Predictors of Severe Acute Malnutrition among Children Aged 6 to 59 Months Attended out Patient Therapeutic Program Center in Kavre District of Nepal - A Case Control Study
DOI:
https://doi.org/10.6000/1929-4247.2018.07.01.5Keywords:
Acute Malnutrition, Food security, Breast feeding, Therapeutic center, Diarrheal disease.Abstract
Background: Severe acute malnutrition is an excessive loss of weight due to the acute shortage of food or illness. It is one of the major public health problems in developing countries including Nepal. According to multiple indicator cluster survey (MICS) 2014, 2.6% severely malnourished in Nepal and 4.4% are severely malnourished in Kavre district. However, there are limited studies about predictors of severe acute malnutrition in Nepal. Thus, this study was aimed to identify the predictors of severe acute malnutrition in Kavre district of Nepal.
Methods: Health facility based matched case control study was conducted among 210 (70 cases and 140 controls) children aged 6-59 months from November 2015 to April 2016. Data was collected through face to face interview with mother of eligible children using structured questionnaires. Multivariate analysis was applied to estimate adjusted odds ratio along with 95% confidence interval.
Results: Children with severe acute malnutrition were 11.32 times more likely than control to have recurrent diarrhea in past six months (95% CI=4.64-28.21). Similarly, severe acute malnutrition was associated with female sex (AOR=2.44, 95% CI=1.88-6.78), fathers occupation daily labor (AOR=4.69, 95% CI=1.17-13.76) and agriculture (AOR=6.850, 95%CI=3.81-12.93), improper exclusive breast feeding (AOR=6.646, 95%CI=2.11-20.90), not feeding colostrum (AOR=3.89, 95% CI=2.88-11.21), severe food insecurity access (AOR=3.55, 95% CI=1.85-9.77) and monthly income less than average level (AOR=8.214, 95% CI=1.43-22.16).
Conclusion: Severe acute malnutrition was independently associated with sex of child, occupation of father, monthly household income, not feeding colostrum, improper exclusive breast feeding, severe household food insecurity access and recurrent diarrhea.References
NPC. Multi-Sector Nutrition Plan: For Accelerating the Reduction of Maternal and Child Undernutrition in Nepal 2013-2017. 2012.
WHO, WFP, UNSCN, UNICEF.Community-based Management of Severe Acute malnutrition: Geneva 2007. Available from: http://www.who.int/maternal_child_ adolescent/documents/a91065/en/
Dereje N. Determinants of Severe Acute Malnutrition among under Five Children in Shashogo Woreda, Southern Ethiopia-A Community Based Matched Case Control Study. International Journal of Research 2014; (6)1: 339-363. https://doi.org/10.4172/2155-9600.1000300
Collins S, Binns P, Bahwere P, Sadler K, Hallam A. Management of severe acute malnutrition in children. Lancet 2006; 368(9551): 1992-2000. https://doi.org/10.1016/S0140-6736(06)69443-9
Singer PA. What could infant and young child nutrition learn from sweatshops. BMC Publ Health 2011; 11: 276. https://doi.org/10.1186/1471-2458-11-276
Ministry of Health and Population (MOHP) [Nepal], New ERA, and ICF International Inc. 2012. Nepal Demographic and Health Survey 2011. Kathmandu, Nepal: Ministry of Health and Population, New ERA, and ICF International, Calverton, Maryland 2011.
Sharghi A, Kamran A, Faridan M. Evaluating risk factors for protein-energy malnutrition in children under the age of six years: a case-control study from Iran. Int J Gen Med 2011; 4: 607-11.
Solomon A. Risk factors for severe acute malnutrition in children under the age of five: A case-control study. Ethiop J Health Dev 2006.
Jamro B, et al. Risk factors for severe acute malnutrition in children under the age of five year in Sukkur. Pak J Med Res 2012; 51(4): 111-113.
