Musa, et al.: Risk factors of severe acute malnutrition 13 Journal of Medical Sciences and Health/Sep-Dec 2017/Volume 3/Issue 3 Risk Factors of Severe Acute Malnutrition among Under-five Children: A Hospital-based Study in Bangladesh Mustapha Kabir Musa 1 , Faisal Muhammad 2 , Kabir Musa Lawal 3 , A B M Alauddin Chowdhury 2 , Ahmed Hossain 1 ABSTRACT Background: Malnutrition is a major public health problem of developmental concern with both health and socioeconomic consequences. The study was aimed to determine the risk factors of severe acute malnutrition among under-five children. Material and Methods: This hospital-based case control study was conducted from December 2015 to April 2016 whereby a total of 196 children under 5 years (98 cases and 98 controls) whose age ranged from 6 to 60 months were included in the study, data were collected retrospectively using a questionnaire, and mid-upper arm circumference (MUAC) was taken using standard procedures. SPSS statistical software version 19 was used to analyze the dataset. Results: The mean ± standard deviation (SD) age of the cases and controls was 18.34 ± 14.6 and 16.93 ± 14.1 months, respectively, and the mean ± SD MUAC of the cases and controls was 9.36 ± 1.1 and 14.59 ± 2.2 cm, respectively. Risk factors associated with severe acute malnutrition were lack of taking balanced diet more than 3 times/day (adjusted odds ratio [AOR] = 5.355, 95% confidence interval [CI] = 1.162– 24.690), irregular hand washing with soap or other cleaning agents before feeding child (AOR = 0.317, 95% CI = 0.139–0.723), and father’s education level 0–8 class (AOR = 0.190, 95% CI = 0.054–0.676). Conclusions: Severe acute malnutrition was found to be associated with father’s education level, lack of taking balanced diet, and irregular hand washing. Interventions to reduce malnutrition and address the factors contributing to malnutrition should be a policy priority. KEY WORDS: Bangladesh, diarrhea, malnutrition, nutrition, public-health, under-five children 1 Department of Public Health, North South University Dhaka 1229, Bangladesh, 2 Department of Public Health, Daffodil International University, Dhaka 1207, Bangladesh, 3 Department of Public Health, Northern University Bangladesh, Dhaka 1205, Bangladesh Address for correspondence: Faisal Muhammad, Department of Public Health, Daffodil International University, Dhaka 1207, Bangladesh. Phone: +8801723406483. E-mail: fokkanya@yahoo.com Introduction Childhood undernutrition still remains one of the most serious public health problems in many countries, more especially low- and middle-income countries, and it has been reported that annually death of children in developing countries is about 1.7–3.6 million due to severe acute malnutrition (SAM) and moderate acute malnutrition, respectively. [1] Globally, it contributes to almost close to half of all child deaths, i.e.,, above 3 million children yearly. [2] SAM, which includes wasting (low weight-for-height or low mid-upper arm circumference [MUAC]) and nutritional edema, affects a small portion of numbers of children but is of particular concern as a result of high case fatality. [3,4] Recent estimation indicated that 8.5 million infants <6 months of age throughout the world are wasted by the World Health Organization (WHO) growth standards, which define wasting as a weight-for- length Z score (WFLz) of <−2. [5] In children aged 6–60 months, the MUAC, with simple cutoffs, is at least as predictive of death as WFLz. [6] MUAC can be measured easily, quickly, and affordably. Values below the cutoffs of 125 and 115 mm are used to define moderate and SAM, respectively. [7] Rates of malnutrition in Bangladesh are among the highest worldwide, with 6 million children estimated to be chronically undernourished. The decline in chronic malnutrition seen previously from three-fifth Access this article online Quick Response Code: Website: www.jmsh.ac.in ORIGINAL ARTILCE