Malnutrition and its Related Factors among Children under Five Years of Age

Background: Malnutrition is one of public health concerns among children leading to high morbidity and mortality. The present study aimed to determine the prevalence and the determinants of malnutrition among under-five-year-old children in Zahedan, Iran. Methods: This cross-sectional study included under-five children and their mothers who attended Zahedan comprehensive urban health centers. The participants were recruited from a quota sampling. Data on the characteristics of children and mothers were obtained from the child care records, and maternal reporting when necessary. Weight and height of children were measured according to the standard protocol by a trained person. Malnutrition was measured in terms of underweight, stunting and wasting. Multivariable logistic regression analysis and the area under the curve (AUC) were used to identify determinants of malnutrition. Results: A total of 825 mother-child pairs were included. Prevalence of underweight, stunting and wasting was 7.6%, 20.6% and 5.8%, respectively. The results of multivariable analysis revealed that underweight may be predicted by mother's education, low birth weight (LBW), birth interval, nutrition style, age of introduction of complementary feeding (AUC=0.75); stunting by sex, age, maternal age, father's education, family size, LBW, birth order and nutrition style (AUC=0.67) and wasting by sex, age, mother's education, LBW and nutrition style (AUC=0.72). LBW was a significant shared determinant in the nomograms with an odds ratio of over 2.00. Conclusion: Our findings demonstrate a moderate to high prevalence of malnutrition and identify a combination of parent's educational attainment, LBW, birth order, birth interval and nutritional practice as determinants of malnutrition among children under five years of age, in Zahedan.