Determinants of Acute Malnutrition in Children Aged 6 to 59 Months in the Miabi Rural Health Zone, Kasai Oriental Province, Democratic Republic of Congo

Child malnutrition is a major public health problem, particularly in developing countries. This study aims to identify the determinants of acute malnutrition in children aged 6 to 59 months in the Miabi Rural Health Zone, Democratic Republic of Congo (DRC), an area classified as being on red alert by health authorities. The quantitative, analytical, and cross-sectional study was conducted with 401 mothers or caregivers of children aged 6 to 59 months, selected using multi-level probability sampling. The descriptive data reveal a high prevalence of young mothers (under 28 years old) with limited education (primary level), mostly housewives with a low monthly income (less than 100,000 Congolese francs). The prevalence of acute malnutrition (mid-upper arm circumference <115 mm or presence of nutritional edema) among the children studied is alarming. The results of the bivariate and multivariate analysis (not presented in this section) will be essential to determine the socio-economic, demographic, dietary practices and morbidity factors associated with this condition in the region.

Objective: Given this persistent situation, the overall objective of this study is to contribute to improving the health status of the population of the Miabi Health Zone by identifying the determinants of malnutrition in children aged 6 to 59 months in this area and to contribute to universal health.

Materials and methods: Quantitative and analytical in nature, conducted cross-sectionally in households in the Miabi Rural Health Zone, Miabi Territory, Kasai-Oriental Province, DRC. The data collection period extended from July 3 to September 2, 2025. The health zone has a total population of 209,168 inhabitants (2025).

The target population consists of all children aged 6 to 59 months in the area. The respondents are the mothers or caregivers of these children. The sample size was calculated using Fischer's formula, using an expected proportion (p) of 50% and a desired degree of precision (d) of 0.05.

n = (d)²(Zα)² × p × q = (0.05)²(1.96)² × 0.5 × 0.5 = 384 subjects

Adding 5% to account for possible loss to follow-up, the final sample size retained is 403 subjects.

Results: The prevalence of acute malnutrition, estimated by a basal body height <115 mm (8.7%) and the presence of edema (6.5%), is concerning, consistent with the red alert classification of the area by health authorities. Furthermore, feeding practices are suboptimal, with exclusive breastfeeding not being practiced in 55.9% of cases.

Further analysis of the association and determinants (bivariate and multivariate variables) will make it possible to quantify the exact impact of these factors (low income, low level of education, non-compliance with exclusive breastfeeding, etc.) on the occurrence of acute malnutrition in children aged 6 to 59 months, and to formulate targeted recommendations for public health interventions in the Miabi Rural Health Zone.