BMJ Open 1:e000109 doi:10.1136/bmjopen-2011-000109
  • Epidemiology
    • Research

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

  1. Debarati Guha-Sapir1
  1. 1CRED-Centre for Research on the Epidemiology of Disasters, Institute of Health and Society, Université catholique de Louvain, Brussels, Belgium
  2. 2Voluntary Health Association of India, New Delhi, India
  1. Correspondence to Jose Manuel Rodriguez-Llanes; jose.rodriguez{at}
  • Received 25 February 2011
  • Accepted 9 August 2011
  • Published 1 November 2011


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.


  • Correction notice The “To cite: …” information and running footer in this article have been updated with the correct volume number (volume 1).

  • To cite: Rodriguez-Llanes JM, Ranjan-Dash S, Degomme O, et al. Child malnutrition and recurrent flooding in rural eastern India: a community-based survey. BMJ Open 2011;1:e000109. doi:10.1136/bmjopen-2011-000109

  • Funding This research was funded by the European FP6 6th Framework Programme under The MICRODIS Project—Integrated Health, Social and Economic Impacts of Extreme Events: Evidence, Methods and Tools (Contract No GOCE-CT-2007-036877).

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval Ethics approval was provided by the Community Health Ethics Committee, Voluntary Health Association of India, New Delhi.

  • Contributors DG-S obtained the funding. DG-S, AM, SR-D, JMR-L conceived and designed the study. SR-D and AM collected the data and supervised the study. JMR-L, DG-S, OD analysed and interpreted the data. JMR-L conducted the statistical analyses and drafted the manuscript. SR-D, JMR-L, DG-S and AM provided administrative, technical or material support. All authors critically revised the manuscript for important intellectual content.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Statistical code available from the corresponding author.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: and

blog comments powered by Disqus