Determinants of Severe Acute Malnutrition among Children age 6-59 Months Old in Two Public Hospitals, North West Ethiopia: a Case Control Study

Introduction Globally sever acute malnutrition affects 16.4 million under five children and more than one quarter of those children live in Africa. In Ethiopia, about 3% of children are severely wasted and continues to be persistent over the past 15 years. To implement an effective intervention, it is essential to identify predictors predispose to it. This study therefore, aimed to identify determinants of severe acute malnutrition among under five children in selected public health facilities, Northwest Ethiopia. Methods Institution based; age matched case control study was conducted on 104 cases and 208 controls. Bivariate and multivariate analyses were done using conditional logistic regression to identify predictors. Variables having P-value ≤ 0.2 during binary analysis were entered into multivariate analysis. P value < 0.05 was considered as statistically significant. Results Children from households of large family size(AOR=2.7, 95% CI: 1.06 – 6.9), having monthly income less than 1500 birr (AOR = 5.17, 95% CI: 1.7-15.3), which are food insecure (AOR = 2.9, 95% CI:1.17-7.28)), which didn’t receive any nutrition information (AOR= 3.47,95% CI: 1.14 - 7.10), didn’t practice exclusive breastfeeding (AOR = 2.69, 95% CI: 1.18 - 6.10), and practice infrequent hand washing (AOR= 7.6 95% CI:2.44-23.6) as well as children who had history of diarrhea two weeks prior to the survey (AOR 3.2, 95%CI:1.4-7.2) were more likely to suffer from severe acute malnutrition. Conclusion Family size, monthly income, food security status, exclusive breastfeeding practice, access to information on child feeding, hand washing practice and history of diarrhea were identified to be predictors of severe acute malnutrition. Due emphasis should be given to promoting family planning, improve household livelihoods and food security, strength awareness creation on exclusive breastfeeding and frequent hand washing practices as well as prevention of diarrhea.