Study of Factors Associated with the Occurrence of Severe Acute Malnutrition in Children Aged 6 to 59 Months in the Hina Health District, Far North Region of Cameroon

Study of Factors Associated with the Occurrence of Severe Acute Malnutrition in Children Aged 6 to 59 Months in the Hina Health District, Far North Region of Cameroon | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Study of Factors Associated with the Occurrence of Severe Acute Malnutrition in Children Aged 6 to 59 Months in the Hina Health District, Far North Region of Cameroon Etoile Brillant KOUAM, Ghislain MAFFO TAZOHO, Alex ONGLA NDJEBAYE, and 5 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7811233/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 12 You are reading this latest preprint version Abstract Severe acute malnutrition (SAM) remains a major public health issue in developing countries, particularly affecting children under five years of age. This study aimed to identify risk factors associated with the occurrence of SAM among children aged 6 to 59 months in the Hina Health District. A case-control study was conducted from May 15 to June 30, 2023, involving 65 mother-child pairs (malnourished and well-nourished children) recruited from health facilities. Sociodemographic, clinical, nutritional, and hygiene-related data were collected using a standardized questionnaire and analyzed with SPSS Statistics 26 and Epi-Info. Statistical associations were assessed through multivariate logistic regression to estimate odds ratios (ORs) with 95% confidence intervals (CI). The results revealed that sociodemographic factors such as lack of maternal education (P < 0.001; OR = 19.5), child age between 12 and 23 months (P < 0.001; OR = 7.77), female sex (P < 0.001; OR = 11.40), and household size greater than 10 (P = 0.001; OR = 7.09), as well as clinical factors such as home delivery (P < 0.001; OR = 6.21) and recent diarrhea (P < 0.001; OR = 10.13), were significantly associated with SAM. Nutritional and hygiene practices, including the use of plain maize or millet porridge as complementary feeding (P < 0.001; OR = 7.50) and lack of maternal knowledge about dietary diversification (P < 0.001; OR = 28.88), also showed strong associations. In conclusion, this study highlights key sociodemographic, clinical, and nutritional determinants that should be targeted through preventive interventions to reduce the burden of severe acute malnutrition in this health district of Cameroon. Severe acute malnutrition risk factors children aged 6 to 59 months Hina Far North Region of Cameroon Figures Figure 1 1. Introduction Malnutrition is a major public health concern in many countries worldwide and is recognized as a priority within the Sustainable Development Goals. It refers to deficiencies, excesses, or imbalances in the energy and/or nutrient intake of an individual (UNICEF, 2021), and is associated with serious consequences for child survival, impairing cognitive and physical development, as well as the economic productivity of individuals and society (Pravana et al. , 2017; David et al. , 2020). According to the World Health Organization (WHO, 2020), 159 million children under the age of five were stunted, 45 million were wasted, and 38.9 million were overweight, with 45% of deaths among children under five linked to malnutrition. Children suffering from severe acute malnutrition are nine times more likely to die than their well-nourished counterparts. The United Nations estimates that approximately one million children under five die each year from SAM (UNICEF, 2019 ). In Cameroon, prevalence rates recorded in 2018 were 11%, 29%, 4%, and 11% for underweight, stunting, wasting, and overweight respectively among children under five years of age, with approximately 20% suffering from diarrhea (INS and ICF, 2020). In 2019, the World Food Program (WFP) and the Cameroonian government launched a Blanket Supplementary Feeding Program (BSFP) in the Far North Region as an operational platform to deliver multiple services, including household food assistance, specialized nutritious foods, social and behavior change communication, healthcare, and water, sanitation, and hygiene (Ndah et al. , 2024). This program targeted children aged 6 to 24 months and aimed to prevent malnutrition in general, and severe acute malnutrition (SAM) in particular. Several other interventions have been implemented in the region to combat malnutrition. Despite the deployment of these programs, malnutrition remains a serious threat to the survival of children under five in the Far North Region, with 38.2% affected and 1.4% suffering from SAM (UNICEF & UNHCR, 2021). Although this prevalence is high, few studies have been conducted to assess the factors associated with the risk of developing SAM. As part of efforts to prevent severe acute malnutrition (SAM), several studies have been conducted in developing countries to identify its determinants. In Nepal, Dahal et al. ( 2021 ) demonstrated that a household size greater than five members is a factor associated with SAM. Furthermore, Pravana et al. ( 2017 ) reported that non-exclusive breastfeeding, delayed introduction of complementary foods, recent episodes of diarrhea, and low birth weight are significant risk factors for malnutrition in children. In Ethiopia, Awoke et al. ( 2018 ) and Endris et al. ( 2017 ) identified child age, birth interval, and maternal education level as independent determinants. In Bangladesh, Musa et al. ( 2017 ) highlighted paternal low educational attainment, fewer than three meals per day, and lack of regular handwashing practices. Finally, in India, David et al. ( 2020 ) confirmed the importance of complementary feeding and hygiene practices as associated factors. These various studies underscore that SAM is a multifactorial condition influenced by socioeconomic, clinical, nutritional, and hygiene-related factors. However, cultural and environmental variations necessitate country-specific investigations. In Cameroon, few studies have addressed this issue, and those that exist are geographically limited. Agbor et al. (2021), in the Tolle health area (Southwest Region), demonstrated that SAM was associated with child age, lack of vaccination, poor feeding practices, and household size. More recently, Ndah et al. ( 2024 ), in the Mokolo Health District (Far North Region), identified male sex, age between 6 and 12 months, gastroenteritis, malaria, pneumonia, absence of exclusive breastfeeding, delayed introduction of complementary feeding, poor dietary diversification, and the use of traditional herbal decoctions as associated factors. These findings reveal significant regional disparities, making national generalization difficult and highlighting the need to investigate additional districts. In this context, the present study aimed to identify factors associated with SAM among children aged 6 to 59 months in the Hina Health District, Far North Region of Cameroon, in order to provide evidence-based insights for the planning of targeted preventive interventions. 2. Materials and Methods 2.1. Study Setting and Period This study was conducted over a period from May 15 to June 30, 2023, corresponding to a duration of six weeks. Hina is a municipality and administrative subdivision of the Mayo-Tsanaga Division in the Far North Region of Cameroon. It is bordered to the north by Mokolo, to the south by Guider (Mayo-Louti Division, North Region), to the east by Ndoukoula, and to the west by Bourha. The total population is estimated at 153,000 inhabitants (MINSANTE, 2023). The Hina Health District comprises thirteen health areas. For this study, data were collected from five health areas: Gamdougoum, Zidim, Bering, Boula, and Gawar selected based on their high prevalence of malnutrition.. 2.2- Target Population and Sampling Method The target population consisted of mother–child pairs, with children aged 6 to 59 months, who attended consultations at health centers within the Hina Health District. Inclusion criteria encompassed all children aged 6 to 59 months, whether suffering from severe acute malnutrition (SAM) with or without complications, accompanied by their mothers. Participation required either written or verbal informed consent from the mothers. A non-probability sampling approach was employed. Selection of eligible mother–child pairs was based on simple random sampling. The sample size was calculated using a statistical formula as described by Charan and Biswas ( 2013 ). $$\:{\varvec{n}}^{2}={\varvec{t}}^{2}\frac{\varvec{p}(1-\varvec{p})}{{\varvec{m}}^{2}}$$ With: n = required sample size t = reliability coefficient at a 95% confidence interval P = prevalence of 1.4% of Severe Acute Malnutrition (SAM) in 2019 in the Far North region of Cameroon (UNICEF & UNHCR, 2021) m = margin of error set at 5% (standard value: 0.05) Using this formula, the minimum sample size was determined to be 21 participants. For the purposes of this study, a sample of 65 participants was collected, including 21 malnourished and 44 non-malnourished individuals. 2.3- Data Collection Tools and Methods The tools used for data collection included: A structured questionnaire designed to gather sociodemographic information, clinical data, and both nutritional and non-nutritional practices from mothers of children. A MUAC (Mid-Upper Arm Circumference) tape to assess the nutritional status of children aged 6 to 59 months, in accordance with the 2017 National Protocol for the Integrated Management of Acute Malnutrition (IMAM). After explaining the purpose of the study to the mothers and obtaining informed consent using a pre-designed consent form, the children's mid-upper arm circumference was measured using the MUAC tape. Subsequently, the questionnaire was administered orally through guided interviews. In cases where mothers did not speak any official language, a translator was employed to facilitate communication. Responses were recorded accordingly. Following data collection, the mothers were gathered for a nutrition education session focused on infant and young child feeding practices, as well as proper hygiene behaviors. 2.4- Ethical Considerations This study was conducted within the framework of the NGO Helen Keller INTL Cameroon and was therefore subject to the organization's core values and ethical principles. Administrative authorization No. 383/L/MINSANTE/SG.DRSPEN/SAG for data collection was obtained from the Regional Delegation of Public Health of the Far North. To ensure participant anonymity, identification numbers were used on each questionnaire instead of names. Verbal consent was obtained from all participants prior to administering the questionnaire, and the purpose of the study was clearly explained to them. Privacy and confidentiality of the collected information were strictly upheld at all stages of the research process. 2.5- Statistical Analysis The questionnaire was designed using Sphinx Lexica software. Statistical analyses were performed using SPSS version 26 and Epi Info. Descriptive analyses were conducted to characterize the sociodemographic profile of the mother–child pairs, as well as clinical data, nutritional and non-nutritional practices. Means and standard deviations were reported for normally distributed continuous variables, while categorical variables were expressed as proportions. Chi-square tests were used to assess associations between Severe Acute Malnutrition (SAM) and sociodemographic, dietary, and non-dietary characteristics. Odds ratios with confidence intervals were calculated to identify potential risk factors. 3. Results 3.1- Description of Participants’ Sociodemographic Characteristics Table 1 shows that the majority of children were female (60%), compared to 40% male. The most represented age group was 6–11 months (43.1%), followed by 12–23 months (35.4%) and 24–59 months (21.5%), with a mean age of 16.43 ± 9.03 months. Mothers ranged in age from 14 to 46 years, with the highest proportion in the 21–30 age group (50.8%), followed by 31–40 years (29.2%). In terms of education, 30.8% had never attended school, 44.6% had completed primary education, and 24.6% had reached secondary level. Regarding marital status, 86.2% of women were married, of whom 59.6% were in polygamous unions and 40.4% in monogamous ones; 10.8% were single and 3.1% divorced. Religiously, the distribution was relatively balanced: 50.8% Muslim, 47.7% Christian, and 1.5% Animist. The majority of participants resided in rural areas (78.5%), compared to 21.5% in urban settings. The primary occupation among mothers was homemaking (63.1%), followed by farming (24.6%), trading (9.2%), and civil service (3.1%). Regarding spouses, agriculture was the predominant occupation (46.2%), followed by commerce (26.2%). Additionally, 10.8% were unemployed, while others worked as civil servants (4.6%) or masons (1.5%). At the household level, 41.5% of mothers had between four and five children, 20% had more than five, 20% had two to three children, and 18.5% had only one child. Among mothers with at least two children, the most common birth interval was two years (58%). Household size varied, with most families comprising 3 to 5 members (50.5%), followed by 5 to 10 members (26.2%) and more than 10 members (23.1%). Tableau 1: Sociodemographic Characteristics of the Participants Variables Frequency (N=65) Percentage Child’s Age Group 06 to 11 months 28 43,1% 12 to 23 months 23 35,4% 24 to 59 months 14 21,5% Child’s Age (In months) Minimum 06 Maximum 42 Mean ± SD 16,43±9,03 Median 14 Child’s sex Male 26 40% Female 39 60% Mother’s education level Never attended school 20 30,8% Primary 29 44,6% Secondary 16 24,6% Marital status Single 07 10,8% Married 56 86,2% Divorced 02 3,1% Type of marriage Polygamous 34 59,64% Monogamous 23 40,35% Residential area Urban 14 21,5% Rural 51 78,5% Mothers’s occupation Homemaker 41 63,1% Trader 06 9,2% Farmer 16 24,6% Civil servant 02 3,1% Mother’s religion Christian 31 47,7% Muslim 33 50,8% Animist 01 1,5% Mother’s Age group (years) 10-20 09 13,8% 21-30 33 50,8% 31-40 19 29,2% >40 04 6,2% Mother’s Age Minimum 14 ans Maximum 46 ans Mean ± SD 27,92±7,66 Median 27 Father’s occupation Unemployed 07 10,8% Civil servant 03 4,6% Trader 17 26,2% Farmer 30 46,2% Mason 01 1,5% HOUSEHOLD CHARACTERISTICS Number of children per mother 01 child 12 18,5% 2-3 children 13 20% 4-5 children 27 41,5% More than 5 children 13 20% Birth interval 1 year 14 26% 2 years 30 58% 3 years 07 14% More than 3 years 02 4% Household size 3-5 members 33 50,5% 5-10 members 17 26,2% More than 10 members 15 23,1% 3.2- Impact of Sociodemographic Factors on Severe Acute Malnutrition Among Children Aged 6 to 59 Months in the Hina Health District Table 2 illustrates the association between sociodemographic characteristics of mother–child pairs and the nutritional status of children aged 6 to 59 months in the Hina Health District. Bivariate analysis revealed statistically significant associations between severe acute malnutrition (SAM) and the following factors: child age group 12–23 months (p < 0.001), female sex (p < 0.001), lack of maternal education (p < 0.001), and households with more than 10 members (p = 0.001). These factors respectively increased the risk of SAM by odds ratios of 7.77, 11.40, 19.50, and 7.09. Tableau 2: Relationship Between Sociodemographic Factors and Severe Acute Malnutrition Among Children Aged 6 to 59 Months in the Hina Health District Risk factors Nutritional Status Adjustments Case : n=21 (%) Control : n=44 (%) OR (95% CI) P value Child’s Age Group 06 to 11 months 04 (14,28) 24 (85,72) 0,19 (0,05-0,67) 0,006 12 to 23 months 14 (60,8) 09 (39,2) 7,77 (2,42-24,96) <0,001 24 to 59 months 03 (21,42) 11 (78,58) 1 Child’s sex Male 02 (7,69) 24 (92,31) 1 Female 19 (48,71) 20 (51,29) 11,40 (2,36-54,97) <0,001 Mother’s education level Never attended school 15 (75) 5 (25) 19,5 (5,16-73,57) <0,001 Primary 05 (13,79) 24 (86,21) 0,26 (0,08-0,83) 0,019 Secondary 01 (6,25) 15 (93,75) 1 1 Marital status Single 01 (14,28) 06 (85,72) 0,31 (0,03-2,81) 0,280 Married 20 (33,89) 36 (66,11) 1 Divorced 00 (0) 02 (100) ND 0,321 Type of marriage Polygamous 15 (44,11) 19 (55,89) 2,84 (0,85-9,43) 0,082 Monogamous 05 (21,73) 18 (78,27) 1 Mother’s religion Christian 09 (29,03) 22 (70,97) 1 1 Muslim 11 (33,33) 22 (66,67) 1,10 (0,38-3,11) 0,857 Animist 01 (100) 00 (0) ND 0,144 Mothers’s occupation Homemaker 15 (36,58) 26 (63,42) 1,73 (0,56-5,31) 0,335 Trader 01 (16,66) 05 (83,34) 0,39 (0,04-3,56) 0,389 Farmer 05 (31,25) 11 (68,75) 0,937 (0,27-3,15) 0,917 Civil servant 00 (0) 02 (100) 1 Mother’s Age group (years) 10-20 02 (22,22) 07 (77,78) 0,55 (0,10-2,94) 0,485 21-30 10 (30,30) 23 (69,7) 0,83 (0,29-2,35) 0,725 31-40 07 (36,84) 12 (63,16) 1 >40 02 (50) 02 (50) 2,21 (0,28-16,89) 0,434 Father’s occupation Unemployed 01 (14,28) 06 (85,72) 0,28 (0,03-2,51) 0,230 Civil servant 00 (0) 03 (100) 1 Trader 05 (29,41) 12 (70,59) 0,63 (0,18-2,18) 0,473 Farmer 14 (46,66) 16 (53,34) 3,20 (1,01-10,16) 0,043 Mason 00 (0) 01 (100) ND 0,464 Number of children per mother 01 child 02 (16,66) 10 (83,34) 0,35 (0,07-1,80) 0,199 2-3 children 04 (30,76) 09 (69,24) 1 4-5 children 10 (37,03) 17 (62,97) 1,44 (0,50-4,12) 0,491 More than 5 children 05 (38,46) 08 (61,54) 1,40 (0,39-4,97) 0,595 Birth interval 1 year 02 (14,28) 12 (85,72) 0,21 (0,04-1,9) 0,049 2 years 13 (43,33) 17 (56,67) 2,16 (0,66-7,03) 0,194 3 years 04 (57,14) 03 (42,86) 2,75 (0,54-13,10) 0,207 More than 3 years 00 (0) 02 (100) 1 Household size 3-5 members 06 (18,18) 27 (81,82) 1 5-10 members 05 (29,41) 12 (70,59) 0,83 (0,25-2,77) 0,766 More than 10 members 10 (66,6) 05 (33,4) 7,09 (2,00-25,12) 0,001 ND : Not Defined OR : Odds ratio CI : Confidence Interval Statistical significance was considered at p-value < 0.05 3.3- Description of Clinical Parameters of Mother–Child Pairs Table 3 summarizes the clinical parameters of the children included in the study. Among them, 21 (32.3%) were diagnosed with severe acute malnutrition (SAM), while 44 (67.7%) exhibited a normal nutritional status. More than half (61.5%) were born with low birth weight, compared to 38.5% with normal birth weight. Regarding the place of delivery, the majority of births occurred in health facilities (66.2%), whereas 33.8% took place at home. In the two weeks preceding the episode of Severe Acute Malnutrition (SAM), 64.6% of children had experienced an illness, while 35.4% remained unaffected. Figure 1 illustrates the distribution of these conditions, indicating that diarrhea was the most prevalent (44.6%), followed by malaria (30.8%), pneumonia (16.9%), tuberculosis (3.1%), and gastroenteritis (3.1%). No cases of measles or HIV/AIDS were reported. Additionally, 30.8% of the children had fathers who consumed alcohol, and 13.8% had fathers who smoked tobacco. Regarding preventive measures, 72.3% of the children had received vitamin A supplementation, and 50.8% had undergone deworming treatment. Tableau 3 : Clinical Parameters of the Participants Variables Frequency (N=65) Percentages Nutritional Status of the Child SAM 21 32,3% Not malnourished 44 67,7% Birth Weight of the Child Low 40 61,5% Normal 25 38,5% Place of Delivery In a health facility 43 66,2% At home 22 33,8% Presence of Illness during the Two Weeks Preceding the Episode of SAM Yes 42 64,6% No 23 35,4% Paternal Alcohol Consumption Yes 20 30,8% No 45 69,2% Father’s Tobacco Consumption Yes 09 13,8% No 56 86,2% Vitamin A Supplementation Yes 47 72,3% No 18 27,7% Child Deworming Yes 33 50,8% No 32 49,2% SAM: Severe Acute Malnutrition 3.4 - Effect of Clinical Parameters on Severe Acute Malnutrition Among Children Aged 6 to 59 Months in the Hina Health District The bivariate analysis presented in Table 4 indicates that certain clinical parameters were strongly associated with severe acute malnutrition (SAM) among children aged 6 to 59 months in the Hina Health District. Specifically, home delivery (p < 0.001) and the occurrence of diarrhea within the two weeks preceding the diagnosis of SAM (p < 0.001) emerged as significant risk factors, increasing the likelihood of developing SAM by 6.31 times (95% CI: 2.00–19.86) and 10.13 times (95% CI: 2.85–35.98), respectively. Table 4 : Association Between Clinical Factors and Severe Acute Malnutrition Among Children Aged 6 to 59 Months in the Hina Health District Risk factors Nutritional status Adjustments Case Control OR (95% CI) P value Birth Weight of the Child Low 17 (42,5) 23 (57,5) 3,88 (1,12-13,40) 0,026 Normal 04 (16) 21 (84) 1 Place of Delivery In a health facility 08 (18,60) 35 (81,4) 1 At home 13 (59,09) 09 (40,91) 6,31 (2,00-19,86) <0,001 Presence of Illness during the Two Weeks Preceding the Episode of SAM Tuberculosis Yes 00 (0) 01 (100) 0,00 0,486 No 21 (32,81) 43 (67,19) 1 Pneumonia Yes 05 (45,45) 06 (54,55) 1,97 (0,52-7,42) 0,306 No 16 (69,62) 38 (70,38) 1 Diarrhea Yes 17 (56,66) 13 (43,34) 10,13 (2,85-35,98) <0,001 No 04 (11,42) 31 (88,58) 1 Malaria Yes 10 (50) 10 (50) 3,09 (1,01-9,37) 0,042 No 11 (24,44) 34 (75,56) 1 Gastroenteritis Yes 00 (0) 02 (100) 0,00 0,321 No 21 (33,33) 42 (66,67) 1 Paternal Alcohol Consumption Yes 06 (30) 14 (70) 0,85 (0,27-2,67) 0,790 No 15 (33,33) 30 (66,67) 1 Father’s Tobacco Consumption Yes 03 (33,33) 06 (66,67) 1,05 (0,23-4,70) 0,943 No 18 (32,14) 38 (67,86) 1 Vitamin A Supplementation Yes 16 (34,04) 31 (65,96) 1 No 05 (27,77) 13 (72,23) 0,74 (0,22-2,46) 0,628 Child Deworming Yes 08 (24,24) 25 (75,76) 1 No 13 (40,62) 19 (59,38) 2,13 (0,73-6,19) 0,157 SAM: Severe Acute Malnutrition OR : Odds ratio CI : Confidence Interval Statistical significance was considered at p-value < 0.05 3.5. Description of Dietary and Hygienic Practices Among Mother–Child Dyads According to Table 5, the dietary practices and nutritional knowledge of mothers and children in the Hina health district reveal significant gaps. Only 38% of children were exclusively breastfed up to six months of age, while 41.5% did not receive exclusive breastfeeding. Early introduction of foods other than breast milk occurred in 38.5% of children before six months, 59.2% at six months, and 12.3% after six months. The most commonly used complementary foods were fortified porridge (41.5%) and plain porridge made from maize or millet (40%), whereas breast milk and family meals were used in only 1.5% and 16.9% of cases, respectively. The average number of maternal meals per day was 2.34 ± 0.85, ranging from 0 to 4 meals. Knowledge of exclusive breastfeeding was reported by 49.2% of mothers, while 41.5% were aware of complementary feeding practices. Hygiene behaviors indicated that 75.4% of mothers washed their children's hands before meals and 72.3% after defecation. However, 24.6% and 27.7% did not adhere to these practices, respectively. The primary source of drinking water was boreholes (52.3%), followed by wells (29.2%), streams (16.9%), and tap water (1.5%). Regarding child defecation practices, the majority occurred in latrines (66.2%), with 27.7% in open spaces and 6.2% in the bush Tableau 5: Dietary and Hygienic Practices of the Participants Variables Frequency (N=65) Percentages NUTRITIONAL KNOWLEDGE AND DIETARY PRACTICE Exclusive Breastfeeding Practice Yes 38 58,5% No 27 41,5% Introduction of Complementary Feeding Before 6 Months 25 38,5% At 6 Months 32 49,2% After 6 Months 08 12,3% Type of Complementary Food Only Breast Milk 01 1,5% Plain Porridge Made from Maize or Millet 26 40% Fortified Porridge 27 41,5% Maternal Daily Meal Frequency 0 01 1,6% 1 06 9,4% 2 35 54,7 3 15 23,4 4 07 10,9% Knowledge on Exclusive Breastfeeding Yes 32 49,2% No 33 50,8% Knowledge on Complementary Feeding Yes 27 41,5% No 38 58,5% HYGIENE PRACTICES Child’s Handwashing Before Meals Yes 49 75,4% No 16 24,6% Child’s Handwashing After Defecation Yes 47 72,3% No 18 27,7% Source of Drinking Water Borehole 34 52,3% Stream 11 16,9% Well 19 29,2% Tap 01 1,5% Place of Child Defecation In Latrines 43 66,2% In the Bush 04 6,2% In Open Spaces 18 27,7% 3.6- Effect of Dietary and Hygienic Practices on Severe Acute Malnutrition Among Children Aged 6 to 59 Months in the Hina Health District The bivariate analysis presented in Table 6 indicates that certain dietary practices and nutritional knowledge are strongly associated with severe acute malnutrition (SAM) among children aged 6 to 59 months in the Hina Health District. Specifically, the use of plain porridge made from maize or millet as a complementary food (p < 0.001; OR: 7.50; 95% CI: 2.33–24.09), and the lack of maternal knowledge regarding complementary feeding (p < 0.001; OR: 28.28; 95% CI: 3.55–235.06), were identified as significant risk factors, increasing the likelihood of SAM occurrence by 7.50 and 28.28 times, respectively. Tableau 6: Relationship Between Dietary and Hygiene Practices and Severe Acute Malnutrition Among Children Aged 6 to 59 Months in the Hina Health District Risk factors Nutritional status Adjustments Cases Control OR (95% CI) P value NUTRITIONAL KNOWLEDGE AND DIETARY PRACTICE Exclusive Breastfeeding Practice Yes 10 (26,31) 28 (73,69) 1 No 11 (40,74) 16 (59,26) 1,92 (0,67-5,52) 0,220 Introduction of Complementary Feeding Before 6 Months 11 (44) 14 (56) 2,35 (0,81-6,84) 0,111 At 6 Months 07 (21,87) 25 (78,13) 1 After 6 Months 03 (37,5) 05 (62,5) 1,30 (0,27-6,04) 0,737 Type of Complementary Food Only Breast Milk 00 (0) 01 (100) 0,00 0,486 Plain Porridge Made from Maize or Millet 15 (57,69) 11 (42,31) 7,50 (2,33-24,09) <0,001 Fortified Porridge 03 (11,11) 24 (88,89) 1 Type of Complementary Food 03 (27,27) 08 (72,73) 0,75 (0,17-3,17) 0,695 Maternal Daily Meal Frequency 0 00 (0) 1 (100) 0,00 0,486 1 3 (50) 3 (50) 2,27 (0,41-12,38) 0,330 2 10 (28,57) 25 (71,43) 0,69 (0,24-1,96) 0,486 3 6 (37,5) 10 (62,5) 1,36 (0,41-4,42) 0,608 4 2 (28,57) 5 (71,43) 1 Knowledge on Exclusive Breastfeeding Yes 7 (21,87) 25 (78,13) 1 No 14 (42,42) 19 (57,58) 2,63 (0,88-7,79) 0,076 Knowledge on Complementary Feeding Yes 1 (3,70) 26 (96,3) 1 No 20 (52,63) 18 (47,37) 28,88 (3,55-235,06) <0,001 HYGIENE PRACTICES Child’s Handwashing Before Meals Yes 14 (28,57) 35 (71,43) 1 No 7 (43,75) 9 (56,25) 1,94 (0,60-6,24) 0,259 Child’s Handwashing After Defecation Yes 16 (34,04) 31 (65,96) 1 No 5 (27,77) 13 (72,23) 0,74 (0,22-2,46) 0,628 Source of Drinking Water Borehole 9 (26,47) 25 (73,53) 0,57 (0,19-1,62) 0,291 Stream 4 (36,36) 7 (63,64) 1,24 (0,32-4,82) 0,752 Well 7 (36,84) 12 (63,16) 1,33 (0,43-4,10) 0,615 Tap 1 (100) 00 (0) 1 Place of Child Defecation In Latrines 12 (36,36) 31 (63,64) 1 In the Bush 1 (25) 3 (75) 0,68 (0,06-6,99) 0,746 In Open Spaces 8 (44,44) 10 (55,56) 2,09 (0,67-6,46) 0,195 OR : Odds ratio CI : Confidence Interval Statistical significance was considered at p-value < 0.05 4. Discussion The results of this study indicate that severe acute malnutrition (SAM) among children aged 6 to 59 months in the Hina Health District is strongly influenced by sociodemographic, clinical, nutritional, and hygienic factors. These determinants reflect a multifactorial dynamic already documented in various contexts across sub-Saharan Africa and Asia. Regarding sociodemographic factors, the analysis reveals that children aged 12 to 23 months represent a critical period, with a sevenfold increased risk of SAM (OR = 7.77; p < 0.001). This age group, often referred to as the “weaning period,” is particularly vulnerable due to inadequate complementary feeding practices, commonly observed in disadvantaged areas (Agarwal et al., 2023 ; Lakhmawar et al., 2025 ). In this study, 60.8% of malnourished children belonged to this age group and were primarily fed plain millet or maize porridge, which lacks essential nutrients. Similar findings have been reported in Nigeria (Iman et al. , 2020) and Nepal (Dahal et al., 2021 ). Furthermore, female sex was identified as a risk factor (OR = 11.40), echoing observations from Gabon (Mboumba, 2010 ) and Benin (Mongbo et al. , 2018). This disparity reflects cultural biases in resource allocation, as highlighted in studies conducted in predominantly Muslim regions (Thurstans et al., 2022 ; Lakhmawar et al., 2025 ). Maternal education also plays a crucial role: 75% of mothers of malnourished children had never attended school, significantly increasing the risk of SAM (OR = 19.5). This finding aligns with studies by Endris et al. ( 2017 ) in Ethiopia and Ndah et al. ( 2024 ) in Cameroon, although Pravana et al. ( 2017 ) in Nepal reported divergent results. The lack of maternal education is associated with a higher likelihood of child malnutrition, as educated mothers generally possess better knowledge of nutrition and hygiene, greater access to health services, and enhanced decision-making power (Fatema & Kabir, 2017 ; Sey-Sawo et al. , 2023). Additionally, households with more than 10 members were associated with SAM (OR = 7.09), reflecting competition for limited resources. Similar findings were reported by Adedokun & Yaya ( 2021 ) and Gemechu et al. ( 2021 ). Clinically, home delivery (OR = 6.31) emerged as a major determinant, likely due to the absence of postnatal care and appropriate nutritional counseling particularly among uneducated mothers highlighting the importance of access to maternal and neonatal health services. These findings align with those of Ndah et al. ( 2024 ) in Cameroon and Olusanya & Renner ( 2012 ) in Nigeria. Home births often reflect limited access to healthcare services, which can result in inadequate postnatal care, poor infant feeding practices, and lack of immunizations (Guevara & Gutierrez, 2018; Ndah et al., 2024 ). These observations are consistent with studies emphasizing the role of health coverage in improving nutritional outcomes. Moreover, the occurrence of diarrhea within the two weeks preceding the onset of SAM increased the risk by a factor of 10.13, confirming the critical role of infectious diseases. This result is consistent with findings by Awoke et al. ( 2018 ) in Ethiopia and Musa et al. ( 2017 ) in Bangladesh. Diarrhea leads to fluid and electrolyte loss, anorexia, and intestinal malabsorption, which rapidly exacerbate undernutrition. Malnutrition, in turn, weakens the immune system, increasing susceptibility to infections such as diarrhea, further impairing nutrient absorption and appetite (Olusanya & Renner, 2012 ). Nutritionally, the findings also reveal that feeding practices are a critical determinant of severe acute malnutrition (SAM). Children who received plain maize or millet porridge as complementary food had a 7.50-fold increased risk of SAM, while the absence of maternal knowledge about dietary diversification significantly amplified this risk (OR = 28.88). These results are consistent with those reported by Agbor et al. (2021) in Southwest Cameroon and David et al. ( 2020 ), who emphasized the impact of poor dietary diversification on the nutritional quality of infant diets. The low nutrient density of such porridges weakens the immune system and increases susceptibility to infections. Although hygiene practices such as handwashing and latrine use are relatively well adopted in this population, their partial inadequacy may indirectly contribute to the persistence of infectious diseases and, consequently, to malnutrition, as highlighted by Ndah et al. ( 2024 ). These results highlight the interconnectedness of biological, cultural, and socioeconomic factors in the development of severe acute malnutrition (SAM). They underscore the need for integrated multisectoral interventions, including maternal nutrition education, promotion of exclusive breastfeeding, improvement of complementary feeding practices, and strengthened access to maternal and child health services. However, this study presents certain limitations, such as the lack of assessment of key factors (household income, maternal nutritional status, women's decision-making power). Additionally, translation biases between French and Fulfulde may have influenced some of the results. Conclusion This study aimed to identify the risk factors associated with severe acute malnutrition (SAM) among children aged 6 to 59 months in the Hina Health District, located in the Far North Region of Cameroon. The findings revealed that SAM is strongly influenced by sociodemographic