Risk Factors For Severe Acute Malnutrition Among Children Aged 6- 59 Months Admitted At Lubango Pediatric Hospital, Angola

Abstract

About 9% of Sub Sahara Africa (SSA) children have moderate acute malnutrition and 2% of children in developing countries have Severe Acute Malnutrition (SAM). There is no such information about children to allow planning and implementation of nutrition interventions in Angola. The purpose of this study was to determine clinical, complementary feeding practices and socio-demographic risk factors associated with SAM among children admitted at Lubango Pediatric Hospital-Angola. The study adopted a case control study design and data was collected using an interviewer administered questionnaire, clinical examination and anthropometric measurements of the admitted children. In a matched case control study conducted between August 2014 and October 2014 a total of 163 participants (caregivers-child pairs) were recruited. A total of 53 severely malnourished cases aged between six months and five years and110 controls were concurrently recruited. The controls were age and sex matched and without severe acute malnutrition. The majority (52.7%) of the caregivers were single, lived in an urban setting 73.7% (120), were Christian 62.7%, while 55.2% accessed information from a Television (T.V) and 16.5% had no education with 58% getting an monthly income of more than 50USD. The children whose caretakers were single were 2.9 times more likely to have SAM compared to those whose caregivers were married (95% CI 1.50 – 6.15; p value =0.002), Children whose caregivers lived in urban settings when compared to those living in a rural setting, had significantly decreased odds of SAM (OR 0.16; 95% CI 0.08 – 0.35; p value<0.001). However, children from households that got food from the market had an increased odds for SAM of 1.75 times (95% CI 0.74 – 4.15).The children with a previous diagnosis of pneumonia, diarrhea and malnutrition had a significantly increased odds for SAM of 2.17 (95% CI 1.06 – 4.45; p value =0.035), 7.66 (95% CI 3.59 – 16.37; P<0.001) and 11.59 (95% CI 3.14 – 42.83; P<0.001) times respectively. There is need to explore the various socio - demographic characteristics such education level of caregivers among SAM children as well as a need to strengthen adequate availability and quality of foods from the rural settings. Further clinicians need to be proactive in making the accurate diagnosis and ensuring follow-up for children previously admitted for SAM and assessing their risk of malnutrition. For children with recurrent admissions, an assessment of malnutrition and family socio demographic status should be explored. The results findings serve as baseline data for health, policy makers and all stakeholders for designing interventions that can address the impact of SAM in Angola.