Dietary patterns and prevalence of wasting among street children in Lilongwe, Malawi

Abstract

Street children are persons under the age of 18 years who spend all or most of their time on the streets as a result of many social problems within their communities. Although the number of street children is unknown in Malawi, the problem is thought to be increasing. In a cross-sectional study of 36 street children in Lilongwe,  Malawi, dietary practices and the prevalence of wasting were assessed to provide information on the risk of poor dietary intake and malnutrition in this population. A food frequency  questionnaire and 24-hour dietary recalls were used to determine dietary practices, while anthropometric measurements were  taken to assess the prevalence of low weight-for-height (wasting). Because of their high mobility, the participants were recruited using purposive sampling, primarily around the streets that lead to Lilongwe main market. A qualitative checklist was used to  identify prospective participants, and interviews were only done after the respondent had given informed assent. The study  showed that most (91.7%) of the street children are boys aged between 10 and 12 years (47.2%), largely illiterate (58.3%),  sleep at home (41.6%), and have both parents still living (55.6%). Through begging and engaging in piece work, 61.1% of the children indicated that they earn between US$0.55 and US$1.09 per day. The majority (72.2%) use the money solely to buy food from street vendors and restaurants. Foods that are mostly eaten on a daily basis include nsima (100%), rice (50%),  confectionery (44.4%), and mangoes (41.7%). On the other hand, foods that are eaten three times a week are fish (80.6%),  chicken (58.3%), potatoes (36.1%), cookies (19.4%), pumpkin leaves (19.4%), and bananas (13.9%). For the majority of the children, fruits and  vegetables are mostly eaten once a week. Assessment of the children’s nutritional status showed that up to 8.4% were wasted (<-2 weight-forheight Z-scores), the majority (5.6%) severely (<-3 weight-for-height Z-scores). Limited as it is in terms of sample size and breath, the study forms a stepping stone for investigating in more detail, food and nutrition issues that affect street children in Malawi.

Key words: Malawi, cross-sectional study, dietary assessment, street children, wasting