Risk Factors For Acute Malnutrition Research Articles

Determinants of acute malnutrition among 6-59 months old children in public hospitals in Gambella town, Southwest Ethiopia: unmatched case-control study.

Acute malnutrition is a severe public health issue caused by poor nutrition over a short period of time. It is a powerful predictor of mortality. The Gambella region's risk factors for acute malnutrition, however, are not well understood. Thus, the risk factors for acute malnutrition were identified in this study. A facility-based unmatched-case control study design was conducted in public hospitals in Gambella town from February 15 to March 30, 2019. A total of 85 cases and 170 controls were included in the study. According to the average monthly caseload, children between the ages of 6 and 59 months were distributed among the public hospitals. Then, cases and controls were chosen using a systematic random sampling technique. A standardized, previously tested questionnaire was used to collect the data. EPI-data version 3.1 was used to enter the data, which was subsequently exported to SPSS version 20 for analysis. Statistical significance was set at p 0.05 for the bivariate and multivariable logistic regressions that were employed. Household income of <=1,500 birr [AOR = 2.46 at 95% CI (1.37-4.39)], being unemployed [AOR = 2.37 at 95% CI (1.34-4.20)], rural residence [AOR = 1.96 at 95% CI (1.10-3.51)], having diarrhea [AOR = 2.47, 95% CI (1.36-4.51)], fever [AOR = 2.05, 95% CI (1.03-4.10)], and pneumonia (AOR = 2.41), and exclusive breast feeding (AOR = 1.96, and exclusive breast feeding [AOR = 1.96, 95% CI (1.18-4.91)], and exclusive breast feeding (AOR = 1.96) minimum dietary diversity [AOR = 2.86, 95% CI (1.06-3.64)], minimum dietary diversity [AOR = 2.86, 95% CI (1.37-5.95)], weight measurement at birth [AOR = 0.86, 95% CI (0.08-0.93)], unplanned birth of the child [AOR = 1.97, 95% CI (1.02-3.78)], and non-immunized [AOR = 4.12, 95% CI (1.05-16.13)] were associated with acute malnutrition. This research identified multiple risk factors for acute malnutrition in children aged 6-59 months, suggesting health interventions, and programs at all levels of the system executed in an organized manner with substantial program ramifications.

Evaluation of malnutrition and screening tools in hospitalized children

Detecting malnutrition and its related risk factors are crucial, in hospitalized children. Anthropometric z scores are used to assess malnutrition. Screening tools also aim to detect the presence of malnutrition and the developing risk of malnutrition in hospitalized children to determine who may benefit from nutritional support. Therefore, the aims of the study are to detect malnutrition and its related demographic and clinical risk factors in hospitalized children and determining the sensitivity of Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP) and Pediatric Yorkhill Malnutrition Score (PYMS) screening tools. A total of 130 hospitalized children aged between 0 and 18 years were included in to study. A survey including demographic and clinical characteristics, STAMP and PYMS were applied to parents of the children. Patients were classified into nutritional risk groups through screening tools. Anthropometric measurements (body weight, length/height, and middle upper arm circumference (MUAC) of the children were taken. Body mass index-for-age and height-for-age z scores were calculated to assess acute and chronic malnutrition prevalence. MUAC-for-age z scores were calculated as well. To detect independent risk factors for acute and chronic malnutrition multivariable logistic regression models were constructed. A total of 14.6% of hospitalized children had acute malnutrition, 21.5% of children had chronic malnutrition and 27.7% of them had low MUAC standard deviation score (SDS) (less than-2). The independent risk factors for acute malnutrition were younger maternal age at birth and long length of stay (p<0.05). The independent risk factors for chronic malnutrition were being female, younger maternal age at birth, longer illness duration and having urological or allergy and immunological diseases (p<0.05). However, MUAC for age SDS groups were not related to any demographic and clinical factors, in children of all ages (p>0.05). Regarding the screening tools, PYMS displayed 100% sensitivity against acute malnutrition. While PYMS displayed better sensitivity to identify acute malnutrition than STAMP, STAMP was more sensitive than PYMS to detect chronic malnutrition and low MUAC SDS. Low MUAC for age SDS was not related to any demographic and clinical factors, in hospitalized children of all ages, unlike acute and chronic malnutrition, in this study. Pediatric screening tools mainly PYMS did not have high sensitivity to detect chronic malnutrition and low MUAC SDS, in hospitalized children. Therefore, the tools have to be used along with z scores of anthropometric parameters.