determinants (maternal lack of education, female sex of the child, age between 12 and 23 months, and household size >10 members), clinical factors (home delivery, recent history of diarrhea), and nutritional factors (consumption of plain maize or millet porridge as complementary food, lack of maternal knowledge on dietary diversification). These observations suggest that efforts to combat SAM in this area must go beyond therapeutic management and incorporate preventive strategies targeting feeding practices, maternal education, access to neonatal care, and infectious disease prevention. The results thus provide a valuable scientific foundation for guiding multisectoral interventions tailored to the local context and for strengthening policies aimed at reducing childhood malnutrition in the Far North Region. Abbreviations BSFP Blanket Supplementary Feeding Program CI confidence intervals IMAM Integrated Management of Acute Malnutrition MUAC Mid-Upper Arm Circumference NGO Non-Governmental Organization OR Odds ratios SAM Severe acute malnutrition WFP World Food Program Declarations Ethical compliance Ethical clearance was not obtained for this study due to the non-operational status of the ethics committee during the research period. However, administrative authorization for data collection was granted by the Regional Delegation of Public Health following the submission and approval of the research protocol. Declarations Abbreviations BSFP : Blanket Supplementary Feeding Program; CI : confidence intervals; IMAM : Integrated Management of Acute Malnutrition; MUAC : Mid-Upper Arm Circumference; NGO: Non-Governmental Organization; OR : Odds ratios; SAM : Severe acute malnutrition; WFP : World Food Program; Ethics approval and consent to participate The study was conducted as part of an internship at Helen Keller International Cameroon (HKI). All ethical principles and values promoted by the organization were strictly respected during data collection and analysis. Although no formal institutional ethics committee approval number was issued because the ethics committee was not yet operational at that time, the data collection authorization issued by the regional delegation of public health following submission and approval of research protocol served as the sole document ensuring ethical compliance. The study procedures adhered to the principles of the Declaration of Helsinki. Verbal authorization and consent to conduct the survey were obtained from Helen Keller International Cameroon and verbal consent was obtained from all participants prior to administering the questionnaire, and the purpose of the study was clearly explained to them. Consent for publication The authors received approval from Helen Keller International Cameroon (HKI) for the publication of the study. Availability of data and materials The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request, with the verbal authorization of Helen Keller International Cameroon. Competing interests The authors declare that they have no competing interests. Funding This research did not receive any specific grant or financial support from public, commercial, or not-for-profit funding agencies. Contribution of Authors: Conceptualization: EBK, GMT, PFFT, HMW, FZN. Data curation: EBK, GMT. Formal analysis: EBK, GMT. Funding acquisition: EBK, GMT, IT, AON, HMW, FZN. Investigation: EBK, AON, ASK. Methodology: EBK, GMT, AON, ASK, HMW, FZN. Project administration: EBK, GMT, IT, HMW, FZN. Resources: EBK, GMT, IT, HMW, FZN. Software: EBK, PFFT. Supervision: EBK, GMT, ASK, IT, HMW, FZN. Validation: EBK, GMT, PFFT, IT, HMW, FZN. Visualization: EBK, GMT, HMW, FZN. Writing – original draft: EBK, GMT, PFFT. Writing – review & editing: EBK, GMT, IT, HMW, FZN. Acknowledgements The authors express their sincere gratitude to Helen Keller International Cameroon for technical support, access to the study area, and guidance during the data collection process. Special thanks are extended to all participants and field agents who contributed to the success of this research. References Adedokun, S. T., & Yaya, S. (2021). Factors associated with adverse nutritional status of children in sub-Saharan Africa: Evidence from the Demographic and Health Surveys from 31 countries. Maternal and Child Nutrition , 17 (3). https://doi.org/10.1111/MCN.13198 Agarwal, A. K., Rajput, A., Mahore, R., & Dubey, G. (2023). A cross-sectional study of feeding practice status in children (6–23 months), association with malnutrition, and impacts of maternal determinants. Asian Journal of Medical Sciences . https://doi.org/10.3126/ajms.v14i12.58549 Agbor Evon Njigang, Irene U.N. Sumbele, Nkweleko Fankam Falone, Kah Emmanuel and Roland N. Ndip. (2021). Prevalence and Risk Factors of Malnutrition in Children Zero-Five Years in Tole Health Area, South West Region of Cameroon. American Journal of Public Health Research.; 9 (2):71-80. DOI: 10.12691/ajphr-9-2-5 Awoke, A., Ayana, M., & Gualu, T. (2018). Determinants of severe acute malnutrition among under five children in rural Enebsie Sarmidr District, East Gojjam Zone, North West Ethiopia, 2016. BMC nutrition , 4 (1), 4. https://doi.org/10.1186/s40795-018-0211-5 Charan, J., & Biswas, T. (2013). How to calculate sample size for different study designs in medical research? Indian Journal of Psychological Medicine, 35 (2), 121–126. https://doi.org/10.4103/0253-7176.116232 Dahal, K., Yadav, D. K., Baral, D., & Yadav, B. K. (2021). Determinants of severe acute malnutrition among under 5 children in Satar community of Jhapa, Nepal. PloS One, 16(2), e0245151. https://doi.org/10.1371/journal.pone.0245151 David, S. M., Pricilla, R. A., Paul, S. S., George, K., Bose, A., & Prasad, J. H. (2020). Risk factors for severe acute malnutrition among children aged 6–59 months: A community-based case-control study from Vellore, Southern India. Journal of family medicine and primary care , 9 (5), 2237-2243.https://doi.org/10.4103/jfmpc.jfmpc_211_20 Endris, N., Asefa, H., & Dube, L. (2017). Prevalence of malnutrition and associated factors among children in rural Ethiopia. BioMed research international, 2017(1), 6587853. https://doi.org/10.1155/2017/6587853 Fatema, S. R., & Kabir, H. (2017). Maternal Education, Hygienic Practices and Children’s Health Status . 3 (7), 01–13. Gemechu, D. S., Worku, Y., Alemu, A., & Gerema, U. (2021). Determinants of severe acute malnutrition among children aged 6–59 months in the pastoral community of Liban District, Guji Zone, Oromia Regional State, Southeastern Ethiopia: a case–control study. Journal of Nutritional Science, 10, e101. doi:10.1017/jns.2021.98 Guevara Jurado, K. I., & Zevallos Gutierrez, E. del P. (2018). Parto no institucional y no cumplimiento de vacunas correspondientes al primer año de vida en el Perú: un análisis a partir de la encuesta demográfica y de salud familiar (ENDES) 2014 . https://repositorioacademico.upc.edu.pe/handle/10757/623346 Imam, A., Hassan-Hanga, F., Sallahdeen, A., & Farouk, Z. L. (2020). Socio-demographic and household-level risk factors for severe acute malnutrition in pre-school children in north-western Nigeria. Journal of tropical pediatrics , 66 (6), 589-597. https://doi.org/10.1093/tropej/fmaa018 Institut National de la Statistique (INS) & ICF. (2020). Cameroon Demographic and Health Survey 2018. Yaoundé, Cameroon and Rockville, Maryland, USA: INS and ICF. Lakhmawar, N., Shinde, A., Patil, P., Waydande, S., & Mhaske, S. (2025). Socio-Demographic Risk Factors Associated with Severe Acute Malnutrition In Children. Vimshealth Science Journal , 11 (4), 01–08. https://doi.org/10.46858/vimshsj.110401 Mboumba, H. A. (2010). Explanatory Factors of Malnutrition in Children Under Five in Gabon. Yaoundé: University of Yaoundé II, Institute for Training and Demographic Research, Professional Master's in Demography, p. 134. Ministry of Public Health of Cameroon. (2017). National Protocol for the Integrated Management of Acute Malnutrition (IMAM). pp. 40–48. Revised September 2017. Ministry of Public Health of Cameroon. (2023). Directory of Public Health Facilities in Categories 1 to 4 in Cameroon. pp. 105–107. Retrieved from https://www.minsante.cm Mongbo, V., Ade, G. N. J., Sossa-Jerome, C., Makoutodé, P., Saïzonou, J., Aguemon, B., & Ouendo, E. M. (2022). Factors Associated with Malnutrition in Children Under Five in Za-Kpota, Benin, 2018. Moroccan Journal of Public Health , 9(14). https://doi.org/10.34874/IMIST.PRSM/RMSP/26155 Mukuku, O., Mutombo, A. M., Kamona, L. K., Lubala, T. K., Mawaw, P. M., Aloni, M. N., ... & Luboya, O. N. (2019). Predictive model for the risk of severe acute malnutrition in children. Journal of nutrition and metabolism , 2019 (1), 4740825. https://doi.org/10.1155/2019/4740825 Musa, M. K., Muhammad, F., Lawal, K. M., Chowdhury, A. B. M. A., & Hossain, A. (2017). Risk factors of severe acute malnutrition among under-five children: a hospital-based study in Bangladesh. J Med Sci Health , 3 (3), 13-21. https://dx.doi.org/10.46347/jmsh.2017.v03i03.002 Ndah, T., Tazoho, G. M., Youssa, C. N., Ngoufack, F. Z., & Kuiate, J. R. (2024). Risk factors associated with Severe Acute Malnutrition (SAM) in children aged 6–59 months in the Mokolo Health District, Far North region of Cameroon. North African Journal of Food and Nutrition Research, 8 (17), 76-85. https://doi.org/10.51745/najfnr.8.17.76-85 Olusanya, B. O., & Renner, J. (2012). Is home birth a marker for severe malnutrition in early infancy in urban communities of low-income countries? Maternal and Child Nutrition , 8 (4), 492–502. https://doi.org/10.1111/J.1740-8709.2011.00330.X Pravana, N. K., Piryani, S., Chaurasiya, S. P., Kawan, R., Thapa, R. K., & Shrestha, S. (2017). Determinants of severe acute malnutrition among children under 5 years of age in Nepal: a community-based case–control study. BMJ open , 7 (8), e017084. https://doi.org/10.1136/bmjopen-2017-017084 Sey-Sawo, J., Sarr, F., Bah, H. T., & Senghore, T. (2023). Women’s empowerment and nutritional status of children in the Gambia: further analysis of the 2020 Gambia demographic and health survey. BMC Public Health , 23 (1). https://doi.org/10.1186/s12889-023-15494-1 Thurstans, S., Opondo, C., Seal, A., Wells, J. C. K., Khara, T., Dolan, C., Briend, A., Myatt, M., Garenne, M., Mertens, A., Sear, R., & Kerac, M. (2022). Understanding Sex Differences in Childhood Undernutrition: A Narrative Review. Nutrients , 14 (5), 948. https://doi.org/10.3390/nu14050948 UNICEF. (2019). The state of the world’s children 2019: Children, food and nutrition: Growing well in a changing world. New York: UNICEF. ISBN 978-92-806-5003-7. Disponible sur: htpps://www.unicef.org/reports/state-of-worlds-children-2019 UNICEF, & United Nation High Commissioner for Refugees (UNHCR). (2021). Preliminary results, Standardized Monitoring and Assessment of Relief and Transitions (SMART)-SENS 2021. Nutrition Survey. United Nations Children’s Fund (UNICEF). (2021). Fed to Fail? The Crisis of Children’s Diets in Early Life. Child Nutrition Report, pp5-8. WHO (World Health Organization).(2020). Malnutrition : Malnutrition (who.int) Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 09 Dec, 2025 Reviews received at journal 23 Nov, 2025 Reviews received at journal 21 Nov, 2025 Reviews received at journal 20 Nov, 2025 Reviewers agreed at journal 11 Nov, 2025 Reviewers agreed at journal 11 Nov, 2025 Reviewers agreed at journal 10 Nov, 2025 Reviewers invited by journal 05 Nov, 2025 Editor assigned by journal 05 Nov, 2025 Editor invited by journal 25 Oct, 2025 Submission checks completed at journal 24 Oct, 2025 First submitted to journal 24 Oct, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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1","display":"","copyAsset":false,"role":"figure","size":22215,"visible":true,"origin":"","legend":"\u003cp\u003eEpidemiological Distribution of Pediatric Cases in the Hina Health District\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eHIV: Human Immunodeficiency Virus; AIDS: Acquired Immunodeficiency Syndrome\u003c/em\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-7811233/v1/5b64680ed2579595540d9b98.png"},{"id":96158795,"identity":"108cce65-1aa0-43ba-9413-ba3eea99a0d6","added_by":"auto","created_at":"2025-11-18 08:39:22","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2449710,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7811233/v1/c2aa1119-9a66-4a46-be5c-49e0670e1094.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Study of Factors Associated with the Occurrence of Severe Acute Malnutrition in Children Aged 6 to 59 Months in the Hina Health District, Far North Region of Cameroon","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eMalnutrition is a major public health concern in many countries worldwide and is recognized as a priority within the Sustainable Development Goals. It refers to deficiencies, excesses, or imbalances in the energy and/or nutrient intake of an individual (UNICEF, 2021), and is associated with serious consequences for child survival, impairing cognitive and physical development, as well as the economic productivity of individuals and society (Pravana \u003cem\u003eet al.\u003c/em\u003e, 2017; David \u003cem\u003eet al.\u003c/em\u003e, 2020). According to the World Health Organization (WHO, 2020), 159\u0026nbsp;million children under the age of five were stunted, 45\u0026nbsp;million were wasted, and 38.9\u0026nbsp;million were overweight, with 45% of deaths among children under five linked to malnutrition. Children suffering from severe acute malnutrition are nine times more likely to die than their well-nourished counterparts. The United Nations estimates that approximately one million children under five die each year from SAM (UNICEF, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2019\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eIn Cameroon, prevalence rates recorded in 2018 were 11%, 29%, 4%, and 11% for underweight, stunting, wasting, and overweight respectively among children under five years of age, with approximately 20% suffering from diarrhea (INS and ICF, 2020). In 2019, the World Food Program (WFP) and the Cameroonian government launched a Blanket Supplementary Feeding Program (BSFP) in the Far North Region as an operational platform to deliver multiple services, including household food assistance, specialized nutritious foods, social and behavior change communication, healthcare, and water, sanitation, and hygiene (Ndah \u003cem\u003eet al.\u003c/em\u003e, 2024). This program targeted children aged 6 to 24 months and aimed to prevent malnutrition in general, and severe acute malnutrition (SAM) in particular. Several other interventions have been implemented in the region to combat malnutrition. Despite the deployment of these programs, malnutrition remains a serious threat to the survival of children under five in the Far North Region, with 38.2% affected and 1.4% suffering from SAM (UNICEF \u0026amp; UNHCR, 2021). Although this prevalence is high, few studies have been conducted to assess the factors associated with the risk of developing SAM.\u003c/p\u003e\u003cp\u003eAs part of efforts to prevent severe acute malnutrition (SAM), several studies have been conducted in developing countries to identify its determinants. In Nepal, Dahal et al. (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2021\u003c/span\u003e) demonstrated that a household size greater than five members is a factor associated with SAM. Furthermore, Pravana et al. (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2017\u003c/span\u003e) reported that non-exclusive breastfeeding, delayed introduction of complementary foods, recent episodes of diarrhea, and low birth weight are significant risk factors for malnutrition in children. In Ethiopia, Awoke et al. (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2018\u003c/span\u003e) and Endris et al. (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2017\u003c/span\u003e) identified child age, birth interval, and maternal education level as independent determinants. In Bangladesh, Musa et al. (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2017\u003c/span\u003e) highlighted paternal low educational attainment, fewer than three meals per day, and lack of regular handwashing practices. Finally, in India, David et al. (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2020\u003c/span\u003e) confirmed the importance of complementary feeding and hygiene practices as associated factors. These various studies underscore that SAM is a multifactorial condition influenced by socioeconomic, clinical, nutritional, and hygiene-related factors. However, cultural and environmental variations necessitate country-specific investigations.