| Informing the management of acute malnutrition in infants aged under 6 months (MAMI): risk factor analysis using nationally representative demographic & health survey secondary data |
| Authors: |
Marko Kerac, Severine Frison, Nichola Connell, Bethan Page, and Marie McGrath |
| Source: |
PeerJ, 6: e5848; DOI 10.7717/peerj.5848 |
| Topic(s): |
Child health
Infant mortality
Nutrition
|
| Country: |
More than one region
Multiple Regions
|
| Published: |
APR 2019 |
| Abstract: |
Background: Tackling malnutrition is a global health priority, helping children both
survive and thrive. Acute malnutrition (wasting) in infants aged under 6 months
(u6m) is often neglected. Worldwide, some 8.5 million infants u6m are affected
yet recent World Health Organization malnutrition guidelines highlight numerous
evidence gaps on how to best manage them. To inform future research, policy
and programming, we aimed to identify risk factors associated with infant u6m
wasting.
Methods: We did secondary data analysis of nationally representative, cross
sectional Demographic and Health Surveys conducted in the last 10 years.
We compared wasted infants u6m (weight-for-length <-2 z-scores) vs. non-wasted
(weight-for-length ?-2 z-score). We used simple and adjusted (for infant age,
sex, socio-economic status) logistic regression to calculate odds of wasting
associated with risk factors spanning three broad categories: household-related;
maternal-related; infant-related.
Results: We analysed 16,123 infants u6m from 20 countries. Multiple risk factors
were statistically associated with wasting. These included: poverty (Odds ratio,
OR 1.22 (95% CI [1.01–1.48], p = 0.04)); low maternal body mass index (adjusted
OR 1.53(1.29–1.80, p < 0.001); small infant size at birth (aOR 1.32(1.10–1.58,
p < 0.01)); delayed start of breastfeeding (aOR 1.31(1.13–1.51, p < 0.001));
prelacteal feed (aOR 1.34(1.18–1.53, p < 0.001)); recent history of diarrhoea
(aOR 1.37(1.12–1.67, p < 0.01)); mother disempowered (experiences violence;
does not make decisions about health issues; does not engage with health services
such as antenatal care, does not give birth in a health facility). ‘Protective’ factors
associated with signi?cantly decreased odds of infant u6m wasting included: educated
mother (OR 0.64(0 .54–0.76, p < 0.001 )); mother in work (OR 0.82(0.72–0.94,
p < 0.01)); currently breastf ed (aOR 0.62(0. 42–0.91, p = 0.02)), exclusi vely breastf ed
(aOR 0.84(0.73–0.97, p =0.02). |
| Web: |
http://www.readcube.com/articles/10.7717/peerj.5848 |
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