Master's Project Title:

Risk Factors to Malnutrition in Children Under Five Years Old in Djibouti, Africa

MCH Student:

Robie Aden

Date of Defense:

January 28, 2010


Introduction:  Malnutrition in children under five years old has been increasing over the years in Africa, and particularly in Djibouti, where it has become a public health concern and a chronic phenomenon. However, no study to identify its risk factors has been reported to date.

Objectives: To determine the risk factors associated with malnutrition among children aged 0-5 years in Djibouti and to provide information useful to better control this epidemic of malnutrition.

Methods:  Children less than five years old were recruited from a community health care center in Djibouti City in 2008-2009.  The sample consisted of 136 malnourished children (cases) and 131 other children who were not malnourished (controls). Malnutrition was defined as ≤ -2 z-scores for weight to length/height and/or presence of edema. Information was collected from their parents using a structured questionnaire.

Results:  Seventeen potential risk factors contributing to malnutrition were identified; six of them are statistically significant risks including: difficulty accessing a health care center (OR=2.61), low education among parents (mother, OR=2.58; father, OR=1.73), practice of traditional medicine (anal scratching, OR=1.42), lack of good nutrition (meat, OR=1.85), and child anemia (OR=1.76).

Conclusions:  The wasting malnutrition encountered among young children in Djibouti is associated with demographic, socio-economic, nutritional, and health-related factors. A multidisciplinary approach is needed to address these risk factors and reduce the prevalence of malnutrition among young children in Djibouti.