[Infant malnutrition and associated maternal factors in a secondary city south of Benin, Ouidah].

BACKGROUND: The aim of this study was to find the needs and priorities for interventions to improve children's nutritional state in a secondary city in Bénin. It addressed the issues of the magnitude and distribution of infant malnutrition and related maternal factors. It also aimed to identify an easy to use and low cost, but valid, technique to diagnose malnutrition in children.

METHOD: First of all, the prevalence of infant malnutrition was assessed with a representative sample of 492 children aged less than 36 months, in all four communities of the city. Then the sensitivity and specificity of arm circumference were studied and the associations between the children's anthropometric indices were assessed. Secondly in a sub-group of 200 couples of mothers and children, an analysis was conducted to show the links between the indices of mothers' nutritional status, some of their social and economical variables, and the children's anthropometric indices.

RESULTS: The prevalences of wasting and stunting and all other forms confounded among children aged 0-3 years were respectively 5.7%, 22% and 25.9%. They represented 44.7% for the arm circumference. Wasting was more prevalent among children aged 6-23 months (9.6%) than those aged less than 6 months (1.1%) and those of 24 to 36 months (5.2%). The boys had a higher prevalence of stunting (25.1%; p = 0.049) than the girls (18.1%). The correlation between children arm circumference and their indices weight/height, weight/age and height/age were all significant (p < 0.001), but they were higher for weight/age (r = 0.48) and weight/height (r = 0.36) than for height/age (r = 0.30). Low, but significant correlation (r ranged from 0.17 to 0.25) were observed between anthropometric indices of mothers and children. Mothers' instruction level had a tendency to be associated positively and significantly with children z-score weight/height. The effect of socio-economic level on children's nutritional status was significant only at p < 0.10. Unlike the condition observed in the big cities of under-developed countries in general, the central area of Ouidah was more affected by infant malnutrition than peripheral area recently urbanized.

CONCLUSIONS: Infant malnutrition appears to be a really public health problem in this town and children at weaning age are more affected. The interventions to improve children's nutritional status must concern, not only children with malnutrition, but also their mothers. Those interventions must also improve mother's knowledge and practices about weaning foods and their instruction and socioeconomic levels. The cut-off-point 12.5 cm of arm circumference seems to be more appropriate to diagnose wasting among children aged less than 12 months; 13.5 cm is better for 12-36 months aged children.