Prevalence and Associated Factors of Malnutrition among Children Under Five Years with Clefts Attending a Hospital in Rwanda

Background Children with clefts face a high risk of malnutrition (undernutrition) with a range of serious life-threatening challenges. The objective of this study was to estimate the prevalence of malnutrition in children with clefts in Rwanda. Methods A retrospective cross-sectional study was conducted among children with clefts admitted at a Hospital in Rwanda between 2018 and 2022. Descriptive statistics were conducted, and WHO Z-scores were used to classify nutritional status (stunting, wasting, underweight, and overall malnutrition). Subsequently, chi-square and logistic regression analyses identified factors associated with malnutrition, with statistical significance set at P < 0.05.Results The prevalence of malnutrition was 54.2%. Children with combined clefts were 61.8% more malnourished. The odds of malnutrition were 1.69 times (AOR: 1.69; 95% CI: 1.14 to 2.48) more among males. Similarly, the prevalence of malnutrition was about three-fold more among children <12 months of age (AOR: 2.81; 95% CI: 1.61 to 4.87) and 2.20 times more among children of divorced parents AOR: 2.20; 95% CI: 1.26 to 3.83), and 2.50 times (AOR: 2.50; 95% CI: 1.31 to 4.78) more among children with combined clefts. Moreover, household income has a significant association with malnutrition (P=0.049). Similarly, children with cleft lips were 1.58 times (AOR: 1.58; 95% CI: 1.06 to 2.36) more likely to be malnourished than those with cleft palate. Conclusion The burden of malnutrition among children with clefts was high. Early identification and appropriate feeding management are crucial to ensuring no one is left behind in the fight against malnutrition.Rwanda J Med Health Sci 2025;8(2):235-245