Determinants of severe acute malnutrition among children aged 6-59 months in the rural health zone of Nundu, in a context of armed conflict and limited resources in eastern DR Congo: A cross-sectional study
Year: 2026
Type: preprint
Study design: Observational Study
Abstract: Background Severe acute malnutrition (SAM) in children aged 6–59 months remains a critical public health crisis, particularly within conflict-affected and low-income regions. In fragile ecosystems, SAM seriously compromises children's physical, cognitive, and social development, while driving high mortality rates. This study aimed to determine the prevalence of severe acute malnutrition and identify its main socio-demographic, dietary, and economic determinants among children aged 6–59 months in the Nundu rural health zone (NRHZ), South Kivu, Democratic Republic of the Congo. Methods A community-based cross-sectional and analytical study was conducted on a sample of 384 children aged 6–59 months, selected using a proportional stratified sampling approach across 10 health areas. Anthropometric indicators were evaluated using Mid-Upper Arm Circumference (MUAC), where a MUAC < 115 mm defined severe acute malnutrition. Mobile data collection was executed via KoboToolbox. Statistical analyses, including Pearson’s chi-square tests and multivariate logistic regression, were performed using Stata 16 to determine independent risk factors. Results The study revealed an alarming SAM prevalence of 30.7% (95% CI: 26.2–35.0%) among the targeted pediatric population. This rate critically exceeds national and regional emergency thresholds. Multivariate logistic regression identified several independent predictors of SAM: child's age between 12–23 months (aOR = 2.73; 95% CI: 1.57–4.74; p < 0.001), a documented history of malnutrition (aOR = 2.03; p = 0.005), hospitalisation within the 12 months prior to the survey (aOR = 2.76; 95% CI: 1.58–4.81; p < 0.001), structural introduction of non-optimal alternative feeding sources (aOR = 1.73; 95% CI: 1.07–2.79; p = 0.023), failure to maintain exclusive breastfeeding until 6 months of age (aOR = 1.73; 95% CI: 1.08–2.79; p = 0.022), lack of geographic or financial access to healthcare infrastructure (aOR = 5.74; 95% CI: 1.61–20.41; p = 0.007), very low household socioeconomic status (aOR = 9.01; 95% CI: 1.11–73.14; p = 0.040), and household self-perception of extreme poverty (aOR = 3.10; p = 0.010). Conclusion This investigation highlights a devastating nutritional emergency in the Nundu rural health zone, where pediatric malnutrition has crossed critical humanitarian thresholds. Addressing this crisis requires immediate, multi-sectoral emergency nutritional programming, coupled with sustainable investments in primary healthcare access, community-based screening, and maternal economic empowerment.
Source: Research Square
Institution: Université Officielle de Bukavu
Language: English
Subfield: Nutrition and Dietetics
Field: Nursing
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7204842148