Determinants of Acute Malnutrition among Under-Five Children in Governmental Health Facilities in Sodo Town, Southern Ethiopia: Unmatched Case-Control Study.

Acute malnutrition is a major public health challenge among children globally. The burden is high in low-income countries like Ethiopia. Different reports and literatures revealed different risk factors of acute malnutrition in different geographical areas, but there were regional variations. So, the main aim of this study was to identify determinants of acute malnutrition among under-five children in governmental health facilities of Sodo town, Southern Ethiopia. An institutional-based unmatched case-control study was conducted from February 1 to March 1, 2021. Consecutive sampling was used to select cases, and controls were selected using a systematic random sampling technique. An interviewer-administered structured questionnaire was used to collect data, and standardized anthropocentric measurement equipment was used to identify cases and controls. Data were analyzed using SPSS version 26. A logistic regression model was used to identify the determinants of acute malnutrition, and statistical significance was declared at P < 0.05. A total of 133 cases and 266 controls were included in the study making a response rate of 97.8%. Mothers with no formal education, birth interval less than 24 months, marital status (divorced widowed and separated), diarrhea in the past two weeks, using nonprotected water for drinking, exclusive breastfeeding less than 6 months, not taking sick children to health facility within 24 hours of the onset of any sickness, low birth weight, breastfeeding for less than 24 months, using nonimproved toilet, low dietary diversity, and food insecurity were significantly associated with acute malnutrition. This study identified the major determinants of acute malnutrition among under-five children in the study area. Thus, ensuring safe water supply, empowering women, and improving knowledge and practices of mothers regarding exclusive breastfeeding and family planning are recommended.

Risk Factors of Acute Malnutrition among Children Under Five Years of Age

Childhood malnutrition remains a significant global public health concern, and despite numerous advances and improvements in child health care; acute malnutrition among children still one of the main public health challenges in the 21st century, particularly in developing countries and is associated with a high risk of morbidity and mortality. Children are the most vulnerable group to the effects of acute malnutrition during the period of their most rapid physical growth and development, because of the extra nutritional requirements for growth and development at this time. Acute malnutrition results from the complex interplay of a range of distal and proximal factors. This review article gives a comprehensive background on the causes of acute malnutrition among children under five years of age.

Prevalence and risk factors of acute malnutrition among pre-school children in internally displaced person settlements within Abuja Municipal Area Council

Background: Malnutrition is pervasive among displaced populations worldwide. Adequate nutrition is essential to the growth and development of all children, particularly in the preschool age.&#x0D; Methodology: This cross-sectional study was conducted in four internally displaced person (IDP) settlements and their host communities within the Abuja municipal area council between April and May 2019. Using a multistage sampling method, subjects were recruited after parents’ informed consent, from the IDP settlements and equal numbers were drawn from their host communities. The proportion of acute malnutrition using weight for height, MUAC, BMI-for-age Z scores were compared to the 2006 WHO standards. Predictors were determined by logistic regression and statistical significance was set at p less than 0.05.&#x0D; Results: There were 1,179 children aged six to 59 months recruited in each group. The prevalence of wasting was 7.7% (91), moderate acute malnutrition was 7.2% (85), and severe acute malnutrition was 3.1% (37) among the IDPs while they were 7.1% (84), 6.5% (77) and 2.9% (34) respectively in the host communities. The predictors for wasting in both groups were age below 24months (Adj OR, 95% CI - 3.88, 2.38 - 6.32), low birth weight (Adj OR, 95% CI – 2.70, 1.55 – 4.71) and diarrheal disease (Adj OR, 95% CI - 5.45, 2.38 - 12.44). Location was predictive only in the host communities (Adj OR, 95% CI – 2.69, 1.37 – 5.28).&#x0D; Conclusion and recommendation: Acute malnutrition was high among the pre-school children in this study. The nutritional needs of displaced children in the FCT should be met and their families educated on prompt recognition and treatment of diarrhoea.