\u003c/p\u003e\u003cp\u003eIn Cameroon, few studies have addressed this issue, and those that exist are geographically limited. Agbor \u003cem\u003eet al.\u003c/em\u003e (2021), in the Tolle health area (Southwest Region), demonstrated that SAM was associated with child age, lack of vaccination, poor feeding practices, and household size. More recently, Ndah et al. (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2024\u003c/span\u003e), in the Mokolo Health District (Far North Region), identified male sex, age between 6 and 12 months, gastroenteritis, malaria, pneumonia, absence of exclusive breastfeeding, delayed introduction of complementary feeding, poor dietary diversification, and the use of traditional herbal decoctions as associated factors. These findings reveal significant regional disparities, making national generalization difficult and highlighting the need to investigate additional districts. In this context, the present study aimed to identify factors associated with SAM among children aged 6 to 59 months in the Hina Health District, Far North Region of Cameroon, in order to provide evidence-based insights for the planning of targeted preventive interventions.\u003c/p\u003e"},{"header":"2. Materials and Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003e2.1. Study Setting and Period\u003c/h2\u003e\u003cp\u003eThis study was conducted over a period from May 15 to June 30, 2023, corresponding to a duration of six weeks. Hina is a municipality and administrative subdivision of the Mayo-Tsanaga Division in the Far North Region of Cameroon. It is bordered to the north by Mokolo, to the south by Guider (Mayo-Louti Division, North Region), to the east by Ndoukoula, and to the west by Bourha. The total population is estimated at 153,000 inhabitants (MINSANTE, 2023). The Hina Health District comprises thirteen health areas. For this study, data were collected from five health areas: Gamdougoum, Zidim, Bering, Boula, and Gawar selected based on their high prevalence of malnutrition..\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\u003ch2\u003e2.2- Target Population and Sampling Method\u003c/h2\u003e\u003cp\u003eThe target population consisted of mother\u0026ndash;child pairs, with children aged 6 to 59 months, who attended consultations at health centers within the Hina Health District. Inclusion criteria encompassed all children aged 6 to 59 months, whether suffering from severe acute malnutrition (SAM) with or without complications, accompanied by their mothers. Participation required either written or verbal informed consent from the mothers.\u003c/p\u003e\u003cp\u003eA non-probability sampling approach was employed. Selection of eligible mother\u0026ndash;child pairs was based on simple random sampling. The sample size was calculated using a statistical formula as described by Charan and Biswas (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2013\u003c/span\u003e).\u003cdiv id=\"Equa\" class=\"Equation\"\u003e\u003cdiv format=\"TEX\" class=\"mathdisplay\" id=\"FileID_Equa\" name=\"EquationSource\"\u003e\n$$\\:{\\varvec{n}}^{2}={\\varvec{t}}^{2}\\frac{\\varvec{p}(1-\\varvec{p})}{{\\varvec{m}}^{2}}$$\u003c/div\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eWith:\u003c/p\u003e\u003cp\u003e\u003cul\u003e\u003cli\u003e\u003cp\u003e\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;required sample size\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003e\u003cem\u003et\u003c/em\u003e\u0026thinsp;=\u0026thinsp;reliability coefficient at a 95% confidence interval\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;prevalence of 1.4% of Severe Acute Malnutrition (SAM) in 2019 in the Far North region of Cameroon (UNICEF \u0026amp; UNHCR, 2021)\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003e\u003cem\u003em\u003c/em\u003e\u0026thinsp;=\u0026thinsp;margin of error set at 5% (standard value: 0.05)\u003c/p\u003e\u003c/li\u003e\u003c/ul\u003e\u003c/p\u003e\u003cp\u003eUsing this formula, the minimum sample size was determined to be 21 participants. For the purposes of this study, a sample of 65 participants was collected, including 21 malnourished and 44 non-malnourished individuals.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\u003ch2\u003e2.3- Data Collection Tools and Methods\u003c/h2\u003e\u003cp\u003eThe tools used for data collection included:\u003c/p\u003e\u003cp\u003e\u003cul\u003e\u003cli\u003e\u003cp\u003eA structured questionnaire designed to gather sociodemographic information, clinical data, and both nutritional and non-nutritional practices from mothers of children.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eA MUAC (Mid-Upper Arm Circumference) tape to assess the nutritional status of children aged 6 to 59 months, in accordance with the 2017 National Protocol for the Integrated Management of Acute Malnutrition (IMAM).\u003c/p\u003e\u003c/li\u003e\u003c/ul\u003e\u003c/p\u003e\u003cp\u003eAfter explaining the purpose of the study to the mothers and obtaining informed consent using a pre-designed consent form, the children's mid-upper arm circumference was measured using the MUAC tape. Subsequently, the questionnaire was administered orally through guided interviews. In cases where mothers did not speak any official language, a translator was employed to facilitate communication. Responses were recorded accordingly. Following data collection, the mothers were gathered for a nutrition education session focused on infant and young child feeding practices, as well as proper hygiene behaviors.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e\u003ch2\u003e2.4- Ethical Considerations\u003c/h2\u003e\u003cp\u003e This study was conducted within the framework of the NGO Helen Keller INTL Cameroon and was therefore subject to the organization's core values and ethical principles. Administrative authorization No. 383/L/MINSANTE/SG.DRSPEN/SAG for data collection was obtained from the Regional Delegation of Public Health of the Far North. To ensure participant anonymity, identification numbers were used on each questionnaire instead of names. Verbal consent was obtained from all participants prior to administering the questionnaire, and the purpose of the study was clearly explained to them. Privacy and confidentiality of the collected information were strictly upheld at all stages of the research process.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e\u003ch2\u003e2.5- Statistical Analysis\u003c/h2\u003e\u003cp\u003eThe questionnaire was designed using Sphinx Lexica software. Statistical analyses were performed using SPSS version 26 and Epi Info. Descriptive analyses were conducted to characterize the sociodemographic profile of the mother\u0026ndash;child pairs, as well as clinical data, nutritional and non-nutritional practices. Means and standard deviations were reported for normally distributed continuous variables, while categorical variables were expressed as proportions. Chi-square tests were used to assess associations between Severe Acute Malnutrition (SAM) and sociodemographic, dietary, and non-dietary characteristics. Odds ratios with confidence intervals were calculated to identify potential risk factors.\u003c/p\u003e\u003c/div\u003e"},{"header":"3. Results","content":"\u003cp\u003e\u003cstrong\u003e3.1-\u003c/strong\u003e \u003cstrong\u003eDescription of Participants\u0026rsquo; Sociodemographic Characteristics\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTable 1 shows that the majority of children were female (60%), compared to 40% male. The most represented age group was 6\u0026ndash;11 months (43.1%), followed by 12\u0026ndash;23 months (35.4%) and 24\u0026ndash;59 months (21.5%), with a mean age of 16.43 \u0026plusmn; 9.03 months. Mothers ranged in age from 14 to 46 years, with the highest proportion in the 21\u0026ndash;30 age group (50.8%), followed by 31\u0026ndash;40 years (29.2%). In terms of education, 30.8% had never attended school, 44.6% had completed primary education, and 24.6% had reached secondary level. Regarding marital status, 86.2% of women were married, of whom 59.6% were in polygamous unions and 40.4% in monogamous ones; 10.8% were single and 3.1% divorced. Religiously, the distribution was relatively balanced: 50.8% Muslim, 47.7% Christian, and 1.5% Animist.\u003c/p\u003e\n\u003cp\u003eThe majority of participants resided in rural areas (78.5%), compared to 21.5% in urban settings. The primary occupation among mothers was homemaking (63.1%), followed by farming (24.6%), trading (9.2%), and civil service (3.1%). Regarding spouses, agriculture was the predominant occupation (46.2%), followed by commerce (26.2%). Additionally, 10.8% were unemployed, while others worked as civil servants (4.6%) or masons (1.5%).\u003c/p\u003e\n\u003cp\u003eAt the household level, 41.5% of mothers had between four and five children, 20% had more than five, 20% had two to three children, and 18.5% had only one child. Among mothers with at least two children, the most common birth interval was two years (58%). Household size varied, with most families comprising 3 to 5 members (50.5%), followed by 5 to 10 members (26.2%) and more than 10 members (23.1%).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTableau 1:\u0026nbsp;\u003c/strong\u003eSociodemographic Characteristics of the Participants\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency (N=65)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercentage\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eChild\u0026rsquo;s Age Group\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003e06 to 11 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e43,1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003e12 to 23 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e35,4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003e24 to 59 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e21,5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eChild\u0026rsquo;s Age (In months)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003eMinimum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 352px;\"\u003e\n \u003cp\u003e06\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003eMaximum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 352px;\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003eMean \u0026plusmn; SD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 352px;\"\u003e\n \u003cp\u003e16,43\u0026plusmn;9,03\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003eMedian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 352px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eChild\u0026rsquo;s sex\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e40%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e60%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMother\u0026rsquo;s education level\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003eNever attended school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e30,8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003ePrimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e44,6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003eSecondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e24,6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarital status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003eSingle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e10,8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e86,2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003eDivorced\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e3,1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eType of\u0026nbsp;marriage\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003ePolygamous\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e59,64%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003eMonogamous\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e40,35%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eResidential area\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003eUrban\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e21,5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003eRural\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e78,5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMothers\u0026rsquo;s occupation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003eHomemaker\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e63,1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003eTrader\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e9,2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003eFarmer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e24,6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003eCivil servant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e3,1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMother\u0026rsquo;s religion\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003eChristian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e47,7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003eMuslim\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e50,8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003eAnimist\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e1,5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMother\u0026rsquo;s Age group (years)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003e10-20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e13,8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003e21-30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e50,8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003e31-40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e29,2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003e\u0026gt;40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e6,2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMother\u0026rsquo;s Age\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003eMinimum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e14 ans\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003eMaximum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e46 ans\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003eMean \u0026plusmn; SD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e27,92\u0026plusmn;7,66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003eMedian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFather\u0026rsquo;s occupation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003eUnemployed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e10,8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003eCivil servant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e4,6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003eTrader\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e26,2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003eFarmer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e46,2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003eMason \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e1,5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHOUSEHOLD CHARACTERISTICS\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber of children per mother\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003e01 child\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e18,5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003e2-3 children\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e20%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003e4-5 children\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e41,5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003eMore than 5 children\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e20%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBirth interval\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003e1 year\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e26%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003e2 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e58%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003e3 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e14%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003eMore than 3 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHousehold size\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003e3-5 members\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e50,5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003e5-10 members\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e26,2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003eMore than 10 members\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e23,1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e3.2- Impact of Sociodemographic Factors on Severe Acute Malnutrition Among Children Aged 6 to 59 Months in the Hina Health District\u003c/strong\u003e\u003c/p\u003e\n\u003cp id=\"_Toc140815105\"\u003eTable 2 illustrates the association between sociodemographic characteristics of mother\u0026ndash;child pairs and the nutritional status of children aged 6 to 59 months in the Hina Health District. Bivariate analysis revealed statistically significant associations between severe acute malnutrition (SAM) and the following factors: child age group 12\u0026ndash;23 months (p \u0026lt; 0.001), female sex (p \u0026lt; 0.001), lack of maternal education (p \u0026lt; 0.001), and households with more than 10 members (p = 0.001). These factors respectively increased the risk of SAM by odds ratios of 7.77, 11.40, 19.50, and 7.09.