Orapuh Journal | Journal of Oral & Public Health
Prevalence and determinants of severe acute malnutrition among children under five in Kisangani, Democratic Republic of the Congo
Orap J, 6(11), 2025
PDF

Keywords

Feeding practices
household characteristics
risk factors
infant nutrition
public health

How to Cite

Botela, C. P., Okenge, L. N., Mulamba, E., Mukandu, F. L. B. B., Lumanisha, J. K., Mawunu, M., & Koto-Te-Nyiwa Ngbolua, J.-P. (2025). Prevalence and determinants of severe acute malnutrition among children under five in Kisangani, Democratic Republic of the Congo . Orapuh Journal, 6(11), e1302. https://doi.org/10.4314/orapj.v6i11.102

Abstract

Introduction

Malnutrition remains a major cause of morbidity and mortality among children under five in Kisangani, with Severe Acute Malnutrition (SAM) posing serious threats to survival and development. Ongoing ethnic conflicts in some municipalities exacerbate these risks.

Purpose

This study aimed to assess the nutritional status of children under five in Kisangani and identify key risk factors to inform targeted interventions.

Methods

A cross-sectional mixed-methods study was conducted from May to July 2025 among 913 children under five years of age. Quantitative data were collected using structured questionnaires on KoboCollect and analysed with ENA and SPSS version 27. Qualitative insights from focus group discussions and key informant interviews were coded and analysed with Atlas.ti to explore feeding practices and conflict-related vulnerabilities.

Results

The prevalence of SAM was 15.1%. Exclusive breastfeeding was low (7%), and only 5% of children consumed more than five food groups per day. Multivariate analysis identified significant determinants of SAM: children residing in Makiso-Kisangani (OR = 2.53; 95% CI [1.55, 3.49]; p = .004) and Lubunga (OR = 1.89; 95% CI [1.11, 3.21]; p = .019) had higher odds of SAM. Children aged 12–23 months were at increased risk (OR = 1.61; 95% CI [1.01, 2.57]; p = .044), refugees in foster care had elevated risk compared to indigenous children (OR = 2.32; 95% CI [1.55, 3.49]; p < .001), and those living in households with more than 11 members were more likely to be affected (OR = 1.92; 95% CI [1.11, 3.32]; p = .020).

Conclusion

Children in Kisangani remain highly vulnerable to malnutrition, largely due to inadequate infant feeding practices and conflict-driven household vulnerabilities. Immediate interventions to improve feeding practices and integrate conflict-sensitive measures are urgently needed to reduce malnutrition-related morbidity and mortality.

https://doi.org/10.4314/orapj.v6i11.102
PDF

References

Agence Nationale de la Statistique (ANS), Ministère du Plan, & ICF International. (2014). Enquête démographique et de santé (EDS-RDC) 2013-2014 [Demographic and Health Survey (DHS-DRC) 2013-2014]. ANS et Ministère du Plan.

Banque mondiale. (2018). Rwanda stunting prevention and reduction project (P16448445). https://documents1.worldbank.org/curated/en/107081520046058594/pdf/RWANDA-PAD-NEW-02082018.pdf

Bassibila, Z., Sawadogo, P. S., Somda, N. S., Tapsoba, F., Tankoano, A., & Savadogo, A. (2019). Performance et coût de la prise en charge de la malnutrition aiguë sévère avec complications à Kaya, Burkina Faso [Performance and cost of the management of severe acute malnutrition with complications in Kaya, Burkina Faso]. The Pan African Medical Journal, 34, 145. https://doi.org/10.11604/pamj.2019.34.145.17946

Dama, D. U., Tchoffo, D., Onana Akoa, F. A., Abanda, J. N., Dzeuta, M. F., Asobochia, A. T., & Yoniene, P. Y. (2023). Prévalence de la malnutrition chez les enfants de moins de 5 ans dans les départements du Mayo-Tsanaga et du Logone et Chari, Extrême-Nord, Cameroun [Prevalence of malnutrition among children under 5 years in the Mayo-Tsanaga and Logone et Chari departments, Far North, Cameroon]. The Pan African Medical Journal – Clinical Medicine, 14(3), 41534. https://doi.org/10.11604/pamj-cm.2024.14.3.41534

Dikoke, A. (2019). Déterminants de la malnutrition chronique chez les enfants de moins de cinq ans en République Démocratique du Congo : Modélisation d’une réponse polytomique (régression logistique multinomiale) [Determinants of chronic malnutrition among children under five in the Democratic Republic of Congo: Modeling a polytomous response (multinomial logistic regression)] [Mémoire de master, Institut Supérieur des Techniques Médicales de Kinshasa].

Global Nutrition Report. (2024). The burden of malnutrition: Country data for the Democratic Republic of the Congo. https://globalnutritionreport.org

Institut National de la Statistique (INS) & UNICEF. (2018). Enquête par grappes à indicateurs multiples (MICS-Palu) et paludisme, 2017-2018 : Rapport final de résultats [Multiple Indicator Cluster Survey (MICS-Malaria) and malaria, 2017-2018: Final report]. INS et UNICEF. https://www.unicef.org/drcongo/media/3646/file/cod-mics-palu-2018.pdf

Ministère de la Santé Publique, Hygiène et Prévention (RDC). (2021). Rapport narratif annuel 2020 du Programme National de Nutrition (PRONANUT) [2020 annual narrative report of the National Nutrition Program (PRONANUT)].

Organisation mondiale de la Santé (OMS). (2017). Directives pour le traitement hospitalier des enfants sévèrement malnutris [Guidelines for the inpatient treatment of severely malnourished children]. OMS. https://apps.who.int/iris/handle/10665/326880

Organisation mondiale de la Santé (OMS). (2024). Directives pour le traitement hospitalier des enfants sévèrement malnutris [Guidelines for the inpatient treatment of severely malnourished children]. OMS. https://apps.who.int/iris/handle/10665/326880

Programme National de Nutrition (PRONANUT). (2021). Enquêtes nutritionnelles de SMART dans la province de Tanganyika en RDC [SMART nutrition surveys in Tanganyika Province, DRC]. Rapport PRONANUT, Kinshasa.

Programme National de Nutrition (PRONANUT, RDC). (2023). Enquêtes nutritionnelles dans la province de la Tshopo en RDC [Nutrition surveys in Tshopo Province, DRC]. Rapport PRONANUT, Kinshasa.

UNICEF. (2022). Malnutrition à l’Afrique de l’Ouest et du Centre [Malnutrition in West and Central Africa]. UNICEF. https://www.unicef.org

UNICEF, Organisation mondiale de la Santé, & Groupe de la Banque mondiale. (2024). Niveaux et tendances de la malnutrition infantile : Résumé des estimations conjointes 2024 UNICEF/OMS/Banque mondiale [Levels and trends in child malnutrition: 2024 joint estimates summary UNICEF/WHO/World Bank]. UNICEF.

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.