Malnutrition and its Related Factors among Children under Five Years in Zahedan, Southeastern Iran

Background & Aim: Malnutrition is one of public health concerns among children leading to high morbidity and mortality. The present study aimed to determine the prevalence and identify the determinants of malnutrition among children under five years in Zahedan. Materials and Methods: This cross-sectional study included children under five years and their mothers who attending two Zahedan comprehensive urban health centers. Participants were recruited from a quota sampling. Data on characteristics of children and mothers were obtained from child care records and maternal reporting as necessary. Weight and height of children were measured according to the standard protocol by a trained person. Malnutrition is measured in terms of underweight, stunting and wasting. Multivariable logistic regression analysis and the area under the curve (AUC) were used to identify determinants of malnutrition. Results: A total of 825 mother-child pairs were included. Prevalence of underweight, stunting and wasting were 7.6%, 20.6% and 5.8%, respectively. The results of multivariable analysis showed that underweight may be determined using by mother’s education, low birth weight (LBW), birth interval, nutrition style, age of introduction of complementary feeding (AUC=0.75); stunting using by sex, age, maternal age, father’s education, family size, LBW, birth order and nutrition style (AUC=0.67) and wasting using by sex, age, mother’s education, LBW and nutrition style (AUC=0.72). LBW was significant shared determinant in the nomograms with an odds ratio of over 2.00. Conclusion: Our findings demonstrate a moderate to the high prevalence of malnutrition and a combination of parent's educational attainment, LBW, birth order, birth interval and nutritional practice as determinants of malnutrition among children under five years in Zahedan.