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTableau 2:\u003c/strong\u003e Relationship Between Sociodemographic Factors and Severe Acute Malnutrition Among Children Aged 6 to 59 Months in the Hina Health District\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRisk factors\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNutritional Status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAdjustments\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCase :\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=21 (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eControl\u0026nbsp;:\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=44 (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOR\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(95% CI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eP\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 617px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eChild\u0026rsquo;s Age Group\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e06 to 11 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e04 (14,28)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e24 (85,72)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e0,19 (0,05-0,67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0,006\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e12 to 23 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e14 (60,8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e09 (39,2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e7,77 (2,42-24,96)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0,001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e24 to 59 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e03 (21,42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e11 (78,58)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 617px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eChild\u0026rsquo;s sex\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e02 (7,69)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e24 (92,31)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e19 (48,71)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e20 (51,29)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e11,40 (2,36-54,97)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0,001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 617px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMother\u0026rsquo;s education level\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003eNever attended school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e15 (75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e5 (25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e19,5 (5,16-73,57)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0,001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003ePrimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e05 (13,79)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e24 (86,21)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e0,26 (0,08-0,83)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0,019\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003eSecondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e01 (6,25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e15 (93,75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 617px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarital status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003eSingle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e01 (14,28)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e06 (85,72)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e0,31 (0,03-2,81)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0,280\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e20 (33,89)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e36 (66,11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003eDivorced\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e00 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e02 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eND\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0,321\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 617px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eType of\u0026nbsp;marriage\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003ePolygamous\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e15 (44,11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e19 (55,89)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e2,84 (0,85-9,43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0,082\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003eMonogamous\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e05 (21,73)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e18 (78,27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 617px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMother\u0026rsquo;s religion\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003eChristian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e09 (29,03)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e22 (70,97)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003eMuslim\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e11 (33,33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e22 (66,67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e1,10 (0,38-3,11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0,857\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003eAnimist\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e01 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e00 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eND\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0,144\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 617px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMothers\u0026rsquo;s occupation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003eHomemaker\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e15 (36,58)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e26 (63,42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e1,73 (0,56-5,31)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0,335\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003eTrader\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e01 (16,66)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e05 (83,34)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e0,39 (0,04-3,56)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0,389\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003eFarmer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e05 (31,25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e11 (68,75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e0,937 (0,27-3,15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0,917\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003eCivil servant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e00 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e02 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 617px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMother\u0026rsquo;s Age group (years)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e10-20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e02 (22,22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e07 (77,78)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e0,55 (0,10-2,94)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0,485\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e21-30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e10 (30,30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e23 (69,7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e0,83 (0,29-2,35)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0,725\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e31-40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e07 (36,84)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e12 (63,16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e\u0026gt;40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e02 (50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e02 (50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e2,21 (0,28-16,89)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0,434\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 617px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFather\u0026rsquo;s occupation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003eUnemployed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e01 (14,28)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e06 (85,72)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e0,28 (0,03-2,51)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0,230\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003eCivil servant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e00 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e03 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003eTrader\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e05 (29,41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e12 (70,59)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e0,63 (0,18-2,18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0,473\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003eFarmer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e14 (46,66)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e16 (53,34)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e3,20 (1,01-10,16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0,043\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003eMason \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e00 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e01 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eND\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0,464\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 617px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber of children per mother\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e01 child\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e02 (16,66)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e10 (83,34)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e0,35 (0,07-1,80)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0,199\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e2-3 children\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e04 (30,76)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e09 (69,24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e4-5 children\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e10 (37,03)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e17 (62,97)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e1,44 (0,50-4,12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0,491\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003eMore than 5 children\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e05 (38,46)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e08 (61,54)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e1,40 (0,39-4,97)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0,595\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 617px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBirth interval\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e1 year\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e02 (14,28)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e12 (85,72)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e0,21 (0,04-1,9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0,049\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e2 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e13 (43,33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e17 (56,67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e2,16 (0,66-7,03)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0,194\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e3 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e04 (57,14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e03 (42,86)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e2,75 (0,54-13,10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0,207\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003eMore than 3 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e00 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e02 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 617px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHousehold size\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e3-5 members\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e06 (18,18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e27 (81,82)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e5-10 members\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e05 (29,41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e12 (70,59)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e0,83 (0,25-2,77)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0,766\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003eMore than 10 members\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e10 (66,6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e05 (33,4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e7,09 (2,00-25,12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0,001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eND\u003c/strong\u003e: Not Defined \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003cstrong\u003eOR\u003c/strong\u003e: Odds ratio \u0026nbsp; \u0026nbsp; \u003cstrong\u003eCI\u003c/strong\u003e: Confidence Interval \u0026nbsp; \u0026nbsp; \u0026nbsp;Statistical significance was considered at p-value \u0026lt; 0.05\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.3-\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eDescription of Clinical Parameters of Mother\u0026ndash;Child Pairs\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTable 3 summarizes the clinical parameters of the children included in the study. Among them, 21 (32.3%) were diagnosed with severe acute malnutrition (SAM), while 44 (67.7%) exhibited a normal nutritional status. More than half (61.5%) were born with low birth weight, compared to 38.5% with normal birth weight. Regarding the place of delivery, the majority of births occurred in health facilities (66.2%), whereas 33.8% took place at home.