Factors Associated with Malnutrition Among Under-Five Rohingya Refugee Children in Cox’s Bazar, Bangladesh: A Cross-Sectional Study

Objective To estimate the prevalence and determinants of malnutrition among under-five Rohingya refugee children living in Cox’s Bazar, Bangladesh. Design Community-based cross-sectional study. Setting Rohingya refugee camps, Cox’s Bazar, Bangladesh. Participants A total of 256 children aged 6–59 months residing in refugee camps were enrolled through convenience sampling. Primary outcome measures Stunting, wasting, underweight, and overweight, measured using WHO standards.

It was a cross-sectional study with a 256-sample size. Respondents were selected by convenience sampling. The target population was the Rohingya people of Cox’s Bazar, Bangladesh. A well-designed and pretested set of structured questionnaires was used to collect the information. The total study duration was 3 months of the period following the approval of the protocol. Informed consent was taken from the participants, and ethical issues were ensured by the Declaration of Helsinki. Data were analyzed by using SPSS.

The prevalence of stunting, wasting, underweight, and overweight were 34.4%, 17.6%, 18.9%, and 6.9%, respectively. Age was inversely associated with stunting (AOR=0.97, 95% CI: 0.95–0.99, p=0.006). Male children had higher odds of wasting compared to females (AOR=2.03, 95% CI: 1.34–3.07, p=0.001). Children from poor households were more likely to be stunted (AOR=2.42, 95% CI: 1.31–4.48) and wasted (AOR=2.82, 95% CI: 1.23–6.47). Illiteracy among parents significantly increases the risks of malnutrition.

Malnutrition among Rohingya refugee children under five is alarmingly high. Both biological and socioeconomic determinants significantly influence nutritional status. Urgent multi-sectoral interventions addressing food security, parental education, and sanitation are required. Competing Interest Statement The authors have declared no competing interest. Funding Statement This study did not receive any funding. Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethical approval obtained from North South University IRB. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data Availability All data produced in the present work are contained in the manuscript. Abbreviation - SAM - Severe Acute Malnutrition - MAM - Moderate Acute Malnutrition - MUAC - Mid-Upper Arm Circumference - FDMN - Forcefully Displaced Myanmar National - BMI - Body Mass Index - OTP - Outpatient Therapeutic Center - ISCG - Inter Sector Coordination Group - WHO - World Health Organization - SDG - Sustainable Developmental Goal - ORS - Oral Rehydration Salt - UN - United Nations - GAM - Global Acute Malnutrition - HAZ - Height-For-Age Z-Score. - SD - Standard Deviation. - WAZ - Weight-For-Age Z Score. - WHZ - Weight-For-Height Z Score. - AOR - Adjusted Odds Ratio. - CI - Confidence Interval. - FCS - Food Consumption Score; - FIES - Food Insecurity Experience Scale.