title: Predictors of the risk of malnutrition among children under the age of 5 years in Somalia.
abstract: OBJECTIVE
  To investigate the predictors of wasting, stunting and low mid-upper arm circumference among children aged 6-59 months in Somalia using data from household cross-sectional surveys from 2007 to 2010 in order to help inform better targeting of nutritional interventions.
  
  
  METHODS
  Cross-sectional nutritional assessment surveys using structured interviews were conducted among communities in Somalia each year from 2007 to 2010. A two-stage cluster sampling methodology was used to select children aged 6-59 months from households across three livelihood zones (pastoral, agro-pastoral and riverine). Predictors of three anthropometric measures, weight-for-height (wasting), height-for-age (stunting) and mid-upper arm circumference, were analysed using Bayesian binomial regression, controlling for both spatial and temporal dependence in the data.
  
  
  METHODS
  The study was conducted in randomly sampled villages, representative of three livelihood zones in Somalia.
  
  
  METHODS
  Children between the ages of 6 and 59 months in Somalia.
  
  
  RESULTS
  The estimated national prevalence of wasting, stunting and low mid-upper arm circumference in children aged 6-59 months was 21 %, 31 % and 36 %, respectively. Although fever, diarrhoea, sex and age of the child, household size and access to foods were significant predictors of malnutrition, the strongest association was observed between all three indicators of malnutrition and the enhanced vegetation index. A 1-unit increase in enhanced vegetation index was associated with a 38 %, 49 % and 59 % reduction in wasting, stunting and low mid-upper arm circumference, respectively.
  
  
  CONCLUSIONS
  Infection and climatic variations are likely to be key drivers of malnutrition in Somalia. Better health data and close monitoring and forecasting of droughts may provide valuable information for nutritional intervention planning in Somalia.
authors.affiliation: 1Department Public Health Research,Spatial Health Metris Group,INFORM Project,Kenya Medical Research Institute/Wellcome Trust Research Programme,PO Box 43640-00100,Nairobi,Kenya.
authors.forename: Damaris K
authors.initials: DK
authors.lastname: Kinyoki
authors.affiliation: 2Kenya Medical Research Institute/Wellcome Trust Research Programme,Centre for Geographic Medicine Research (coast),Kilifi,Kenya.
authors.forename: James A
authors.initials: JA
authors.lastname: Berkley
authors.affiliation: 4Nutrition Section,UNICEF,Kenya Country Office,UN Complex Gigiri,Nairobi,Kenya.
authors.forename: Grainne M
authors.initials: GM
authors.lastname: Moloney
authors.affiliation: 1Department Public Health Research,Spatial Health Metris Group,INFORM Project,Kenya Medical Research Institute/Wellcome Trust Research Programme,PO Box 43640-00100,Nairobi,Kenya.
authors.forename: Ngianga-Bakwin
authors.initials: NB
authors.lastname: Kandala
authors.affiliation: 1Department Public Health Research,Spatial Health Metris Group,INFORM Project,Kenya Medical Research Institute/Wellcome Trust Research Programme,PO Box 43640-00100,Nairobi,Kenya.
authors.forename: Abdisalan M
authors.initials: AM
authors.lastname: Noor
mesh_terms: D001132:Arm; D049628:Body Size; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D002980:Climate; D003430:Cross-Sectional Studies; D004032:Diet / Q000009:adverse effects*; D004403:Dysentery / Q000150:complications; D005191:Family Characteristics; D005260:Female; D006130:Growth Disorders / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D008297:Male; D044342:Malnutrition / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology; D009749:Nutrition Surveys; D009752:Nutritional Status; D015995:Prevalence; D012306:Risk; D012959:Socioeconomic Factors; D012998:Somalia / Q000453:epidemiology; D065927:Waist-Height Ratio; D019282:Wasting Syndrome / Q000453:epidemiology / Q000209:etiology
keywords: Malnutrition; Mid-upper arm circumference; Somalia; Stunting; Wasting