• S O Ayaya, F O Esamai, J Rotich, and A R Olwambula.
• Department of Child Health and Paediatrics, Faculty of Health Sciences, Moi University, Eldoret, Kenya.
• East Afr Med J. 2004 Aug 1; 81 (8): 415-21.

BackgroundMalnutrition is one of the leading causes of morbidity and mortality in children aged five years and below. Risk factors for severe protein energy malnutrition (PEM) have been identified as ignorance, family size, mothers and fathers education, poverty, residence, chronic infections, and congenital defects or malformations. The role of such social factors as the caretaker, extended family, homestead surroundings, and family cohesiveness have not been studied in Kenya.ObjectiveTo determine the social and economic factors that predispose children to severe PEM as seen at the Moi Teaching and Referral Hospital (MTRH), Eldoret.DesignProspective and case control study.SettingThe MTRH, Eldoret, Paediatric wards, outpatient and MCH clinics over a 12 month period (June 2001 to June 2002).SubjectsSixty six children aged 3 to 36 months with severe PEM attending the MTRH outpatient clinics and those admitted in the Paediatric wards were age-matched with 66 controls.MethodsA standard pretested questionnaire was used to interview caretakers with severely malnourished children and age-matched controls. The children were weighed after interviewing the caretakers. The data was entered on a computer and analysed using the statistical package for social sciences (SPSS) programme.ResultsThe social risk factors for PEM were single mothers (Odds Ratio) OR 14.93, p= 0.00001), young mothers aged 15-25 years (OR 3.95, p= 0.00020), the child's living conditions such as living in a temporary house (OR 3.627 p= 0.00257), caretaker who was not married to the child's parent (OR 0.10, p= 0.00005) and not staying with both parents in the past six months (OR 0.28606, p=0.00101). The economic risk factors were father's lack of ownership of land (OR 0.401, p= 0.01732), cattle (OR 0.24, p=0.00022), not growing maize (OR 0.15, p=0.00013), not growing beans (OR 0.36, p=0.00484) and ownership of small piece of land by grandfather (OR 6.00, p= 0.02274). Other risk factors were incomplete immunization (OR 3.87, p= 0.00151) and female sex (p=0.03721).ConclusionPoverty, social conditions under which the child was living, sex of the child and incomplete immunizations were risk factors for the severe protein energy malnutrition.

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