Factors Associated With Severe Acute Malnutrition in Children Aged 6-59 Months at Embu Level V Hospital

Abstract

Background: Childhood malnutrition is a complex problem with far-reaching consequences. The factors that lead to it are varied and inter-connected. The aim of this study is to establish the characteristics of children who develop severe acute malnutrition and are admitted to Embu Level V hospital. Methodology: A case control study was carried out in Embu Level V hospital paediatric wards. Cases were children with a MUAC of below 11.5 cm or a WHZ score of below -3 SD from the median of WHO reference. Controls were children with a MUAC of above 13.5 cm and a WHZ score of between -1 SD and +1 SD from the median of WHO reference. Anthropometric measurements of child’s weight, height and MUAC were taken. Information on demographic, socio-economic, nutritional, child care, household and individual characteristics were collected using an interviewer-administered questionnaire. Results: A total of 116 children and their caregivers were enrolled in the study, 58 cases and 58 controls. SAM was significantly associated with increasing birth order [AOR (95% CI) 1.90 (1.21, 2.85)], inappropriate initiation of complementary feeding [AOR (95% CI) 2.87 (1.74, 4.71)], increasing feeding frequency [AOR (95% CI) 0.66 (0.53, 0.82)], lacking any form of protein in diet [AOR (95% CI) 2.24 (1.22, 4.11)], monthly family income of below Ksh.10,000 [AOR (95% CI) 1.44 (1.02, 1.40), and owning <1 acre of land [AOR (95% CI) 9.65 (6.09, 15.31)] In the 6 months prior to this study, 65% had monthly MCH clinic visits, and weight was plotted at each MCH clinic visit more times than height (76.1% and 51.7% respectively). For the cases, a diagnosis of malnutrition was missed 54% of the time. Conclusion: To reduce SAM in this population, proper infant and young child feeding practises should be encouraged. Increasing access to food and the earning power of families should also be facilitated. Regular and accurate growth monitoring could detect malnutrition early facilitating early intervention.