Factors influencing the pattern of malnutrition among acutely ill children presenting in a tertiary hospital in Nigeria

Abstract

Introduction: The burden of childhood malnutrition in Nigeria has remained unchanged for nearly a decade between the two Demographic and Health Surveys (NDHS) of 2003 and 2008.The causes of malnutrition are complex and multifactorial. It results from the interplay of socioeconomic, dietary inadequacy and environmental factors. Objective: To describe factors that influence the pattern of malnutrition in acutely ill children in a tertiary Hospital in central Nigeria. Methods: Cross sectional and descriptive study. Children aged 6 to 59 months presenting with acute illnesses to the paediatric emergency unit were concurrently recruited over a 7 month period, (April-October 2012). All had comprehensive clinical assessment done including anthropometric (weight, mid arm circumference, height/length) measurements and z-scores calculated for the individual nutritional characteristics. Results: A total of 379 children were recruited with a mean age of 21.7±13.9 months. There was no difference in the mean age between male and female (P=0.8). The prevalence of wasting was (26.9%), (18%) for stunting and (18.9%) for underweight. The prevalence of severe wasting, WHz scores <-3SD was (5.9%), (5.4%) for stunting and (4.6%) for underweight. The highest prevalence of wasting and stunting were in age groups 6-11 and 12-23 months, at 9.3% and 6.3% respectively.The factors associated with malnutrition included early introduction of complementary diets, number of children in the home, maternal illiteracy and lower socioeconomic status of the parents. Female children were commenced on complementary diets much earlier than male (P=0.01). Conclusion: This study demonstrates the association between childhood malnutrition and factors such as early initiation of complementary diet, maternal illiteracy, number of children in the home and poor parental socioeconomic status.