\u003c/p\u003e\n\u003cp id=\"_Toc140815106\"\u003eIn the two weeks preceding the episode of Severe Acute Malnutrition (SAM), 64.6% of children had experienced an illness, while 35.4% remained unaffected. Figure 1 illustrates the distribution of these conditions, indicating that diarrhea was the most prevalent (44.6%), followed by malaria (30.8%), pneumonia (16.9%), tuberculosis (3.1%), and gastroenteritis (3.1%). No cases of measles or HIV/AIDS were reported.\u003c/p\u003e\n\u003cp\u003eAdditionally, 30.8% of the children had fathers who consumed alcohol, and 13.8% had fathers who smoked tobacco. Regarding preventive measures, 72.3% of the children had received vitamin A supplementation, and 50.8% had undergone deworming treatment.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTableau 3 :\u003c/strong\u003e Clinical Parameters of the Participants\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 300px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 216px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency (N=65)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercentages\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNutritional Status of the Child\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 357px;\"\u003e\n \u003cp\u003eSAM\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e32,3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 357px;\"\u003e\n \u003cp\u003eNot malnourished\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e67,7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBirth Weight of the Child\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 357px;\"\u003e\n \u003cp\u003eLow\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e61,5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 357px;\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e38,5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePlace of Delivery\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 357px;\"\u003e\n \u003cp\u003eIn a health facility\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e43 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e66,2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 357px;\"\u003e\n \u003cp\u003eAt home\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e33,8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePresence of Illness during the Two Weeks Preceding the Episode of SAM\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 357px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e64,6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 357px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e35,4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePaternal Alcohol Consumption\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 357px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e30,8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 357px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e69,2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFather\u0026rsquo;s Tobacco Consumption\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 357px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e13,8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 357px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e86,2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVitamin A Supplementation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 357px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e72,3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 357px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e27,7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eChild Deworming\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 357px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e50,8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 357px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e49,2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eSAM:\u0026nbsp;\u003c/strong\u003eSevere Acute Malnutrition\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.4 -\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eEffect of Clinical Parameters on Severe Acute Malnutrition Among Children Aged 6 to 59 Months in the Hina Health District\u003c/strong\u003e\u003c/p\u003e\n\u003cp id=\"_Toc140815107\"\u003eThe bivariate analysis presented in Table 4 indicates that certain clinical parameters were strongly associated with severe acute malnutrition (SAM) among children aged 6 to 59 months in the Hina Health District. Specifically, home delivery (p \u0026lt; 0.001) and the occurrence of diarrhea within the two weeks preceding the diagnosis of SAM (p \u0026lt; 0.001) emerged as significant risk factors, increasing the likelihood of developing SAM by 6.31 times (95% CI: 2.00\u0026ndash;19.86) and 10.13 times (95% CI: 2.85\u0026ndash;35.98), respectively.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4 :\u003c/strong\u003e Association Between Clinical Factors and Severe Acute Malnutrition Among Children Aged 6 to 59 Months in the Hina Health District\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRisk factors\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNutritional status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 201px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAdjustments\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCase\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eControl\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOR (95% CI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eP\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBirth Weight of the Child\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003eLow\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e17 (42,5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e23 (57,5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e3,88 (1,12-13,40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e0,026\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e04 (16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e21 (84)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePlace of Delivery\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003eIn a health facility\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e08 (18,60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e35 (81,4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003eAt home\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e13 (59,09)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e09 (40,91)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e6,31 (2,00-19,86)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0,001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePresence of Illness during the Two Weeks Preceding the Episode of SAM\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTuberculosis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e00 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e01 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0,00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e0,486\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e21 (32,81)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e43 (67,19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePneumonia\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e05 (45,45)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e06 (54,55)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1,97 (0,52-7,42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e0,306\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e16 (69,62)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e38 (70,38)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDiarrhea\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e17 (56,66)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e13 (43,34)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e10,13 (2,85-35,98)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0,001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e04 (11,42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e31 (88,58)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMalaria\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e10 (50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e10 (50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e3,09 (1,01-9,37)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e0,042\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e11 (24,44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e34 (75,56)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGastroenteritis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e00 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e02 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0,00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e0,321\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e21 (33,33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e42 (66,67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePaternal Alcohol Consumption\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e06 (30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e14 (70)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0,85 (0,27-2,67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e0,790\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e15 (33,33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e30 (66,67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFather\u0026rsquo;s Tobacco Consumption\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e03 (33,33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e06 (66,67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1,05 (0,23-4,70)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e0,943\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e18 (32,14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e38 (67,86)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVitamin A Supplementation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e16 (34,04)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e31 (65,96)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e05 (27,77)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e13 (72,23)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0,74 (0,22-2,46)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e0,628\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eChild Deworming\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e08 (24,24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e25 (75,76)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e13 (40,62)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e19 (59,38)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e2,13 (0,73-6,19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e0,157\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp id=\"_Toc142025073\"\u003e\u003cstrong\u003eSAM:\u0026nbsp;\u003c/strong\u003eSevere Acute Malnutrition\u003cstrong\u003e\u0026nbsp;OR\u003c/strong\u003e: Odds ratio \u003cstrong\u003eCI\u003c/strong\u003e: Confidence Interval Statistical significance was considered at p-value \u0026lt; 0.05\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.5. \u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eDescription of Dietary and Hygienic Practices Among Mother\u0026ndash;Child Dyads\u003c/strong\u003e\u003c/p\u003e\n\u003cp id=\"_Toc140815108\"\u003eAccording to Table 5, the dietary practices and nutritional knowledge of mothers and children in the Hina health district reveal significant gaps. Only 38% of children were exclusively breastfed up to six months of age, while 41.5% did not receive exclusive breastfeeding. Early introduction of foods other than breast milk occurred in 38.5% of children before six months, 59.2% at six months, and 12.3% after six months. The most commonly used complementary foods were fortified porridge (41.5%) and plain porridge made from maize or millet (40%), whereas breast milk and family meals were used in only 1.5% and 16.9% of cases, respectively.\u003c/p\u003e\n\u003cp\u003eThe average number of maternal meals per day was 2.34 \u0026plusmn; 0.85, ranging from 0 to 4 meals. Knowledge of exclusive breastfeeding was reported by 49.2% of mothers, while 41.5% were aware of complementary feeding practices. Hygiene behaviors indicated that 75.4% of mothers washed their children\u0026apos;s hands before meals and 72.3% after defecation. However, 24.6% and 27.7% did not adhere to these practices, respectively. The primary source of drinking water was boreholes (52.3%), followed by wells (29.2%), streams (16.9%), and tap water (1.5%). Regarding child defecation practices, the majority occurred in latrines (66.2%), with 27.7% in open spaces and 6.2% in the bush\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTableau 5:\u003c/strong\u003e Dietary and Hygienic Practices of the Participants\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 300px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 216px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency (N=65)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercentages\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNUTRITIONAL KNOWLEDGE AND DIETARY PRACTICE\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eExclusive Breastfeeding Practice\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 357px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e58,5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 357px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e41,5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIntroduction of Complementary Feeding\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 357px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBefore 6 Months\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e38,5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 357px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAt 6 Months\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e49,2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 357px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAfter 6 Months\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e12,3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eType of Complementary Food\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 357px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOnly Breast Milk\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e1,5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 357px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePlain Porridge Made from Maize or Millet\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e40%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 357px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFortified Porridge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e41,5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMaternal Daily Meal Frequency\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 357px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e1,6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 357px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e9,4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 357px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e54,7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 357px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e23,4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 357px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e10,9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eKnowledge on