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Risk Factors for Malnutrition Among Under-Five-Year olds in an Inner City Community inIbadan: A Case-Control Study
Abstract
Background:Morbidity and mortality rates associated with malnutrition in the under-five-year olds are high especially among children from the low socio-economic class, yet not all children from this deprived environment develop malnutrition.
Objectives: To identify risk factors associated with the development of malnutrition in the under-five-year olds in a homogeneous inner city community.
Design: A community-based, case-control study.
Materials and Methods: One hundred and thirty eight children (subjects and controls) aged less than five years living in the traditional area of Idikan, Ibadan, participated in the study. All households with children under five years were listed and visited over a period of three months. All children in these households were examined and those with weight-for-age less than 2 standard deviations of the NCHS median value were enrolled as subjects. A control, who was not malnourished, was selected for every subject identified; they were matched 1:1 by age and sex from the same compound or adjacent compounds.
Results: The youngest malnourished child was two months old while the mean age of the subjects was 22.5 ± 14.1 months. A significantly higher proportion of subjects than controls had primary caretakers who were not their parents (16.9 percent vs 6.2 percent; p<0.0001), and were commenced on complementary diet earlier (t=2.06, p=0.04). There were no significant differences in morbidity pattern among subjects and controls for fever, acute respiratory tract infections and diarrhoeal diseases (p>0.05). In the case-control analysis, low paternal education (incomplete primary school education and less)(p<0.0001), not being up to date with immunization (p=0.037), and starting complementary feeds before the age of six months (p=0.026), were associated with an increased risk of malnutrition. When confounding covariates were controlled in multivariate analysis, only age less than six months at adding complementary feeds was significant (p=0.038) but only explained 51.6 percent in the variance due to malnutrition.
Conclusion: Infants should be breastfed exclusively for the first six months of life, and breastfeeding should continue up to the age of two years. Immunization coverage needs to be improved in the community. These measures should help in reducing malnutrition in the community.
Keywords: Malnutrition, Under-five morbidity, Low socio-economic environment, Immunization,
Nigerian Journal of Paediatrics 2003. 30:7-12
Objectives: To identify risk factors associated with the development of malnutrition in the under-five-year olds in a homogeneous inner city community.
Design: A community-based, case-control study.
Materials and Methods: One hundred and thirty eight children (subjects and controls) aged less than five years living in the traditional area of Idikan, Ibadan, participated in the study. All households with children under five years were listed and visited over a period of three months. All children in these households were examined and those with weight-for-age less than 2 standard deviations of the NCHS median value were enrolled as subjects. A control, who was not malnourished, was selected for every subject identified; they were matched 1:1 by age and sex from the same compound or adjacent compounds.
Results: The youngest malnourished child was two months old while the mean age of the subjects was 22.5 ± 14.1 months. A significantly higher proportion of subjects than controls had primary caretakers who were not their parents (16.9 percent vs 6.2 percent; p<0.0001), and were commenced on complementary diet earlier (t=2.06, p=0.04). There were no significant differences in morbidity pattern among subjects and controls for fever, acute respiratory tract infections and diarrhoeal diseases (p>0.05). In the case-control analysis, low paternal education (incomplete primary school education and less)(p<0.0001), not being up to date with immunization (p=0.037), and starting complementary feeds before the age of six months (p=0.026), were associated with an increased risk of malnutrition. When confounding covariates were controlled in multivariate analysis, only age less than six months at adding complementary feeds was significant (p=0.038) but only explained 51.6 percent in the variance due to malnutrition.
Conclusion: Infants should be breastfed exclusively for the first six months of life, and breastfeeding should continue up to the age of two years. Immunization coverage needs to be improved in the community. These measures should help in reducing malnutrition in the community.
Keywords: Malnutrition, Under-five morbidity, Low socio-economic environment, Immunization,
Nigerian Journal of Paediatrics 2003. 30:7-12
