RISK-FACTORS FOR THE PREVALENCE OF MALNUTRITION AMONG URBAN CHILDREN IN GHANA

A case-control study was completed at the Princess Marie Louise Hospit al in Accra, Ghana, to identify risk factors for the prevalence of und erweight and severe malnutrition in urban African children. A total of 170 children, aged 8 to 36 mo, with normally nutritional status (grea ter than or equal to 80% W/A of NCHS reference), underweight (moderate malnutrition) (60-80% W/A), or severe malnutrition (<80% W/A and pres ence of edema, or <60% of W/A) were recruited at the clinical ward and at the public health service section of the hospital. Anthropometric measurements and physical examinations were completed, and the guardia ns were interviewed about their children's health status, birth weight , child care, and household conditions. The severely malnourished chil dren were more likely to have young mothers (p < 0.05) and low weight at birth (p < 0.05). The underweight children were also observed to ha ve low birth weight (p < 0.05). The severely malnourished group showed the tendencies of less feeding frequency (p < 0.01), less access to b reast-feeding (p < 0.01), and less support by both parents (p < 0.05), Moreover, the parents of the severely malnourished children had lower educational levels and lower income jobs, compared with those of the normal children (mother's education, p < 0.001; father's education, p < 0.001; mother's occupation, p < 0.05; father's occupation, p < 0.001 ). No significant differences in most variables existed between the no rmal and underweight groups. Multivariable analysis resulted in the co nclusion that the Z-score of weight-for-age, birth weight, and mother' s educational level were highly associated with one another. We conclu de that low birthweight is one of the important risk factors for the p revalence of underweight and severe malnutrition and that the lack of a mother's education is also a risk factor for the prevalence of sever e malnutrition in the urban children in Ghana.