Abstract
Background: Malnutrition, especially in children, is a real
problem that grips humanity, preventing many individuals, even entire
societies, from realizing their full potential (Briend, 1997).
It remains a public health problem among vulnerable groups in
the Democratic Republic of Congo (DRC), which constitute young children,
pregnant women and breastfeeding women in particular.
Indeed, one in four children under five, or 146 million
children in developing countries, is underweight for their age, which increases
their risk of premature death (PEBN, 2006). Because malnutrition prevents these
children from reaching their full physical and mental potential. Health and
physical consequences of prolonged states of malnutrition in children:
retardation of their physical growth and motor development; Lower intelligence
quotient (IQ), greater behavioral problems and poor social skills,
susceptibility to disease (FAO, 2008; R Black, 2003).
The DRC (Congo) is one of the countries affected by
malnutrition (mortality) of children under five, aggravated by undernutrition
(Mukalay AM et al, 2009).
Also, we are concerned through this study to determine the
various factors associated with the malnutrition of children under five in the
DRC.
Objectives : The purpose of this study is to determine the
factors associated with the malnutrition of children under five years old
between 2013-2014, in the DRC. To achieve this, we have defined the following
specific objectives: determine the prevalence of malnutrition in children under
five in the DRC, to be distributed in each province between 2013-2014, identify
the factors associated with chronic malnutrition in children under five less
than five years between 2013-2014, in the DRC.
Methods: To better achieve the objective we have set for
ourselves, we have opted for a modeling of a polytomous response (multinomial
logistic regression) in order to identify the different determinants of chronic
malnutrition in children under five, in DR. Congo. We carried out this study on
the data collected in a cross-sectional manner using retrospective data through
the 2013-2014 DHS database, because this survey meets all the criteria of a
probability sampling of mothers of children under five. years and their own
children in DR Congo. After
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processing the data from this database, we selected a sample
of 8,059 statistical units. These data were analyzed using SPSS Version 25, R
and Stata12 software.
Results: The first specific objective of this study was to
determine the prevalence of malnutrition in children under five in the DRC, to
be distributed in each province between 20132014, after analyzing the data, it
was found that the prevalence of severe chronic malnutrition was 30% in the
DRC, i.e. the province of South Kivu presented the highest prevalence (33.7%),
while the province of Kinshasa presented a low prevalence with (3.5% ).
Moderate chronic malnutrition showed that the DRC has a prevalence of (20.77%),
the highest prevalence was observed in the province of Sankuru with 28.4% and
the lowest prevalence was observed in the province of Kinshasa with (10.7%).
Regarding mild chronic malnutrition, the DRC presented a prevalence of (22.30),
i.e. a high presence was observed in the province of Equateur with (26.7%)
while the low prevalence was observed in the province of Sankuru with (15.8%).
Based on these results, the first objective has been achieved.
The second specific objective was to identify the factors
associated with the different variants of chronic malnutrition in children
under 5 years 2013-2014 in the DRC. Here it is shown that children in rural
areas have 26% more risk of developing severe malnutrition than those in urban
areas, OR: 1.26 (1.04-1.52), low level of education (illiterate ) has 3.09
times more risk of developing severe chronic malnutrition than high school and
university level, OR: 3.09 (2.114.55), male children have 59% more risk of
suffering of severe chronic malnutrition than female children, OR: 1.59
(1.40-1.81), vaccination status revealed a statistically significant
relationship with chronic malnutrition, unvaccinated have 28% lower risk to
suffer from moderate chronic malnutrition than vaccinated children, OR: 0.72
(0.58-0.90). It is shown that with each increase in one month, children have a
59% greater risk of developing severe chronic malnutrition, OR: 1.59
(1.39-1.81). Children living in the south-eastern provinces are 7.75 times more
likely to suffer from severe chronic malnutrition than those living in the
province of Kinshasa (4.4313.57). Mothers with an inter-reproductive interval =
24 months have a 44% greater risk of suffering from severe chronic malnutrition
than children of mothers with an inter-reproductive interval> 24 months, OR:
1.44 (1.23-1.68), children of poor parents are 83% more likely to develop
severe chronic malnutrition than children of rich parents, OR: 1.83
(1.50-2.24). Finally, the age of the mother is associated with the appearance
of chronic malnutrition, with each increase of one year of the mother, the
children have 3% less risk of severe malnutrition, OR: 0.97 (0.96-0.99). From
all of the above, this second goal has been well achieved.
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Conclusion: This study identified the following determinants
of chronic malnutrition: children living in rural areas, the mother's low level
of education, the child's male sex, and the child's age. Vaccinated children,
central and south-eastern provinces of the DRC, the inter-reproductive interval
= 24 months, low income level, and finally, younger mothers. Improving the
socioeconomic, cultural and health conditions of the people of the DRC would
reduce chronic malnutrition among children under five.
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