Factors Influencing Wasting in Children Under 5 in Arid Regions of Kenya.

Abstract

Child wasting is a major public health problem in low- and middle-income countries. Our study aimed to identify immediate, underlying and basic factors influencing wasting among children in Turkana and Samburu, two arid and semi-arid regions in Kenya. Data are from a longitudinal study of children under 3 years of age at baseline, with follow-up every 4 months for 2 years. Generalized estimating equations were used to assess risk factors of wasting in this population. Among immediate factors, children who recently experienced diarrhoea had 19% and 23% higher odds of wasting, and those who consumed animal-source foods had 12% and 22% lower odds of wasting in Turkana and Samburu, respectively. Among underlying factors, children in Turkana whose caregivers used alcohol had 32% higher odds of wasting, whereas there was no effect of household food insecurity or factors related to water and sanitation on wasting in either county. Children in Turkana whose caregivers had 3-5 or 6 or more children had 39% and 70% higher odds, whereas those in female-headed households had 34% and 81% higher odds of wasting in Turkana and Samburu, respectively. Male children also had increased odds of wasting; 21% and 41% in Turkana and Samburu, respectively. Children in Turkana's fisherfolk communities had 36% higher odds of wasting compared with those in urban or peri-urban areas. Key risk factors for wasting included child sex, reported diarrhoea, caregiver's use of alcohol (in Turkana), caregiver's number of children, female-headed households and fisherfolk livelihood (in Turkana) while consuming animal-source foods was associated with lower risk. Interventions should target these intersecting factors to reduce wasting in these counties.