Risk Factors for Acute Malnutrition Among Children 6-36 Months Old Receiving a Dietary Supplement, South Darfur, Sudan Open Access

Abstract

Introduction: Despite dietary supplementation, refugees and internally displaced persons in Africa's Sahel are faced with a seasonal doubling of acute malnutrition. This study aims to determine risk factors for acute malnutrition during the hunger gap among 6-36 month old internally displaced persons receiving a dietary supplement for prevention of this outcome in South Darfur, Sudan.

Methods: A 6-month cohort study was conducted from March to October 2011 among 220 6-36 month olds in Gereida Internally Displaced Persons camp, South Darfur, Sudan. Anthropometric indicators of weight, height, and mid-upper arm circumference were collected along with information on illnesses and product adherence, and feeding of the child. This information was analyzed to determine risk factors associated with development of acute malnutrition.

Results: Among our study's participants, 24.8% developed acute malnutrition while receiving Plumpy'doz over the 6-month follow-up. Among children 6-12 months of age, 11/28 (39%) developed acute malnutrition. Those with diarrhea at baseline had 2.7 times the risk of becoming acutely malnourished when adjusting for age and gender (95% Confidence Interval 1.2, 6.4).

Discussion: Nearly 25% of this population developed acute malnutrition while receiving Plumpy'doz to prevent this outcome. Since our study found that risk of developing acute malnutrition was heightened among children who had diarrhea and were less than 1 year of age, it is important for humanitarian actors to consider these factors when implementing blanket supplementary feeding programs to prevent acute malnutrition during the hunger gap.

Table of Contents

MANUSCRIPT 1

ABSTRACT 1

INTRODUCTION 1

METHODS 3

Study Design 3

Measurements 3

Additional Variables 4

Data Analysis 4

ETHICAL CONSIDERATIONS 5

RESULTS 5

DISCUSSION 6

APPENDICES 8

APPENDIX A: FIGURES AND TABLES 8

APPENDIX B: LITERATURE REVIEW 11

Causes of Malnutrition 11

Causes of Severe Acute Malnutrition 14

Causes of Global Acute Malnutrition 17

Gaps in the Literature 20

APPENDIX C: DATA COLLECTION INSTRUMENTS 20

First Questionnaire 20

Follow-up Questionnaire 23

APPENDIX D: SUPPLEMENTAL ANALYSES 28

Mean Weight-for-Height Z-Score 28

Illness in Gereida Camp 31

APPENDIX E: SAS CODE 31

REFERENCES 42

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Nutrition Health Sciences, Public Health Health Sciences, Epidemiology
Keyword	Sudan emergency nutrition
Committee Chair / Thesis Advisor	Navarro Colorado, Carlos , Emory University
Committee Members	Sullivan, Kevin M, Emory University
Partnering Agencies	International Non-governmental organization (e.g., CARE, Inc.) CDC

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