Risk factors of severe acute malnutrition in children aged 12 to 23 months. A case-control study in the Kabinda Health Zone, Lomami Province, Democratic Republic of Congo (DRC)

Abstract

Abstract Objective: To identify the risk factors of severe acute malnutrition (SAM) in children aged 12 to 23 months in the Kabinda health zone, Democratic Republic of Congo. Methods: We conducted an unmatched case-control study in a hospital setting. We enrolled 180 children (60 cases and 120 controls) aged 12 to 23 months admitted to the Kabinda general referral hospital in the Kabinda health zone between May and August 2023. Data were collected by interview of mothers/caregivers using an electronic questionnaire and by measuring the children's anthropometric parameters. The nutritional status of cases and controls was determined according to the 2006 WHO growth standards. Risk factors of severe acute malnutrition were identified using logistic regression by reporting the odds ratios and confidence intervals at the 95% threshold. A p-value < 0.05 was considered as the threshold for statistical significance. All analyzes were carried out using STATA 17 software. Results: In this study, the risk factors of SAM among 12 to 23 months olds were the initiation of complementary feeding before the age of 6 months (aOR = 2.93; 95% CI: [1.26 - 6.80] ; p = 0.012), household size greater than 5 members (aOR = 3.66; 95% CI: [1.61 - 8.28]; p = 0.002) and the household wealth index: very poor (aOR = 16.39; 95% CI: [3.19; 84.20]; p = 0.001), poor (aOR = 5.64; 95% CI: [1.07 - 29.56]; p = 0.041) and average households (aOR = 5.75; 95% CI: [1.09 - 30.31]; p = 0.039). Conclusion: The study identified household size, household wealth index and initiation of complementary feeding before 6 months of age as risk factors of SAM among children aged 12 to 23 months. A multisectoral approach is necessary for the implementation of intervention strategies aimed at improving the socioeconomic level of households, family planning and the promotion among mothers of good infant and young child feeding practices in order to have an impact more important on the SAM situation.