Tesfai C, Ratnayake R, Myatt M. Measuring local determinants of acute malnutrition in Chad: a case-control study. Lancet 2013; 381: 144. https://doi.org/10.1016/S0140-6736(13)61398-7
Rohana AJ. Assessment of Food Insecurity and Nutritional Outcomes in Bachok, Kelantan. J Nutr Food Sci 2014; 5. https://doi.org/10.4172/2155-9600.1000373
Motbainor A, Worku A, Kumie A. Stunting Is Associated with Food Diversity while Wasting with Food Insecurity among Underfive Children in East and West Gojjam Zones of Amhara Region Ethiopia. PLoS One 2015; 10(8): 133-42. https://doi.org/10.1371/journal.pone.0133542
Naser I, et al. Association between household food insecurity and nutritional outcomes among children in Northeastern of peninsular Malaysia. Nutr Res Pract 2014; 8: 304-11. https://doi.org/10.4162/nrp.2014.8.3.304
WHO. The management of nutrition in major emergencies. Rev Panam Salud Pública 2000; 8: 218-9. https://doi.org/10.1590/S1020-49892000000800017
Government of Nepal, N.P.C.S. CBS and UNICEF. Multiple Indicator Cluster Survey 2014. 2015; 3-4.
Coates J, Swindale a, Bilinsky P. Household Food Insecurity Access Scale (HFIAS) for measurement of food access: indicator guide. Washington DC. Food Nutr Tech 2007; Version 3.
WHO. Indicators for assessing infant and young child feeding practices 2010; pp. 1-19.
Bank NR. Fifth Household budget survey 2015; 2016.
Talbert A, et al. Diarrhoea complicating severe acute malnutrition in kenyan children: A prospective descriptive study of risk factors and outcome. PLoS One 2012; 7. https://doi.org/10.1371/journal.pone.0038321
Roy SK, et al. Risk factors of mortality in severely-malnourished children hospitalized with diarrhoea. J Heal Popul Nutr 2011; 29: 229-35. https://doi.org/10.3329/jhpn.v29i3.7870
Setsw G. Prevalence and risk factors for malnutrition among children aged 5 years and less in the Lefaragatlha village of Bophuthatswana. Curationis 1994; 17: 33-35.
Fuchs C, et al. Factors associated with acute malnutrition among children admitted to a diarrhoea treatment facility in Bangladesh. International Journal of Pediatrics 2014. https://doi.org/10.1155/2014/267806
Saito K, Jekel F, Bhattacharji S. A case-control study of maternal knowledge of malnutrition and health- care-seeking attitudes in rural South India. Yale Journal of Biology and Medicine 1997; 70(2): 149-160.
Egata G. Predictors of acute undernutrition among children aged 6 to 36 months in east rural Ethiopia: a community based nested case - control study. BMC Pediatrics 2014; 14(91). https://doi.org/10.1186/1471-2431-14-91
Mishra K, et al. Risk factors for severe acute malnutrition in children below 5 y of age in India: a case-control study. Indian J Pediatr 2014; 81(8): 762-5. https://doi.org/10.1007/s12098-013-1127-3
Ajao KO, Ojofeitimi EO, Adebayo AA, Fatusi AO, Afolabi OT. Influence of family size, household food security status, and child care practices on the nutritional status of under-five children in Ile-Ife, Nigeria. Afr J Reprod Health 2010; 14: 117-26.
Wong HJ, Moy FM, Nair S. Risk factors of malnutrition among preschool children in Terengganu Malaysia: a case control study. BMC Public Health 2014; 14(1): 785. https://doi.org/10.1186/1471-2458-14-785
Downloads
Published
How to Cite
Issue
Section
License
Policy for Journals/Articles with Open Access
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are permitted and encouraged to post links to their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work
Policy for Journals / Manuscript with Paid Access
Authors who publish with this journal agree to the following terms:
- Publisher retain copyright .
- Authors are permitted and encouraged to post links to their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work .
