Risk factors for the prevalence of malnutrition among urban children in Ghana.

Abstract

A case-control study was completed at the Princess Marie Louise Hospital in Accra, Ghana, to identify risk factors for the prevalence of underweight and severe malnutrition in urban African children. A total of 170 children, aged 8 to 36 mo, with normally nutritional status (≥80% W/A of NCHS reference), underweight (moderate malnutrition) (60-80% W/A), or severe malnutrition (<80% W/A and presence of edema, or <60% of W/A) were recruited at the clinical ward and at the public health service section of the hospital. Anthropometric measurements and physical examinations were completed, and the guardians were interviewed about their children's health status, birth weight, child care, and household conditions. The severely malnourished children were more likely to have young mothers (p<0.05) and low weight at birth (p<0.05). The under-weight children were also observed to have low birth weight (p<0.05). The severely malnourished group showed the tendencies of less feeding frequency (p<0.01), less access to breast-feeding (p<0.01), and less support by both parents (p<0.05). Moreover, the parents of the severely malnourished children had lower educational levels and lower-income jobs, compared with those of the normal children (mother's education, p<0.001; father's education, p<0.001; mother's occupation, p<0.05; father's occupation, p<0.001). No significant differences in most variables existed between the normal and underweight groups. Multivariable analysis resulted in the conclusion that the Z-score of weight-for-age, birth weight, and mother's educational level were highly associated with one another. We conclude that low birth weight is one of the important risk factors for the prevalence of underweight and severe malnutrition and that the lack of a mother's education is also a risk factor for the prevalence of severe malnutrition in the urban children in Ghana.