Conflict and Climate Factors and the Risk of Child Acute Malnutrition Among Children Aged 24–59 Months: A Comparative Analysis of Kenya, Nigeria, and Uganda

Acute malnutrition affects a sizeable number of young children around the world, with serious repercussions for mortality and morbidity. Among the top priorities in addressing this problem are to anticipate which children tend to be susceptible and where and when crises of high prevalence rates would be likely to arise. In this article, we highlight the potential role of conflict and climate conditions as risk factors for acute malnutrition, while also assessing other vulnerabilities at the individual- and household-levels. Existing research reflects these features selectively, whereas we incorporate all the features into the same study. The empirical analysis relies on integration of health, conflict, and environmental data at multiple scales of observation to focuses on how local conflict and climate factors relate to an individual child’s health. The centerpiece of the analysis is data from the Demographic and Health Surveys conducted in several different cross-sectional waves covering 2003–2016 in Kenya, Nigeria, and Uganda. The results obtained from multi-level statistical models indicate that in Kenya and Nigeria, conflict is associated with lower weight-for-height scores among children, even after accounting for individual-level and climate factors. In Nigeria and Kenya, conflict lagged 1–3 months and occurring within the growing season tends to reduce WHZ scores. In Uganda, however, weight-for-height scores are primarily associated with individual-level and household-level conditions and demonstrate little association with conflict or climate factors. The findings are valuable to guide humanitarian policymakers and practitioners in effective and efficient targeting of attention, interventions, and resources that lessen burdens of acute malnutrition in countries prone to conflict and climate shocks.

Risk factors of acute malnutrition among children aged 6\u201359\u2009months enrolled in a community-based programme in Kurigram, Bangladesh: a mixed-method matched case-control study

BackgroundRisk factors of acute malnutrition in Bangladesh are well documented. However, due to regional variations in prevalence of acute malnutrition, it is important to explore the risk factors specific to the region, for designing and implementing public health interventions.MethodsA mixed-method matched case-control study was conducted in the Kurigram district of Bangladesh. Community perspectives on causes of acute malnutrition were collected from 75 purposively selected caregivers through interviews, focus group discussions and informal group discussions. The data was analysed manually by coding and sub-coding according to different themes. Caregivers of 52 malnourished and 95 well-nourished children matched in age group and sex with the malnourished children, were interviewed using a structured questionnaire. The conditional logistic regression analysis was performed to identify the risk factors of acute malnutrition.ResultsCaregivers perceived inappropriate feeding practice as a major cause of acute malnutrition whereas birth order (first child OR 0.3, 95% CI 0.09, 0.96), number of family members (OR 1.30, 95% CI 1.02, 1.65), illness in the last 2 weeks (OR 3.08, 95% CI 1.13, 8.42) and access to hygienic latrine (OR 0.25, 95% CI 0.07, 0.82) were also associated with acute malnutrition among children under five in Kurigram.ConclusionsCommunity awareness on infant feeding practices and family planning, management of childhood illness and access to hygienic latrine facilities should be prioritised to prevent acute malnutrition in the northern districts.

