Determinants of Severe Acute Malnutrition among Under Five Children in Shashogo Woreda, Southern Ethiopia: A Community Based Matched Case Control Study

Abstract

Background: Severe acute malnutrition is one of the major killers of under five children in developing countries including Ethiopia. However, little information is known about the determinant factors of severe acute malnutrition. Hence this study identified the determinants of severe acute malnutrition in Shashogo woreda, Southern Ethiopia. Methods: An age matched community based case control study was conducted from February 20 to march 30, 2014 in 12 randomly selected rural kebeles of the Shashogo district, southern Ethiopia. The cases were 108 severely malnourished children under the age of five and the controls (n=108) were children without malnutrition recruited concurrently from under five children of the same kebele. Data was collected by face to face interview using structured questionnaire and the anthropometric measurements of the children was taken using standard procedures. Descriptive and summary statistics was done. Bivariate and multivariate analysis was done using conditional logistic regression on SPSS version 20.0 and Epi info version 7 software in order to determine factors associated with severe acute malnutrition. Result: Multivariate analysis with conditional logistic regression revealed that severe acute malnutrition was associated with maternal illiteracy (AOR=8.683, 95% CI 2.668-28.26), lack of maternal autonomy in decision making (AOR = 3.46, 95% CI 1.272-9.414), diarrhea 2 weeks preceding the survey (AOR = 4.13, 95% CI 1.34-11.47), sub optimal frequency of complementary feeding (AOR = 3.21, 95% CI 1.63-9.33) and visit to health institution after 24 hours of the onset of symptoms for sick child (AOR=3.95, 95% CI 1.465-10.647) after the effects of other significant variables were controlled. Conclusion and recommendation: The findings of this study have confirmed the association of severe acute malnutrition with maternal education, maternal autonomy in decision making and inappropriate infant and young child caring practices. To reduce childhood malnutrition due emphasis should be given in empowering women and improving the knowledge and practice of parents on appropriate infant and young child caring practices.

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

“…Children whose mothers are illiterate were 4 fold at risk to have severe acute malnutrition as compared to those children have literate mothers. Similar findings were revealed at studies done in Shashogo Woreda, Southern Ethiopia [22], Gonder, Ethiopia [17], Oromia region, West Ethiopia [14], Somali Region, Ethiopia [12], in Ghana [24], Gambia and Nigeria [18], Bangladesh [25] and Granada, Nicaragua [26]. This could be due to illiterate mothers have less perception about the nutritional need of their children and most of them have poor socio-economic status.…”

“…A similar finding was obtained in the study conducted in Machakel Woreda, Northwest Ethiopia where diarrhea increases the risk of malnutrition nearest to three times more likely than those who had not diarrhea [13]. Also it is similar to studies conducted in North Gondar [17] which indicated that the risk of diarrhea associated with under five acute malnutrition and conducted in Shashogo Woreda, Southern Ethiopia revealed that severe wasting was 4 times more likely to occur in children who had diarrhea before 2 weeks than those children who hadn't diarrhea within 2 weeks preceding (AOR=4.13, 95%, CI 1.34-11.47) [22] and other study conducted at Beta-Israel also revealed that diarrhea episode was among the main contributing factors for under-five malnutrition [20]. This could be due to increases loss of body nutrients and fluid which leads to weight loss.…”

Mortality and morbidity trends and predictors of mortality in under-five children with severe acute malnutrition in Hadiya zone, South Ethiopia: a four-year retrospective review of hospital-based records (2012–2015)

“…This study showed no significant association of SAM and comorbid diseases. This is inconsistent with study done in south Ethiopia, which showed morbidity of the child by diarrhoea was associated with SAM [15]. The difference may be due to difference in study design.…”

Determination of risk factors associated with malnutrition among children under the age of five: a case control study at Arthur Davison children’s hospital in Ndola, Zambia

“…A study which was done in Ethiopia reviewed that acute malnutrition is significantly associated with maternal illiteracy and lack of maternal autonomy [10].However, in our study maternal illiteracy and lack of maternal autonomy were not significantly associated with malnutrition. A Study done in India by Jeyaseelan and lakshman reviewed that acute malnutrition is significantly associated with older age of a child [11].…”