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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
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).