Prevalence and determinants of undernutrition among children under 5-year-old in rural areas: A cross-sectional survey in North Sudan

Background: Child malnutrition is a major public health problem in developing countries. Therefore, the aim of this study was to estimate the prevalence of undernutrition among children <5 years in River Nile state (RNS) in North Sudan. Subjects and Methods: A cross-sectional household survey was done in four localities in RNS. Using Multistage Cluster sampling, 1635 under 5 years' children had participated. Pretested questionnaire and anthropometric measures were used during data collection. The analysis was done using SPSS software program version 21 and World Health Organization (WHO) Anthro 2005 software. Indices were reported in z-scores and compared with the WHO 2005 reference population to determine the nutritional status of children. Results: Among 1,447 surveyed children, the prevalence of stunting, underweight, and wasting were 42.5%, 32.7%, and 21%, respectively. Stunting was highest among the 48–60 months of age group (82.5%). Boys had poorer indicators of undernutrition in comparison to girls. Geographically stunting was more prevalent in Berber locality. Infectious diseases (gastroenteritis and respiratory symptoms) and incomplete vaccination were significantly associated with wasting (P = 0.007, P = 0.013, and P = 0.008). Poor socioeconomic status (P = 0.043), poorer household sanitation (P = 0.022), large family size, lack of family spacing, and infants weaned suddenly were regarded as risk factors for undernutrition. Conclusion: There was a high prevalence of undernutrition in the 4th and 5th year of life in RNS population, with significant gender imbalance. Our survey highlighted the importance of urgent need to improve child health in this region