Exclusive Breastfeeding\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 357px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e49,2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 357px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e50,8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eKnowledge on Complementary Feeding\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 357px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e41,5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 357px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e58,5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHYGIENE PRACTICES\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eChild\u0026rsquo;s Handwashing Before Meals\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 357px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e75,4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 357px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e24,6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eChild\u0026rsquo;s Handwashing After Defecation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 357px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e72,3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 357px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e27,7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSource of Drinking Water\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 357px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBorehole\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e52,3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 357px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStream\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e16,9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 357px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWell\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e29,2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 357px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTap\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e1,5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePlace of Child Defecation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 357px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIn Latrines\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e66,2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 357px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIn the Bush\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e6,2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 357px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIn Open Spaces\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e27,7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp id=\"_Toc142025074\"\u003e\u003cstrong\u003e3.6-\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eEffect of Dietary and Hygienic Practices on Severe Acute Malnutrition Among Children Aged 6 to 59 Months in the Hina Health District\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe bivariate analysis presented in Table 6 indicates that certain dietary practices and nutritional knowledge are strongly associated with severe acute malnutrition (SAM) among children aged 6 to 59 months in the Hina Health District. Specifically, the use of plain porridge made from maize or millet as a complementary food (p \u0026lt; 0.001; OR: 7.50; 95% CI: 2.33\u0026ndash;24.09), and the lack of maternal knowledge regarding complementary feeding (p \u0026lt; 0.001; OR: 28.28; 95% CI: 3.55\u0026ndash;235.06), were identified as significant risk factors, increasing the likelihood of SAM occurrence by 7.50 and 28.28 times, respectively.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTableau 6:\u003c/strong\u003e Relationship Between Dietary and Hygiene Practices and Severe Acute Malnutrition Among Children Aged 6 to 59 Months in the Hina Health District\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" class=\"fr-table-selection-hover\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRisk factors\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNutritional status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 201px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAdjustments\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCases\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eControl\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOR (95% CI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eP\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNUTRITIONAL KNOWLEDGE AND DIETARY PRACTICE\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eExclusive Breastfeeding Practice\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e10 (26,31)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e28 (73,69)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e11 (40,74)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e16 (59,26)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1,92 (0,67-5,52)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e0,220\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIntroduction of Complementary Feeding\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBefore 6 Months\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e11 (44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e14 (56)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e2,35 (0,81-6,84)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e0,111\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAt 6 Months\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e07 (21,87)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e25 (78,13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAfter 6 Months\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e03 (37,5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e05 (62,5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1,30 (0,27-6,04)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e0,737\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eType of Complementary Food\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOnly Breast Milk\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e00 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e01 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0,00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e0,486\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePlain Porridge Made from Maize or Millet\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e15 (57,69)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e11 (42,31)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e7,50 (2,33-24,09)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0,001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFortified Porridge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e03 (11,11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e24 (88,89)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eType of Complementary Food\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e03 (27,27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e08 (72,73)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0,75 (0,17-3,17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e0,695\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMaternal Daily Meal Frequency\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e00 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e1 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0,00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e0,486\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e3 (50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e3 (50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e2,27 (0,41-12,38)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e0,330\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e10 (28,57)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e25 (71,43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0,69 (0,24-1,96)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e0,486\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e6 (37,5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e10 (62,5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1,36 (0,41-4,42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e0,608\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e2 (28,57)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e5 (71,43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eKnowledge on Exclusive Breastfeeding\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e7 (21,87)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e25 (78,13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e14 (42,42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e19 (57,58)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e2,63 (0,88-7,79)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e0,076\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eKnowledge on Complementary Feeding\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1 (3,70)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e26 (96,3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e20 (52,63)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e18 (47,37)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e28,88 (3,55-235,06)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0,001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eHYGIENE PRACTICES\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eChild\u0026rsquo;s Handwashing Before Meals\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e14 (28,57)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e35 (71,43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e7 (43,75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e9 (56,25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1,94 (0,60-6,24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e0,259\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eChild\u0026rsquo;s Handwashing After Defecation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e16 (34,04)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e31 (65,96)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e5 (27,77)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e13 (72,23)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0,74 (0,22-2,46)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e0,628\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSource of Drinking Water\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBorehole\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e9 (26,47)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e25 (73,53)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0,57 (0,19-1,62)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e0,291\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStream\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e4 (36,36)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e7 (63,64)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1,24 (0,32-4,82)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e0,752\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWell\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e7 (36,84)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e12 (63,16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1,33 (0,43-4,10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e0,615\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTap\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e00 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 614px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePlace of Child Defecation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIn Latrines\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e12 (36,36)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e31 (63,64)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIn the Bush\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1 (25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e3 (75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0,68 (0,06-6,99)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e0,746\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIn Open Spaces\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e8 (44,44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e10 (55,56)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e2,09 (0,67-6,46)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e0,195\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eOR\u003c/strong\u003e: Odds ratio \u0026nbsp; \u003cstrong\u003eCI\u003c/strong\u003e: Confidence Interval \u0026nbsp; \u0026nbsp; Statistical significance was considered at p-value \u0026lt; 0.05\u003c/p\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eThe results of this study indicate that severe acute malnutrition (SAM) among children aged 6 to 59 months in the Hina Health District is strongly influenced by sociodemographic, clinical, nutritional, and hygienic factors. These determinants reflect a multifactorial dynamic already documented in various contexts across sub-Saharan Africa and Asia. Regarding sociodemographic factors, the analysis reveals that children aged 12 to 23 months represent a critical period, with a sevenfold increased risk of SAM (OR\u0026thinsp;=\u0026thinsp;7.77; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). This age group, often referred to as the \u0026ldquo;weaning period,\u0026rdquo; is particularly vulnerable due to inadequate complementary feeding practices, commonly observed in disadvantaged areas (Agarwal et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Lakhmawar et al., \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2025\u003c/span\u003e). In this study, 60.8% of malnourished children belonged to this age group and were primarily fed plain millet or maize porridge, which lacks essential nutrients. Similar findings have been reported in Nigeria (Iman \u003cem\u003eet al.\u003c/em\u003e, 2020) and Nepal (Dahal et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Furthermore, female sex was identified as a risk factor (OR\u0026thinsp;=\u0026thinsp;11.40), echoing observations from Gabon (Mboumba, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2010\u003c/span\u003e) and Benin (Mongbo \u003cem\u003eet al.\u003c/em\u003e, 2018). This disparity reflects cultural biases in resource allocation, as highlighted in studies conducted in predominantly Muslim regions (Thurstans et al., \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Lakhmawar et al., \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2025\u003c/span\u003e). Maternal education also plays a crucial role: 75% of mothers of malnourished children had never attended school, significantly increasing the risk of SAM (OR\u0026thinsp;=\u0026thinsp;19.5). This finding aligns with studies by Endris et al. (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2017\u003c/span\u003e) in Ethiopia and Ndah et al. (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2024\u003c/span\u003e) in Cameroon, although Pravana et al. (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2017\u003c/span\u003e) in Nepal reported divergent results. The lack of maternal education is associated with a higher likelihood of child malnutrition, as educated mothers generally possess better knowledge of nutrition and hygiene, greater access to health services, and enhanced decision-making power (Fatema \u0026amp; Kabir, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2017\u003c/span\u003e; Sey-Sawo \u003cem\u003eet al.