Malnutrition and its associated factors: A cross-sectional study with children under 2 years in a suburban area in Angola

Background: The prevalence of child malnutrition in Angola is still very high, and little is known about its associated factors. The aim of this study was to identify these factors in children under 2 years in a suburban area of the country's capital city. Methods: We used data from a cross-sectional population-based study conducted in 2010. The outcomes studied were stunting and underweight. Multivariable analysis was conducted; prevalence ratios were estimated by Poisson regression with robust variance using a hierarchical model. Results: Of the children studied (N = 749), 232 [32.0% (95% CI: 28.7-35.5%)] were stunted and 109 [15.1% (95% CI: 12.6-17.9%)] were underweight. In multivariable analysis, occurrence of diarrhea (PR 1.39 [95% CI: 1.07-1.87]) and the death of other children in the household (PR 1.52 [95% CI: 1.01-2,29]) were associated with stunting and underweight, respectively. In the model composed only of distal and intermediate factors, the primary caregiver not being the mother increased the prevalence of stunting by 42% (PR 1.42 [95% CI: 1.10-1.84], and a mother's working outside the house while not being self-employed was associated with its reduced prevalence (PR 0.55 [95% CI: 0.34-0.89]). In the intermediate model, each additional month of delay in the onset of prenatal care increased the relative prevalence of underweight by 20% (PR 1.20 [95% CI: 1.03-1.40]). Conclusions: Despite the high prevalence rates of stunting and underweight, relatively few risk factors were identified for these conditions, suggesting that collective exposures are likely to play a major role in causing malnutrition in Angola. The individual factors identified can be useful for the development of strategies to deal with this public health problem.