Factors associated with malnutrition in children < 5 years in western Kenya: a hospital-based unmatched case control study

Background: Globally, under-nutrition accounts for > 3 million deaths annually among children < 5 years, with Kenya having similar to 35,000 deaths. This study aimed to identify factors associated with malnutrition in children aged < 5 years in western Kenya. Methods: We conducted a hospital-based unmatched case-control study between May and June 2017. Cases were defined as children aged 6-59 months with either z-score for weight-for-height <= -2SD or >= +2SD; weight-for-age <= -2SD or >= +2SD; or height-for-age <= -2SD. Controls were children aged 6-59 months with age-appropriate anthropometric measurements. Cases were consecutively recruited while systematic random sampling was used to select controls. Data from interviews and clinical records were collected and entered into Epi-Info, which was used to run unconditional logistic regression analyses. Results: A total of 94 cases and 281 controls were recruited. Of the cases, 84% (79/94) were under-nourished. Mother not having attended ante-natal clinic (OR = 7.9; 95% CI: 1.5-41.2), deworming (OR = 0.8; 95% CI: 0.4-1.2), and pre-lacteal feeding (OR = 1.8; 95% CI: 1.1-3.0) were associated with under-nutrition. Delayed developmental milestones (AOR = 13.9; 95% CI: 2.8-68.6); low birth weight (AOR = 3.3; 95% CI: 1.4-7.6), and paternal lack of formal education (AOR = 4.9; 95% CI: 1.3-18.9) were independently associated with under-nutrition. Conclusion: Proper pre-natal care, child feeding practices and deworming programs should be enhanced to reduce pediatric malnutrition.