Malnutrition and Socio-economic Factors in HIV Infected and Uninfected Under 5 Children in Zambia

Abstract

Malnutrition contributes to more than one third of all child deaths, although hardly listed as the direct cause. In sub-Saharan Africa, malnutrition accounts for about 2% of deaths and 3% of Disability adjusted life years (DALYs) among under-5 children. In Zambia, 35% of under-5 children are stunted, 4% wasted, 12% underweight and 5% overweight. Malnutrition and HIV interact in complex ways that increase vulnerability to and worsen each condition therefore we sought to determine factors associated with malnutrition among under 5 children in Zambia.Using Stata version 14.2, we extracted and analysed sample data of 159 children aged 0-59 months from the 2016 ZAMPHIA population-based survey, that used a two-stage cluster sampling design. We used Generalised Linear Models to measure socio-economic factors associated with malnutrition. P-value of less than 0.05 was set as level of statistical significance.Factors associated with malnutrition included gender, child's HIV status and wealth index which showed an association with stunting, wasting and being underweight. The 16 (10%) under-5 children living with HIV were significantly more affected by stunting (38% vs 33%), wasting (19% vs 11%) and underweight prevalence (38% vs 10%) than the remaining 143 who were HIV negative. Our sample prevalence was similar to national stunting (33% vs 35%) and underweight prevalence (13% vs 12%) but had three times higher wasting prevalence (12% vs 4%).A high prevalence of malnutrition was found in HIV positive compared to negative under 5 children, wealth index showing an association with malnutrition. Eliminating malnutrition is key to attaining SDG 3 which is to end preventable deaths of newborns and children under 5 years of age.