\u003c/em\u003e, 2023). Additionally, households with more than 10 members were associated with SAM (OR\u0026thinsp;=\u0026thinsp;7.09), reflecting competition for limited resources. Similar findings were reported by Adedokun \u0026amp; Yaya (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2021\u003c/span\u003e) and Gemechu et al. (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2021\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eClinically, home delivery (OR\u0026thinsp;=\u0026thinsp;6.31) emerged as a major determinant, likely due to the absence of postnatal care and appropriate nutritional counseling particularly among uneducated mothers highlighting the importance of access to maternal and neonatal health services. These findings align with those of Ndah et al. (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2024\u003c/span\u003e) in Cameroon and Olusanya \u0026amp; Renner (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2012\u003c/span\u003e) in Nigeria. Home births often reflect limited access to healthcare services, which can result in inadequate postnatal care, poor infant feeding practices, and lack of immunizations (Guevara \u0026amp; Gutierrez, 2018; Ndah et al., \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). These observations are consistent with studies emphasizing the role of health coverage in improving nutritional outcomes. Moreover, the occurrence of diarrhea within the two weeks preceding the onset of SAM increased the risk by a factor of 10.13, confirming the critical role of infectious diseases. This result is consistent with findings by Awoke et al. (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2018\u003c/span\u003e) in Ethiopia and Musa et al. (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2017\u003c/span\u003e) in Bangladesh. Diarrhea leads to fluid and electrolyte loss, anorexia, and intestinal malabsorption, which rapidly exacerbate undernutrition. Malnutrition, in turn, weakens the immune system, increasing susceptibility to infections such as diarrhea, further impairing nutrient absorption and appetite (Olusanya \u0026amp; Renner, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2012\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eNutritionally, the findings also reveal that feeding practices are a critical determinant of severe acute malnutrition (SAM). Children who received plain maize or millet porridge as complementary food had a 7.50-fold increased risk of SAM, while the absence of maternal knowledge about dietary diversification significantly amplified this risk (OR\u0026thinsp;=\u0026thinsp;28.88). These results are consistent with those reported by Agbor \u003cem\u003eet al.\u003c/em\u003e (2021) in Southwest Cameroon and David et al. (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2020\u003c/span\u003e), who emphasized the impact of poor dietary diversification on the nutritional quality of infant diets. The low nutrient density of such porridges weakens the immune system and increases susceptibility to infections. Although hygiene practices such as handwashing and latrine use are relatively well adopted in this population, their partial inadequacy may indirectly contribute to the persistence of infectious diseases and, consequently, to malnutrition, as highlighted by Ndah et al. (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2024\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThese results highlight the interconnectedness of biological, cultural, and socioeconomic factors in the development of severe acute malnutrition (SAM). They underscore the need for integrated multisectoral interventions, including maternal nutrition education, promotion of exclusive breastfeeding, improvement of complementary feeding practices, and strengthened access to maternal and child health services. However, this study presents certain limitations, such as the lack of assessment of key factors (household income, maternal nutritional status, women's decision-making power). Additionally, translation biases between French and Fulfulde may have influenced some of the results.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study aimed to identify the risk factors associated with severe acute malnutrition (SAM) among children aged 6 to 59 months in the Hina Health District, located in the Far North Region of Cameroon. The findings revealed that SAM is strongly influenced by sociodemographic determinants (maternal lack of education, female sex of the child, age between 12 and 23 months, and household size \u0026gt;10 members), clinical factors (home delivery, recent history of diarrhea), and nutritional factors (consumption of plain maize or millet porridge as complementary food, lack of maternal knowledge on dietary diversification). These observations suggest that efforts to combat SAM in this area must go beyond therapeutic management and incorporate preventive strategies targeting feeding practices, maternal education, access to neonatal care, and infectious disease prevention. The results thus provide a valuable scientific foundation for guiding multisectoral interventions tailored to the local context and for strengthening policies aimed at reducing childhood malnutrition in the Far North Region.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003e\u003cb\u003eBSFP\u003c/b\u003e\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eBlanket Supplementary Feeding Program\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003e\u003cb\u003eCI\u003c/b\u003e\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003econfidence intervals\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003e\u003cb\u003eIMAM\u003c/b\u003e\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eIntegrated Management of Acute Malnutrition\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003e\u003cb\u003eMUAC\u003c/b\u003e\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eMid-Upper Arm Circumference\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003e\u003cb\u003eNGO\u003c/b\u003e\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eNon-Governmental Organization\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003e\u003cb\u003eOR\u003c/b\u003e\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eOdds ratios\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003e\u003cb\u003eSAM\u003c/b\u003e\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eSevere acute malnutrition\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003e\u003cb\u003eWFP\u003c/b\u003e\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eWorld Food Program\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical compliance\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical clearance was not obtained for this study due to the non-operational status of the ethics committee during the research period. However, administrative authorization for data collection was granted by the Regional Delegation of Public Health following the submission and approval of the research protocol.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDeclarations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAbbreviations\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eBSFP\u003c/strong\u003e: Blanket Supplementary Feeding Program; \u003cstrong\u003eCI\u003c/strong\u003e: confidence intervals; \u003cstrong\u003eIMAM\u003c/strong\u003e: Integrated Management of Acute Malnutrition; \u003cstrong\u003eMUAC\u003c/strong\u003e: Mid-Upper Arm Circumference; \u003cstrong\u003eNGO:\u003c/strong\u003e Non-Governmental Organization; \u003cstrong\u003eOR\u003c/strong\u003e: Odds ratios; \u003cstrong\u003eSAM\u003c/strong\u003e: Severe acute malnutrition; \u003cstrong\u003eWFP\u003c/strong\u003e: World Food Program;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was conducted as part of an internship at Helen Keller International Cameroon (HKI). All ethical principles and values promoted by the organization were strictly respected during data collection and analysis. Although no formal institutional ethics committee approval number was issued because the ethics committee was not yet operational at that time, the data collection authorization issued by the regional delegation of public health following submission and approval of research protocol served as the sole document ensuring ethical compliance. The study procedures adhered to the principles of the Declaration of Helsinki. Verbal authorization and consent to conduct the survey were obtained from Helen Keller International Cameroon and verbal consent was obtained from all participants prior to administering the questionnaire, and the purpose of the study was clearly explained to them.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors received approval from Helen Keller International Cameroon (HKI) for the publication of the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request, with the verbal authorization of Helen Keller International Cameroon.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research did not receive any specific grant or financial support from public, commercial, or not-for-profit funding agencies.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eContribution of Authors:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eConceptualization: EBK, GMT, PFFT, HMW, FZN. Data curation: EBK, GMT. Formal analysis: EBK, GMT. Funding acquisition: EBK, GMT, IT, AON, HMW, FZN. Investigation: EBK, AON, ASK. Methodology: EBK, GMT, AON, ASK, HMW, FZN. Project administration: EBK, GMT, IT, HMW, FZN. Resources: EBK, GMT, IT, HMW, FZN. Software: EBK, PFFT. Supervision: EBK, GMT, ASK, IT, HMW, FZN. Validation: EBK, GMT, PFFT, IT, HMW, FZN. Visualization: EBK, GMT, HMW, FZN. Writing – original draft: EBK, GMT, PFFT. Writing – review \u0026amp; editing: EBK, GMT, IT, HMW, FZN.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors express their sincere gratitude to Helen Keller International Cameroon for technical support, access to the study area, and guidance during the data collection process.\u003c/p\u003e\n\u003cp\u003eSpecial thanks are extended to all participants and field agents who contributed to the success of this research.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAdedokun, S. T., \u0026amp; Yaya, S. (2021). Factors associated with adverse nutritional status of children in sub-Saharan Africa: Evidence from the Demographic and Health Surveys from 31 countries. \u003cem\u003eMaternal and Child Nutrition\u003c/em\u003e, \u003cem\u003e17\u003c/em\u003e(3). https://doi.org/10.1111/MCN.13198\u003c/li\u003e\n\u003cli\u003eAgarwal, A. K., Rajput, A., Mahore, R., \u0026amp; Dubey, G. 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Is home birth a marker for severe malnutrition in early infancy in urban communities of low-income countries? \u003cem\u003eMaternal and Child Nutrition\u003c/em\u003e, \u003cem\u003e8\u003c/em\u003e(4), 492\u0026ndash;502. https://doi.org/10.1111/J.1740-8709.2011.00330.X\u003c/li\u003e\n\u003cli\u003ePravana, N. K., Piryani, S., Chaurasiya, S. P., Kawan, R., Thapa, R. K., \u0026amp; Shrestha, S. (2017). Determinants of severe acute malnutrition among children under 5 years of age in Nepal: a community-based case\u0026ndash;control study. \u003cem\u003eBMJ open\u003c/em\u003e, \u003cem\u003e7\u003c/em\u003e(8), e017084. https://doi.org/10.1136/bmjopen-2017-017084\u003c/li\u003e\n\u003cli\u003eSey-Sawo, J., Sarr, F., Bah, H. T., \u0026amp; Senghore, T. (2023). 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Disponible sur: htpps://www.unicef.org/reports/state-of-worlds-children-2019 \u003c/li\u003e\n\u003cli\u003eUNICEF, \u0026amp; United Nation High Commissioner for Refugees (UNHCR). (2021). Preliminary results, Standardized Monitoring and Assessment of Relief and Transitions (SMART)-SENS 2021. Nutrition Survey.\u003c/li\u003e\n\u003cli\u003eUnited Nations Children\u0026rsquo;s Fund (UNICEF). (2021). \u003cem\u003eFed to Fail? The Crisis of Children\u0026rsquo;s Diets in Early Life. Child Nutrition Report,\u003c/em\u003e pp5-8.\u003c/li\u003e\n\u003cli\u003eWHO (World Health Organization).(2020). \u003cem\u003eMalnutrition\u003c/em\u003e : Malnutrition (who.int)\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Severe acute malnutrition, risk factors, children aged 6 to 59 months, Hina, Far North Region of Cameroon","lastPublishedDoi":"10.21203/rs.3.rs-7811233/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7811233/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eSevere acute malnutrition (SAM) remains a major public health issue in developing countries, particularly affecting children under five years of age. This study aimed to identify risk factors associated with the occurrence of SAM among children aged 6 to 59 months in the Hina Health District. A case-control study was conducted from May 15 to June 30, 2023, involving 65 mother-child pairs (malnourished and well-nourished children) recruited from health facilities. Sociodemographic, clinical, nutritional, and hygiene-related data were collected using a standardized questionnaire and analyzed with SPSS Statistics 26 and Epi-Info. Statistical associations were assessed through multivariate logistic regression to estimate odds ratios (ORs) with 95% confidence intervals (CI). The results revealed that sociodemographic factors such as lack of maternal education (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001; OR\u0026thinsp;=\u0026thinsp;19.5), child age between 12 and 23 months (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001; OR\u0026thinsp;=\u0026thinsp;7.77), female sex (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001; OR\u0026thinsp;=\u0026thinsp;11.40), and household size greater than 10 (P\u0026thinsp;=\u0026thinsp;0.001; OR\u0026thinsp;=\u0026thinsp;7.09), as well as clinical factors such as home delivery (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001; OR\u0026thinsp;=\u0026thinsp;6.21) and recent diarrhea (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001; OR\u0026thinsp;=\u0026thinsp;10.13), were significantly associated with SAM. Nutritional and hygiene practices, including the use of plain maize or millet porridge as complementary feeding (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001; OR\u0026thinsp;=\u0026thinsp;7.50) and lack of maternal knowledge about dietary diversification (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001; OR\u0026thinsp;=\u0026thinsp;28.88), also showed strong associations. In conclusion, this study highlights key sociodemographic, clinical, and nutritional determinants that should be targeted through preventive interventions to reduce the burden of severe acute malnutrition in this health district of Cameroon.\u003c/p\u003e","manuscriptTitle":"Study of Factors Associated with the Occurrence of Severe Acute Malnutrition in Children Aged 6 to 59 Months in the Hina Health District, Far North Region of Cameroon","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-18 08:38:17","doi":"10.21203/rs.3.rs-7811233/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-12-09T12:12:23+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-23T08:04:27+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-22T03:00:14+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-21T02:09:53+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"98376388720171784317108203172342456481","date":"2025-11-11T18:50:17+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"269918137874504206286251731416816601300","date":"2025-11-11T10:10:54+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"9416061636802084631026813096960028842","date":"2025-11-10T14:15:18+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-11-06T02:00:41+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-11-06T01:58:40+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-10-25T04:42:27+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-10-24T09:19:16+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Public Health","date":"2025-10-24T09:15:41+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"e4f8ba04-2b52-47fd-adf4-20adedd132a0","owner":[],"postedDate":"November 18th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-02-26T03:53:27+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-18 08:38:17","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7811233","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7811233","identity":"rs-7811233","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}