooled multivariable models, underweight participants were 42% less likely (adjusted prevalence ratio [PR] 0.58 [0.44, 0.77]) to have experienced menarche in comparison to normal-weight individuals. The likelihood of experiencing menarche increased for overweight [PR 1.47 (1.30,1.66)] and obese [PR 1.57 (1.35,1.82)] in comparison to normal-weight girls. Those stunted were 47% less likely to have experienced menarche [PR 0.53 (0.41, 0.69)] than their nonstunted counterparts. A lower likelihood of menarche among those experiencing moderate/severe hunger when compared to those with no/little hunger was also observed (PR 0.78 [0.63,0.96]). No evidence of association with dietary quality was found. Further research is needed to strengthen the body of evidence and inform evidence-based initiatives in low- and middle-income settings

Confidence interval · Environmental health · Geography · Logistic regression · Menarche · Menstruation · Obesity · Overweight · Poisson regression · Population · Tanzania · Underweight · Demography · Growth Hormone and Insulin-like Growth Factors · Hypothalamic control of reproductive hormones · Medicine · Menstrual Health and Disorders · Endocrinology · Pediatrics