Application of the Boruta Algorithm to assess the multi-dimensional determinants of malnutrition among children under five years living in southern Punjab, Pakistan

Author:

Saleem Javeria1,Zakar Rubeena1,Butt Muhammad Salman1,Aadil Rana Muhammad2,Ali Zulfiqar1,Bukhari Gul Mehar Javaid3,Ishaq Muhammad1,Fischer Florian4

Affiliation:

1. University of the Punjab

2. University of Agriculture

3. Federal Medical College

4. Institute of Public Health, Charité – Universitätsmedizin Berlin

Abstract

Abstract Background: A nutrient deficit caused by malnutrition has physical and clinical manifestations. Globally, there were 47 million wasted children under the age of five in 2019. One in four were located in sub-Saharan Africa, with half being in South Asia. This study aims to apply the Boruta algorithm to identify the determinants for malnutrition among children under five living in Dera Ghazi Khan one of the marginalized districts of densely populated Punjab province in Pakistan. Methods: A multicenter cross-sectional study design was used to collect data from 185 severe acute malnutrition children aged under five years visiting the OTPs centers located in Dera Ghazi Khan, Punjab, Pakistan. A purposive sampling technique was used to collect data using a pretested structured questionnaire from parents/caregivers regarding family sociodemographic characteristics, child nutrition, and biological and healthcare characteristics. Anthropometric measurements including height, weight, and mid-upper arm circumference were collected. The data was analyzed using the Boruta package in R studio. Results: This study included 185 children, with a mean age of 15.36 ± 10.23 months and had MUAC of 10.19 ± 0.96 cm. Boruta analysis identifies age, mid-upper arm circumference, weaning practices, and immunization status as significant determinants for weight-for-height prediction in children under five. The study identifies Boruta algorithm determinants for weight-for-age prediction, with MUAC and Income per month as confirmed. Under five age, income per month, exclusive breastfeeding and immunization status resulted as important determinants for undernutrition. Conclusion: Age, weaning methods, immunization status, and household income are all associated with malnutrition and undernutrition in children under five. Malnutrition must be addressed by collaborative efforts from all areas, including dietary knowledge and growth factors.

Publisher

Research Square Platform LLC

Reference31 articles.

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4. Levels and trends in child malnutrition: UNICEF/WHO/The World Bank. Group joint child malnutrition estimates: key findings of the 2021 edition. Available from: https://www.who.int/publications-detail-redirect/9789240025257.

5. PAKISTAN U. Key findings of National Nutrition Survey Pakistan. 2018; Available from: https://www.unicef.org/pakistan/media/1951/file/Final.

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