Association Between Acute Malnutrition and Neurodevelopment Outcomes Among Children Under Five Years Old in Nairobi Informal Settlements

Patrick Amboka^1*Margaret Nampijja¹Peninah Kinya Masibo^2,3

• ¹African Population and Health Research Center (APHRC), Nairobi, Kenya
• ²Amref International University, Nairobi, Kiribati
• ³University of California San Francisco, San Francisco, United States

Background A child’s early years of life are a critical period for brain development, and malnutrition at this stage is associated with irreversible developmental delays. Developmental delays can be affected by maternal, child, and household factors. This study examined the association between acute malnutrition relapse and neurodevelopmental outcomes among children under five years old in Nairobi’s informal settlements. Methodology The study used a comparative cross-sectional design that was hospital-based and was carried out in Viwandani and Korogocho informal settlements in Nairobi, Kenya. The three groups that were compared were children under five years old who had never suffered acute malnutrition, those who had the first episode of acute malnutrition, and those who had acute malnutrition relapse. The study used both quantitative and qualitative methods, and the purposive sampling technique was used in both methods. The Malawi Development Assessment Tool(MDAT) assessed the neurodevelopment outcomes. Quantitative data is presented at both univariate, bivariate, and multi-variate levels. Qualitative data was analyzed thematically, and predetermined themes and emerging themes were identified and added. Results Acute malnutrition relapse was a significant predictor of neurodevelopment outcomes among children under five years old. Children who had either never relapsed from acute malnutrition or had normal nutrition status were 2.08 times more likely to have normal neurodevelopmental outcomes compared to children who had relapsed [AOR=2.08; CI:1.11, 3.90; p-value, 0.02]. Maternal postpartum depression and child maturity status at birth were also significant predictors of neurodevelopmental outcomes among children under five years in Nairobi informal settlements [AOR=3.62; CI:1.86, 7.04; p-value < 0.001], [AOR=2.93; CI:1.21, 7.12; p-value, 0.02], respectively. The qualitative findings further showed that breastfeeding, sanitation, and diarrhea have an association with children’s neurodevelopmental outcomes Conclusion This study demonstrates that children under five who experience relapses due to acute malnutrition exhibit significantly delayed neurodevelopmental outcomes compared to those who do not relapse. Furthermore, qualitative findings showed that breastfeeding, sanitation, and diarrhea have an association with children’s neurodevelopmental outcomes.