Determinants of acute malnutrition among children under five in arid regions, Kenya

Acute malnutrition, defined as a weight-for-height Z-score below -2 standard deviations of the WHO growth standards, is prevalent among children in low- and middle-income countries. Our study aimed to identify immediate, underlying, and basic determinants of acute malnutrition among children in Turkana and Samburu, two arid and semi-arid regions in Kenya. Data are from a longitudinal study that recruited children under 3 years of age, with follow-up every 4 months over six waves. Generalized estimating equations were used to assess risk factors of acute malnutrition in this population. Among immediate factors, children who recently experienced diarrhea had 19% and 23% higher odds of acute malnutrition and those who consumed animal-source foods had 12% and 22% lower odds of acute malnutrition in Turkana and Samburu, respectively. Among underlying factors, children in Turkana whose caregivers used alcohol had 32% higher odds of acute malnutrition. Among basic factors, children in Turkana whose caregivers had 3-5 or 6 or more children had 39% and 70% higher odds, whereas those in female-headed households had 34% and 81% higher odds of acute malnutrition in Turkana and Samburu, respectively. Children in Turkanas fisherfolk communities had 36% higher odds of acute malnutrition compared with those in urban or peri-urban areas. Key risk factors for acute malnutrition included child diarrhea, caregivers use of alcohol (in Turkana), caregivers number of children, female-headed households, and fisherfolk livelihood (in Turkana), while consuming animal-source foods was associated with lower risk. Interventions should target these intersecting factors to reduce acute malnutrition in these counties. Key messagesO_LIAcute malnutrition in children under 5 years is persistent in East Africas arid and semi-arid lands. C_LIO_LIAmong immediate factors, children who had diarrhea were more likely to have acute malnutrition, while those who consumed animal-source foods were less likely to have acute malnutrition in both counties. C_LIO_LIAmong underlying factors, children whose caregivers used alcohol were more likely to have acute malnutrition in Turkana only. Household food insecurity and water, sanitation, and hygiene were not directly associated with acute malnutrition. C_LIO_LIA variety of basic factors were associated with a higher likelihood of acute malnutrition, including number of children in the household, the household being headed by a female, and fisherfolk livelihood (in Turkana). C_LI