Determinants of acute malnutrition in children under five years in Harare City Zimbabwe 2011

Abstract

Background: Malnutrition is associated with 35% of the top five causes of childhood mortality in Zimbabwe. The aim of the study was to identify factors associated with acute malnutrition in Harare City. Methods: A 1:1 age group matched case-control study using a structured interviewer administered questionnaire was done. A case was a child with low weight for height or a mid-upper arm circumference less than 125mm. A control was a child with no signs of malnutrition. Results: We interviewed 116 cases and 115 controls in the six to 24 month age group and 57 cases and 60 controls in the 25 to 59 month age group. The median age was 18 months (Q1=11, Q3=27) for cases and (Q1=10, Q3=29) for controls. Significant determinants of malnutrition were: breastfeeding less than eight times a day [OR=1.83(1.05-3.20)]; eating less than three meals a day [OR=2.16 (1.22-3.81)]; drinking less during fever or cough [OR=2.12 (1.08-4.16)] and birth weight less than 2300g [OR=2.67 (1.01-7.06). Cases used more coping strategies, 110 (Q1=92, Q3=122) for finding food than controls, 91 (Q1=78, Q3=112), p-value 0.01. After further analysis, acute malnutrition remained independently associated with breastfeeding less than eight times the previous day [OR=1.86 (1.02-3.39)] and eating less than three meals a day [OR 2.16 (1.20-3.88)]. Conclusion: Determinants of acute malnutrition are breastfeeding less than eight times a day and children not feeding more than three times a day. To reduce childhood malnutrition, emphasis should be given to increasing the knowledge of caregivers on infant and young child feeding practices.