A case-control study of severe acute malnutrition in children in Tete (Mozambique)

Abstract

Introduction: Acute malnutrition is a highly prevalent disease and it is linked to a great deal of younger than 5-year-old children deaths. The knowledge in the scientific community about the pathogenesis and epidemiological context is not fully defined. There are few data about the social, economic, environmental features of acute malnutrition and its risk factors. Aims: To establish the risk factors related to severe and moderate acute malnutrition. To compare with the existent data about acute malnutrition and to carry out a comparative between the observed characteristics and those of the chronic form. To suggest actuation plans from this study’s conclusions. Material and methods: In Tete, Mozambique, a study of 69 patients’ cases and controls (23 cases and 46 controls) was carried out. Their ages went from 28 days to 5-year-old. Familial and maternal variables, medical and diet history and socio-environmental features of the child’s habitat were evaluated. Results: Risk factors were found to be the oldest maternal age now (p 0,001; OR=2,97 [CI95% 1,03 – 8,60] for those older than 24), the fact of having siblings (OR 7,39 [CI95% 1,55 – 35,33]; p 0,006), a bigger average of siblings (p 0,016) and the use of eating tools (p 0,045). As a protective factor, the fact of having had the first pregnancy at teenage (OR 0,233 [CI95% 0,074 – 0,738]; p 0,01). Conclusions: Acute malnutrition risk factors were found to be: at the maternal level, her oldest age; in the family structure, the fact of having siblings and the highest number of these; and regarding the eating habits, the use of tools when eating. As a protective factor, the fact of having had the first pregnancy at teenage. We confirm the hypothesis that there are multiple factors affecting the acute malnutrition development, and that action must start from the perinatal period, both at health and political levels. In order to be able to assess the differences between chronic and acute malnutrition risk factors, new studies will be needed: studies that determine in an isolated way the specific characteristics of each one of them.