Risk Factors Associated with Severe Acute Malnutrition Among Children Under Five Years of Age: A Systematic Review of Recent Studies

Background: Severe acute malnutrition (SAM) remains a significant public health challenge globally, particularly in low- and middle-income countries, contributing substantially to under-five mortality. Despite various interventions, the prevalence of SAM continues to exceed global targets in many regions. Objective: This study aimed to identify and analyze key risk factors associated with severe acute malnutrition among children under five years of age through a systematic review of recent literature. Methods: A systematic review was conducted of studies published between 2020-2025 that investigated risk factors for SAM in children under five years. Four key studies were analyzed in depth. Results: Multiple interrelated risk factors were identified across studies. Child-related factors included age (6-24 months) and low birth weight. Nutrition-related factors encompassed lack of exclusive breastfeeding and inadequate caloric intake. Disease-related factors included HIV infection, tuberculosis, diarrheal diseases, pneumonia, severe anemia, sepsis, and shock. Environmental and social factors such as lack of household sanitation facilities, low socioeconomic status, and maternal underweight were also significant contributors. The presence of nutritional edema was associated with higher mortality risk. Conclusion: SAM in children under five years results from complex interactions between biological, nutritional, infectious, and socioeconomic factors. Effective prevention strategies must address these multiple dimensions through integrated approaches that combine nutritional support, infectious disease prevention and treatment, improved sanitation, and socioeconomic interventions targeting vulnerable populations.