Co-Occurrence of Anemia and Overweight among Women of Reproductive Age in Burkina Faso: A Limited Double Burden?

Abstract

The double burden of malnutrition (DBM), defined as the coexistence of undernutrition and overweight or obesity (OWO) in the same individual, is an emerging challenge in sub-Saharan Africa. In Burkina Faso, where anemia affects 28.0% of women and obesity 11.0%, few studies have examined the determinants of their co-occurrence. This study aims to determine whether this DBM occurs randomly or follows a specific sociodemographic trend. We analyzed data from 7987 women aged 15 - 49 years from the Burkina Faso Demographic and Health Survey (DHS-V). DBM was defined as the simultaneous presence of anemia (Hb < 12.0 g/dL) and overweight/obesity (OWO) (BMI ≥ 25.0 kg/m 2 ). Analyses used methods adapted to the complex sampling design, including Rao-Scott chi-square tests and multivariate logistic regression. DBM was significantly less frequent than expected (observed/expected ratio = 0.89, p < 0.001). 10.1% of women presented with DBM. Compared to women in the lowest wealth quintile, those in the highest quintile (aOR = 0.35; 95% CI: 0.23 - 0.52) had significantly reduced odds of being protected. Similarly, older age was associated with 66% lower odds of protection versus the youngest group age showed a negative association (aOR = 0.34 for 35+ years vs. <25 years; 95% CI: 0.27 - 0.44), while rural residence was modestly protective (aOR = 1.32; 95% CI: 1.00 - 1.73). The anemia-obesity DBM presents an epidemiological profile characterized by an inverse wealth gradient and increased vulnerability with age. These results suggest that nutritional interventions should target women from wealthier households and older women, and support the protective benefits of traditional rural lifestyles.