Determinants of severe acute malnutrition among under 5 children in Satar community of Jhapa, Nepal

Abstract

Background Severe acute malnutrition (SAM) is the most extreme and visible form of undernutrition plagued by chronic poverty, household food insecurity, lack of education. One of the indigenous and marginalized community of Nepal, Satar/Santhal has often been neglected and is devoid of good education and are economically deprived. This predisposes under 5 children of Satar into malnutrition. The study aims to assess determinants of SAM among children under 5 years of age in Satar community of Jhapa district, Nepal. Material & methods A community based matched case control study was carried from September 2019 to February 2020 among under five children of Satar community residing in Jhapa district. Multistage random sampling technique was used to select 50 cases and 100 controls in the ratio of 1:2. Information was collected through personal interview with the parents and anthropometric measurement of the children was measured. Bivariate and multivariate conditional logistic regression analysis was used to explore the determinants of severe acute malnutrition. Results A total of 664 children between the age group of 6–59 months were screened for SAM. The prevalence of SAM was found 7.53%. Factors like, low economic status, birth interval less than 2 years, frequency of breast feeding <8 times/day and household food insecurity were found to be significant determinants of SAM. Multivariate logistic regression documented low economic status (AOR: 11.14, 95% CI 1.42 to 87.46); and frequency of breast feeding <8 times/day (AOR: 2.09, 95% CI 1.00 to 4.37) as determinants of SAM. Conclusion Low economic status and frequency of breast feeding less than 8times/day were major determinants of SAM among children under 5yrs of age. Ending malnutrition will require greater efforts and integrated approaches to eradicate extreme poverty. Multi-sector approaches have been conducting for SAM in Nepal but there are no specific approaches for marginalized community.

Risk factors associated with Severe Acute Malnutrition (SAM) in children aged 6 – 59 months in the Mokolo Health District, Far North region of Cameroon

“…This could also be due to the early or late introduction of adequate complementary feeding and lack of adherence to proper hygiene practices in mitigating the risk of SAM among infants. The findings of this study resonate with prior research, such as that conducted by Dahal et al 8 who similarly observed a heightened prevalence of malnutrition among children aged 6 to 12 months compared to their older counterparts (24 to 59 months) in a community-based matched case-control study. Moreover, maternal educational attainment emerged as a significant determinant of SAM.…”

“…Economic status stands as a fundamental determinant of malnutrition and serves as a pathway to various underlying causes. In a community-based matched case-control study, Dahal et al 8 identified low economic status, birth intervals of less than 2 years, breastfeeding frequency of less than 8 times per day and household food insecurity as significant determinants of SAM. Similarly, a study conducted in the Bara district of Nepal, found that maternal age at birth (<20 years) and short birth intervals (<12 months) were associated with SAM 9 .…”

Factors Associated With Severe Acute Malnutrition Among Children Aged 6 Months to 59 Months Attending Moroto Regional Referral Hospital Moroto Municipality. A Cross-Sectional Study.

“…Also, the lack of adequate nutrition in mothers limits sufficient milk production to feed their children per requirements. These findings are in agreement with those found by Dahal K et al, 2021) in the community-based matched case control in the Satar community of Jhapa Nepal where a total of 664 children aged 6 months to 59 months were screened for SAM frequency of feeding less than 8 times a day was found to be determinant of SAM.…”

Effects of short birth interval on child malnutrition in the Asia‐Pacific region: Evidence from a systematic review and meta‐analysis

“…Among the 56 studies included in this review, the largest proportion of studies were conducted in Bangladesh ( n = 20 studies) (Akram et al, 2018; Anwar et al, 2013; Bhowmik & Das, 2017, 2019; Das & Hossain, 2008; Das & Rahman, 2011; Das et al, 2020; Goyal & Canning, 2018; Huda et al, 2018; Islam & Biswas, 2020; Kamal & Moniruzzaman, 2021a; Khan & Gulshan, 2020; Khan & Raza, 2014; Khan et al, 2021; Mozumder et al, 2000; Rayhan & Khan, 2006; Siddiqi et al, 2011; Sultana et al, 2019; Talukder, 2017; Talukder et al, 2018). The second most common country was India ( n = 18 studies) (Ansuya et al, 2018; Ashok et al, 2015; Basit, 2012; Bharathi, 2021; Chungkham et al, 2020; Gupta & Santhya, 2020; Ishwarji et al, 2018; Khan & Raza, 2016; Patel et al, 2021; Rachana et al, 2020; Rajaram et al, 2003; Rana et al, 2021; Sengupta et al, 2010; Singh et al, 2017; Sk et al, 2021; Som et al, 2006, 2007; Yadav & Nilima, 2021), followed by Nepal ( n = 7 studies) (Adhikari et al, 2017; Alelign et al, 2015; Dahal et al, 2021; Hanley‐Cook et al, 2022; Karki et al, 2021; Pravana et al, 2017; Tiwari et al, 2020) (see Supporting Information S1: Table S6). Additionally, 11 studies were conducted in multiple countries (Achakzai & Khan, 2016; Angeles‐Agdeppa et al, 2019; Farid‐ul‐Hasnain & Sophie, 2010; Gribble et al, 2009; Ikeda et al, 2013; Mendes Kiik & Saleh Nuwa,…”

“…The second most common country was India (n = 18 studies) (Ansuya et al, 2018;Ashok et al, 2015;Basit, 2012;Bharathi, 2021;Chungkham et al, 2020;Gupta & Santhya, 2020;Ishwarji et al, 2018;Khan & Raza, 2016;Patel et al, 2021;Rachana et al, 2020;Rajaram et al, 2003;Rana et al, 2021;Sengupta et al, 2010;Singh et al, 2017;Sk et al, 2021;Som et al, 2006Som et al, , 2007Yadav & Nilima, 2021), followed by Nepal (n = 7 studies) (Adhikari et al, 2017;Alelign et al, 2015;Dahal et al, 2021;Hanley-Cook et al, 2022;Karki et al, 2021;Pravana et al, 2017;Tiwari et al, 2020) (see Supporting Information S1: Table S6). Additionally, 11 studies were conducted in multiple countries (Achakzai & Khan, 2016;Angeles-Agdeppa et al, 2019;Farid-ul-Hasnain & Sophie, 2010;Gribble et al, 2009;Ikeda et al, 2013;Mendes Kiik & Saleh Nuwa, 2021; F I G U R E 1 Schematic presentation of the studies included and excluded in the systematic review.…”