Analysis of determinants of stunting among children under five years using curve analysis of receiver operating characteristics

Stunting in children is still a global public health issue. Compared to other middle-income nations, Indonesia has one of the highest rates of stunting, and Bandung City is one of the worst affected areas in the country. The purpose of this study is to analyze the determinants of stunting and identify predictive indices of stunting incidence in children aged 12-59 months using curve analysis of receiver operating characteristics. In Bandung City, 400 participants (200 cases and 200 controls) participated in a case-control study. Simple random sampling and proportional sampling methods were used to draw samples. Data were gathered by anthropometric measurements and interviews using structured questionnaires. Predictive indices were determined using receiver operating characteristic analysis and the multiple logistic regression test. A history of infectious disease (p=0.003, OR=2.524, 95% CI=1.361-4.683), not being exclusively breastfed (p=0.020, OR=1.929, 95% CI=1.109-3.356), incomplete immunization history (p=0.0001, OR=4.703, 95% CI=2.747-8.052), inadequate drinking water source (p=0.0001, OR=2.587, 95% CI=1.543-4.337), and birth spacing < 24 months were all associated with stunting. According to the receiver operating characteristics study, the stunting prediction index may identify toddlers who are actually stunted by 31.0% of the stunted population, with a Sensitivity (0.31) and Specificity (0.31) value. The risk of stunting is 93.2% if the child is born less than 24 months apart from a sibling, is not breastfed exclusively, has an incomplete immunization history, has a history of infectious diseases, and the drinking water source does not satisfy the necessary standards. Therefore, in order to combat malnutrition, policymakers and stakeholders are advised to enhance prevention and promotion strategies during the prenatal, antenatal, and postnatal phases.