Determinants for Acute Malnutrition among Under-Five Children at Public Health Facilities in Gedeo Zone, Ethiopia: A Case-Control Study

Introduction: Childhood poor nutritional status continues to be a serious public health problem in Ethiopia. Despite the high magnitude of childhood acute malnutrition, previously there is no study conducted to determine risk factors for acute malnutrition in Gedeo Zone. Thus, the main aim of this study was to identify risk factors for acute malnutrition among under-five children in Gedeo Zone, Ethiopia. Methods: The unmatched case-control study was conducted on 451 under-five children (151 cases and 300 controls). Data were collected through interviewer-administered the structured questionnaire and measuring midupper arm circumference. Statistical package for social science version 20 software was used for data entry and analysis. Odds Ratio along with 95% the confidence interval was estimated using the multivariable logistic regression. The level of statistical significance was declared at P<0.05. Result: Determinants identified for acute malnutrition among under five children were; diarrheal diseases (AOR=3.601 CI=(1.36, 9.53)), complimentary feeding started before 6 months or late after 6 months (AOR=4.4, CI=(1.6, 11.84)), household monthly income <750 ET.BRR, (AOR=4.6 CI=(1.1, 21.6)), maternal illiteracy (AOR=4.18, CI=(1.36, 12.8)), merchant mothers (AOR=7.45 CI=(2.6, 21.2)), mothers’/care givers’ infrequently hand washing (AOR=5.4 CI (1.15, 25.8)) and family size more than four (AOR=5.9, CI (2.1, 16.7)). Conclusion: In this study, socio-demographic and behavioral factors were identified as determinants of acute malnutrition among under-five children. Therefore; collaborative effort is needed to prevent diarrhea among underfive children, promote hand washing practice, create mass awareness about complementary feeding, make family planning methods available and empower women.

Determinants of Acute Malnutrition among Children Aged 6-59 Months in Public Health Facilities of Pastoralist Community, Afar Region, Northeast Ethiopia: A Case Control Study.

Background In low income countries, acute malnutrition continues to be the most important risk factor for illnesses and deaths. The aim of this study was to assess the determinants of acute malnutrition among children aged 6–59 months. Methods A facility based unmatched case control study was employed on 420 (140 cases and 280 controls) children aged 6–59 months with their caregivers between January 20 and February 20, 2014. Data was analyzed using SPSS version 20.0. A P value < 0.05 was considered statistically significant. Results Children aged 12–23 months [AOR = 10.51, 95% CI = 4.93, 22.34], rural residence [AOR = 2.42, 95% CI = 1.22, 4.79], illiterate father [AOR = 2.47, 95% CI = 1.32, 4.61], Monthly income of less than 1000 birr [AOR = 3.98, 95% CI 2.05, 7.69], and food served together with family [AOR = 2.18, 95% CI = 1.10, 4.30] were associated with acute malnutrition. Conclusion Rural residence, illiterate father, monthly income of less than 1000 birr, and food served together with family are statistically associated with acute malnutrition. Improving practices of parents on appropriate child feeding and creating awareness related to key risk factors of acute malnutrition should be further strengthened.

An epidemiological study of acute malnutrition in children of age 6 months to 5 years in an Urban Slum of Mumbai, Maharashtra

Introduction: Malnutrition continues to be one of the major causes of morbidity and mortality among under-five children in developing countries. There are numerous factors that directly or indirectly affect the nutritional status of the children. Aim: This study aims to study the prevalence and associated risk factors of acute malnutrition in children 6 months to 5 years of age in an urban slum. Subjects and Methods: This community-based cross-sectional study was carried out in an urban slum in Mumbai. A total of 270 children of age 6 months to 5 years were enrolled in the study. Samples were selected by simple random sampling from various sectors. All mothers/informant were interviewed, and anthropometric measurements were recorded. Data were analyzed using SPSS version 20.0 and Chi-square test was used to find out the association between two qualitative variables. Results: The prevalence of underweight, stunting, and wasting were 52.2%, 42.2%, and 50.4%, respectively. The factors associated with acute malnutrition were age of the child, mother's educational status, occupation of mother, type of family, socioeconomic status, age at marriage below 18 years, children who were given prelacteal feeds, were not exclusively breastfed and were partially immunized. Conclusions: The findings of the present study revealed that higher prevalence of acute malnutrition was found in the children of urban slum in Mumbai. Socioeconomic development along with counseling on breast-feeding practices and nutrition education among the urban slum masses needs to be ensured which is an important factor to combat malnutrition.

