Prevalence and factors associated with malnutrition among children aged 5- 17 years living in Nakivale Refugee Settlement, Isingiro district.

Abstract

Background: Hunger and malnutrition are rampant among refugees and displaced populations, many of whom are infants and children. These suffer from one or more of the multiple forms of malnutrition. Nakivale Refugee Settlement is one of the largest and oldest refugee settlements in Western Uganda. The nutritional status of children under 5 years in the settlement has improved over the years, but the nutritional status of the children above 5 years has never been assessed in the settlement, despite its importance in relation not only to physical health but also to cognitive capacity and educational achievements of children. Objective: To determine the prevalence and factors associated with malnutrition among children aged 5-17 years living in Nakivale refugee settlement, Isingiro district. Methods: A cross sectional study design was used and the study was carried out in Nakivale Refugee Settlement Isingiro district. Children aged 5 to 17 years found at home and consent obtained from their caregivers were enrolled. Data was collected with the aid of structured questionnaires administered to caregivers and children. The data collected was entered into Epi data 3.1 and analyzed using STATA version 14. The primary outcome was the prevalence of thinness, and was determined by calculating the total number of children with thinness over the total number of children studied. Secondary outcomes included the prevalence of stunting and underweight. Participant characteristics were summarized in a table using frequencies and percentages. Univariate analysis was used to summarize baseline characteristics and proportions. Bivariate analysis was used to test the association between thinness and independent variables; and then multiple logistic regression models of odds ratios were used to determine the factors associated with thinness at 95% Confidence interval and p< 0.05 level of significance. Results: A total of 420 children aged 5- 17 years were enrolled into the study; their median age (IQR) was 8.6 (5.0) and 248 (59.1%) were female. The prevalence of thinness was 5.5% [95% CI: 3.7%-8.1%]; of stunting was 24.3%; and of underweight was 8%. The factors independently associated with thinness were living with a chronic disease [aOR 6.47, 95%CI; 1.63 - 24.64, p= 0.008], use of water from natural sources [aOR 3.32, 95%CI; 1.27 - 8.71, p= 0.015], and duration of stay in the settlement of less or equal to 10 years [aOR 3.19, 95%CI; 1.15 - 8.83, p= 0.025]. Conclusion: The prevalence of thinness among children 5- 17 years in Nakivale refugee settlement at 5.5% is relatively high; and the factors associated with thinness were living with a chronic disease, use of water from natural sources and a shorter duration of stay in the settlement. On the other hand, 24 in every 100 children aged 5- 17 years in Nakivale are stunted, while 8 in every 100 children aged 5 – 10 years in the settlement are underweight. These findings imply that children with chronic disease should receive extra food supplementation and have routine growth monitoring as part of their chronic care.