{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:01:39Z","timestamp":1787022099075,"version":"build-2736575974"},"reference-count":37,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2021,12,20]],"date-time":"2021-12-20T00:00:00Z","timestamp":1639958400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008975","name":"University of Massachusetts Amherst","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008975","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006641","name":"UNICEF","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006641","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"crossref","award":["R01 MH66801 (Earls and Carlson, Moshi Study)"],"award-info":[{"award-number":["R01 MH66801 (Earls and Carlson, Moshi Study)"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>\n                    Research on geographic differences in health focuses largely on children less than five years; little is known about adolescents\u2014and even less regarding younger adolescents\u2014a vulnerable group at a critical stage of the life course. Africa\u2019s rapid population growth and urbanization rates, coupled with stagnant rates of undernutrition, further indicate the need for country-specific data on rural-urban health disparities to inform development policies. This study examined rural-urban disparities in body mass index-for-age-and-sex (BAZ) and height-for-age-and-sex z-scores (HAZ) among younger adolescents in Tanzania. Participants were randomly selected adolescents aged 10\u201314 years (\n                    <jats:italic>N<\/jats:italic>\n                    = 1,125) residing in Kilosa (rural) and Moshi (urban) districts of Tanzania. Individual and household-level data were collected using surveys and anthropometric data was collected on all adolescents. Age, sex, household living conditions, and assets were self-reported. BAZ and HAZ were calculated using the WHO reference guide. The prevalence of undernutrition was 10.9% among rural and 5.1% among urban adolescents (\n                    <jats:italic>p<\/jats:italic>\n                    &lt;0.001). Similarly, stunting prevalence was greater in rural (64.5%) than urban (3.1%) adolescents (\n                    <jats:italic>p<\/jats:italic>\n                    &lt;0.001). After adjusting for covariates, rural residence was significantly and inversely associated with BAZ (\n                    <jats:italic>B<\/jats:italic>\n                    = -0.29, 95% CI: -0.52, -0.70,\n                    <jats:italic>p<\/jats:italic>\n                    = 0.01), as well as with HAZ (\n                    <jats:italic>B<\/jats:italic>\n                    = -1.79, 95% CI: -2.03, -1.54,\n                    <jats:italic>p<\/jats:italic>\n                    &lt;0.001). Self-identified males had lower BAZ (\n                    <jats:italic>B<\/jats:italic>\n                    = -0.23, 95% CI: -0.34, -0.11,\n                    <jats:italic>p<\/jats:italic>\n                    &lt;0.001) and HAZ (\n                    <jats:italic>B<\/jats:italic>\n                    = -0.22, 95% CI: -0.35, -0.09,\n                    <jats:italic>p<\/jats:italic>\n                    = 0.001) than self-identified female adolescents. Rural-urban disparities in nutritional status were significant and gendered. Findings confirm place of residence as a key determinant of BAZ and HAZ among younger adolescents in Tanzania. Targeted gender-sensitive interventions are needed to limit growth faltering and improve health outcomes in rural settings.\n                  <\/jats:p>","DOI":"10.1371\/journal.pone.0261480","type":"journal-article","created":{"date-parts":[[2021,12,20]],"date-time":"2021-12-20T13:41:49Z","timestamp":1640007709000},"page":"e0261480","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":9,"title":["Rural-urban disparities in the nutritional status of younger adolescents in Tanzania"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7400-5483","authenticated-orcid":true,"given":"Lorraine S.","family":"Cordeiro","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas P.","family":"Otis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindiwe","family":"Sibeko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerusha","family":"Nelson-Peterman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,12,20]]},"reference":[{"key":"pone.0261480.ref001","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1016\/S0140-6736(13)60937-X","article-title":"Maternal and child undernutrition and overweight in low-income and middle-income countries","volume":"382","author":"RE Black","year":"2013","journal-title":"The Lancet"},{"key":"pone.0261480.ref002","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1177\/156482651403500203","article-title":"Determinants of stunting and overweight among young children and adolescents in sub-Saharan Africa","volume":"35","author":"S Keino","year":"2014","journal-title":"Food Nutr Bull"},{"key":"pone.0261480.ref003","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1111\/tmi.13341","article-title":"Prevalence and predictors of adolescent linear growth and stunting across the urban\u2013rural gradient in eastern Ethiopia","volume":"25","author":"AA Irenso","year":"2020","journal-title":"Trop Med Int Health"},{"key":"pone.0261480.ref004","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1111\/j.1748-0361.2012.00408.x","article-title":"Child nutritional status by rural\/urban residence: A cross-national analysis.","volume":"28","author":"K Fox","year":"2012","journal-title":"J Rural Health"},{"key":"pone.0261480.ref005","article-title":"Household structure, maternal characteristics and children\u2019s stunting in sub-Saharan Africa: evidence from 35 countries","author":"S Yaya","year":"2020","journal-title":"Int Health."},{"key":"pone.0261480.ref006","first-page":"3012","article-title":"Urban-rural disparities in the nutritional status of school adolescent girls in the Mizan district, south-western Ethiopia","volume":"15","author":"TM Berheto","year":"2015","journal-title":"Rural Remote Health"},{"key":"pone.0261480.ref007","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1002\/ajpa.21463","article-title":"The shape of things to come? household dependency ratio and adolescent nutritional status in rural and urban Ethiopia","volume":"144","author":"C Hadley","year":"2011","journal-title":"Am J Phys Anthropol"},{"key":"pone.0261480.ref008","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1017\/S0021932010000234","article-title":"Gender and rural-urban differences in the nutritional status of in-school adolescents in south-western Nigeria","volume":"42","author":"OO Omigbodun","year":"2010","journal-title":"J Biosoc Sci"},{"key":"pone.0261480.ref009","volume-title":"Nutrition in adolescence: issues and challenges for the health sector: issues in adolescent health and development.","author":"World Health Organization","year":"2005"},{"key":"pone.0261480.ref010","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/S2352-4642(18)30022-1","article-title":"The age of adolescence","volume":"2","author":"SM Sawyer","year":"2018","journal-title":"Lancet Child Adolesc Health"},{"key":"pone.0261480.ref011","doi-asserted-by":"crossref","first-page":"1741","DOI":"10.3945\/jn.111.155994","article-title":"Household food security Is inversely associated with undernutrition among adolescents from Kilosa, Tanzania","volume":"142","author":"LS Cordeiro","year":"2012","journal-title":"J Nutr"},{"key":"pone.0261480.ref012","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1111\/tmi.13330","article-title":"Gender differences in nutritional status, diet and physical activity among adolescents in eight countries in sub-Saharan Africa","volume":"25","author":"AM Darling","year":"2020","journal-title":"Trop Med Int Health"},{"key":"pone.0261480.ref013","author":"L. 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