Maternal profiles and social determinants of severe acute malnutrition among children under five years of age: A case-control study in Nepal
Research snapshot1
Malnutrition remains a major public health issue in Nepal and is estimated to be the underlying cause of 50% of child deaths. An estimated 10% of children under five years of age are wasted in Nepal and the prevalence of severe acute malnutrition (SAM) has increased considerably since 2001. Understanding the determinates of SAM in this context is important for finding effective ways to prevent cases. This recent study gathered data from general hospital admissions to identify maternal and social factors associated with SAM.
Using an unmatched case-control study design, admissions to the study hospital were screened and 256 children aged 6-59 months identified for inclusion. A total of 128 children were classified as SAM based on mid-upper arm circumference (MUAC)<115mm or oedema and 128 were classified as controls (MUAC>125mm). Any children with a chronic illness such as human immunodeficiency virus, tuberculosis or disability were excluded. Using backwards, stepwise logistic regression, the authors found odds of SAM were lower among boys (adjusted odds ratio (AOR) = 0.50, 95% CI = 0.27–0.92), mothers with higher socioeconomic status (AOR = 0.469, 95% CI = 0.26–0.83), those breastfeeding infants aged 6 to 12 months (AOR = 0.21, 95% CI = 0.05–0.68), those breastfeeding infants aged ≥13 months (AOR = 0.18, 95% CI = 0.05–0.54) and those providing optimal complementary feeding (AOR = 0.40, 95% CI = 0.22–0.70). Odds of SAM were significantly higher among younger children (aged 6-24 months; AOR = 2.57, 95% CI = 1.30–5.22) and children with a history of diarrhoea (AOR = 1.75, 95% CI = 0.92–3.39).
These results suggest that prevalence of SAM could be positively impacted though scale-up of services to improve education and job opportunities for mothers. Infant and young child feeding interventions, such as increasing the prevalence of exclusive breastfeeding and optimal complementary feeding, could also reduce risk of SAM. Girls seem to be more vulnerable than boys in this setting and so could be prioritised where services are limited. Lastly, results suggest that interventions to reduce risk of diarrhoea in children, such as availability and usage of soap for handwashing, could also positively impact nutritional status.
1 Hossain, Ahmed et al. Maternal profiles and social determinants of severe acute malnutrition among children under-five years of age: A case-control study in Nepal. Heliyon 6.5 (2020): e03849.
More like this
FEX: Ethiopia: Are children of employed mothers less stunted than those of unemployed mothers?
View this article as a pdf Kedir Mohammed is the Nutrition Cluster Coordinator of the Sub-National Emergency Nutrition Coordination Unit (ENCU), Semera, Afar Region,...
FEX: Factors associated with stunting among pre-school children in Tanzania
Research snapshot1 Stunting is a major public health problem in Africa, affecting more than one third of children under five years (Black et al, 2013). In Tanzania in 2014,...
FEX: Mortality risk factors in severelymalnourished children hospitalised with diarrhoea
Summary of published research1 Acase-control study conducted in the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) to identify...
FEX: Severe wasting among Indian infants under six months of age
View this article as a pdf Research snapshot1 The burden and risk factors for wasting among infants under six months of age in India are not well documented. Data from...
Resource: Informing the management of acute malnutrition in infants aged under 6 months (MAMI): risk factor analysis using nationally-representative demographic & health survey secondary data
Background Tackling malnutrition is a global health priority, helping children both survive and thrive. Acute malnutrition (wasting) in infants aged under 6 months (u6m) is...
FEX: Risk factors associated with severe acute malnutrition in infants under six months in India: a cross sectional analysis
By Susan Thurstans Susan is a registered nurse and midwife with over 12 years' experience in maternal and child health and nutrition programmes in both development and...
FEX: Nutritional support services and HIV in sub-Saharan African countries
Summary of research1 On the basis of the latest WHO criterion for HIV treatment initiation (CD4 cell count =350 cells/mm³), anti-retroviral therapy (ART) was accessed by an...
FEX: Risk factors for acutely malnourished infants aged under six months
Research snapshot 1 Acute malnutrition (wasting) in infants aged under 6 months (< 6m) is often neglected. Worldwide, some 8.5 million infants < 6m are affected, yet...
en-net: CMAM admission by MUAC gender biased?
I am currently analysing OTP patient cards from Concern's CMAM pilot in Bardiya, Nepal and found the following: In total I have 1469 new admissions registered. According to...
FEX: The effect of acute malnutrition on enteric pathogens, moderate-to-severe diarrhoea, and associated mortality
View this article as a pdf Research snapshot1 Children with acute malnutrition are three times more likely to die from diarrhoea than children with better nutritional status,...
FEX: Early initiation of breastfeeding reduces neonatal mortality
Summary of published research1 A recently published study assessed the contribution of the timing of initiation of breastfeeding to neonatal death. The study also set out to...
FEX: High burden of undernutrition among at-risk children in neonatal follow-up clinic in Rwanda
View this article as a pdf Research snapshot1 A Paediatric Development Clinic (PDC) in rural Rwanda provides a medical home model for the medical, nutritional and...
FEX: Severe malnutrition in children presenting to health facilities in an urban slum in Bangladesh
Summary of research1 Location: Urban slum, Bangladesh What we know already: Both severe acute malnutrition (wasting) and severe chronic malnutrition (stunting) are prevalent...
en-net: Vitamin A related mortality study in patients with eodema
Any one can help in guiding me where i could find the study that shown increased mortality rate among children with severe acute malnutrition with edema after receiving vitamin...
FEX: Routine amoxicillin use in treatment of uncomplicated SAM in children
Summary of research1 Location: Niger What we know: Routine use of broad-spectrum antibiotics is recommended in uncomplicated SAM case management; there is a lack of evidence...
FEX: Determining predictors for severe acute malnutrition: Causal analysis within a SQUEAC assessment in Chad
By Ruwan Ratnayake, Casie Tesfai and Mark Myatt Ruwan Ratnayake is the Epidemiology Technical Advisor with the International Rescue Committee based in New York. He supports...
FEX: Follow-up status of children with SAM treated with RUTF in peri-urban and rural Northern Bangladesh
By Dr. Charulatha Banerjee, Monsurul Hoq and Dr. Ehsanul Matin Charulatha Banerjee is Regional Advisor on Maternal and Child Health & Nutrition, South Asia with the Terre des...
FEX: Study of the Risk Factors for the Development of Nutritional Oedema in North Kivu, DRC
By Mark Myatt and Frances Mason Mark Myatt is a consultant epidemiologist and senior research fellow at the Division of Epidemiology, Institute of Opthalmology, University...
en-net: Higher Prevalence of Under-nutrition in Boys than Girls?
Hi, I am looking for the result of any research that shows the reasons for higher prevalence of under-nutrition in boys than girls. I know the reasons could be vary in each...
FEX: Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect
Summary of research1 Location: Global What we know: The decision not to breastfeed a child impacts on the health, nutrition and development of a child and on women's...
Reference this page
Hossain, Ahmed et al. (). Maternal profiles and social determinants of severe acute malnutrition among children under five years of age: A case-control study in Nepal. Field Exchange 63, October 2020. p71. www.ennonline.net/fex/63/maternalprofilesnepal
(ENN_6786)