The role of unconditional cash transfers during a nutritional emergency in Maradi region, Niger: a pre-post intervention observational study.

To assess the effect of an unconditional cash transfer (CT) implemented as part of an emergency response to food insecurity during a declared state of emergency. Pre-post intervention observational study involving two rounds of data collection, i.e. baseline (April 2012) and final survey (September 2012), on the same cohort of 'poor' and 'very poor' households enrolled by Save the Children in an unconditional CT programme. Aguié district, Maradi, Niger. Households with a non-acutely malnourished child aged 6-36 months (n 412). The study showed that the living standards of 'poor' and 'very poor' households improved, as indicated by a reduction in poverty-related indicators and an improvement in household food security. Anthropometric outcomes for children aged 6-36 months improved significantly, despite a decline in child health and women's well-being and autonomy. Risk factors for becoming acutely malnourished post-intervention were being from a very poor household at baseline, starting the lean season with low weight-for-height Z-score (WHZ <-1) and the presence of co-morbidity. The results of the study are consistent with the published evidence regarding the general impact of CT and suggest it is plausible that giving cash during an emergency can help safeguard living standards of the very poor and poor. While improvements in childhood nutrition status were seen it is not possible to attribute these to the CT programme. However, knowledge of the risk factors for acute malnutrition in a particular setting can be used to influence the design of future CT interventions for which a controlled trial would be recommended if feasible.

Factors Associated with Acute Malnutrition among Children Admitted to a Diarrhoea Treatment Facility in Bangladesh.

To assess the risk factors for acute malnutrition (weight-for-height z-score (WHZ) < −2), a case-control study was conducted during June–September 2012 in 449 children aged 6–59 months (178 with WHZ < −2 and 271 comparing children with WHZ ≥ −2 and no edema) admitted to the Dhaka Hospital of icddr,b in Bangladesh. The overall mean ± SD age was 12.0 ± 7.6 months, 38.5% (no difference between case and controls). The mean ± SD WHZ of cases and controls was −3.24 ± 1.01 versus −0.74 ± 0.95 (P < 0.001), respectively. Logistic regression analysis revealed that children with acute malnutrition were more likely than controls to be older (age > 1 year) (adjusted OR (AOR): 3.1, P = 0.004); have an undernourished mother (body mass index < 18.5), (AOR: 2.8, P = 0.017); have a father with no or a low-paying job (AOR: 5.8, P < 0.001); come from a family having a monthly income of <10,000 taka, (1 US$ = 80 taka) (AOR: 2.9, P = 0.008); and often have stopped predominant breastfeeding before 4 months of age (AOR: 2.7, P = 0.013). Improved understanding of these characteristics enables the design and targeting of preventive-intervention programs of childhood acute malnutrition.

Population-Based Study of a Widespread Outbreak of Diarrhea Associated with Increased Mortality and Malnutrition in Botswana, January–March, 2006

In early 2006, coinciding with heavy rains, Botswana health facilities reported increases in diarrhea, mortality, and acute malnutrition among young children. Data on diarrhea, human immunodeficiency virus, feeding, mortality, and water/sanitation were collected by random cluster survey. Anthropometric data were measured and drinking water samples were tested. Of 537 surveyed children less than five years of age, one-third experienced >or= 1 episode of diarrhea. Prevalence of acute malnutrition was 7.9%, and the mortality rate for children less than five years of age was 2.6/10,000/day during the outbreak. Significant risk factors for diarrhea included an age less than two years; breastfeeding was protective. Diarrhea lasting for more than 14 days and failure to thrive were risk factors for acute malnutrition. Prevalence of acute malnutrition was higher than previously documented and the mortality rate in children less than five years of age during the outbreak was above the international threshold for emergency action with an estimated 547 excess deaths. This survey highlights the need for safe infant feeding and effective treatment of malnutrition and diarrhea in young children.