Determinants of severe acute malnutrition in Bangladeshi under-five children: a hospital-based case-control study

Introduction Severe acute malnutrition (SAM) is a critical public health issue in Bangladesh, particularly among children under five, and is a leading cause of death. While most studies have examined malnutrition broadly, this study aims to identify the specific determinants of severe acute malnutrition among hospitalized children in Bangladesh. Method A hospital-based case-control study was conducted from August 2023 to July 2024 among under-five children in Bangladesh. The study included 102 cases of children diagnosed with severe acute malnutrition and 105 controls without severe acute malnutrition. Both cases and controls were hospitalized in a specialized care hospital. Bivariate and multivariate logistic regression analyses were performed to identify the determinants of severe acute malnutrition. Results Multivariate analysis identified several significant determinants of SAM among under-five children in Bangladesh. Children whose fathers had no formal or primary education (adjusted odds ratio, aOR: 3.45, 95% CI: 1.3-9.15), low household income (aOR: 2.49, 95% CI: 1.06-5.86), and lack of exclusive breastfeeding for six months (aOR: 2.93, 95% CI: 1.22-7.0) were at higher risk of SAM. Other significant factors included home births without trained assistance (aOR: 3.56, 95% CI: 1.13-11.26), mothers with low BMI (aOR: 4.46, 95% CI: 1.32-15.11), maternal depression (aOR: 3.82, 95% CI: 1.68-8.7), and drinking unsafe water (aOR: 2.98, 95% CI: 1.26-7.07). Conclusion These findings highlight the significant relation of socio-economic and health-related factors on child nutrition and emphasize the need for targeted interventions to address these issues especially among hospitalized malnourished children.