What type of study is this?

This is a Cross-Sectional Study study.

What question did this study set out to answer?

This study explores factors influencing relapse of severe acute malnutrition in children under five in Mbujimayi.

May 7, 2026Nutrition and Dietary Supplements0 citationsOpen Access

Determinants of Relapse of Severe Acute Malnutrition Among Children Under Five in Mbujimayi Town, Democratic Republic of Congo

DBDésiré BalojiUniversity of Mbuji Mayi TBThérèse BibombaUniversity of Mbuji Mayi CNColin Elumba NgoyUniversity of Mbuji Mayi

Key Points

This study explores factors influencing relapse of severe acute malnutrition in children under five in Mbujimayi.
Conducted a cross-sectional study among children aged 6–59 months with severe acute malnutrition.
Compared relapse and new admission groups based on history and clinical status.
Utilized chi-square test for associations and multivariate logistic regression for risk factors.
Found that 56.6% of the children were aged 24-59 months, with boys representing 52.8%.
History of severe acute malnutrition, lack of vaccination, malaria, and diarrhea increased relapse risk significantly.
Relapse is influenced by previous malnutrition, inadequate preventive care, and concurrent infections.

Abstract

Background: Relapse after treatment for severe acute malnutrition (SAM) undermines child survival and the effectiveness of integrated management of acute malnutrition programs. Evidence on relapse in urban settings of the Democratic Republic of Congo (DRC) remains limited. Methods: We conduct an analytical cross-sectional study among children aged 6– 59 months admitted to outpatient therapeutic nutrition units in the Muya Health Zone, Mbujimayi, from May 2023 to April 2024. Two groups were considered at the time of data collection: children readmitted with SAM following discharge (relapse group) and children newly admitted with SAM during the same study period without documented relapse (new admission group). Data were collected from structured questionnaires and medical records. Descriptive statistics were used to summarize the sociodemographic and clinical characteristics. Bivariate associations were tested using the chi-square test or Fisher’s exact test, and odds ratios (OR) were calculated. Variables with p < 0.20 were entered into multivariate logistic regression. Results: The median age was 24 months (IQR:15– 40) and 56.6% were aged 24– 59 months. Boys accounted for 52.8%. Relapse was independently associated with history of SAM (aOR: 9.847; 95% CI: 3.619– 26.792), lack of measles vaccination (aOR: 3.120; 95% CI: 1.657– 5.873), malaria (aOR: 1.910; 95% CI: 1.012– 3.605), diarrhea at admission (aOR, 3.690; 95% CI, 1.143– 11.921), and clinical outcomes (aOR: 3.660; 95% CI:1.215– 13.026). These findings indicate that relapse in Mbujimayi is driven by the combined effect of prior nutritional vulnerability, incomplete preventive care, and intercurrent infection. Conclusion: SAM relapse was frequent in this urban Congolese setting. Strengthening immunization, infection control, discharge quality, and structured post discharge follow-up may reduce repeated admissions and improve child survival. Keywords: determinants, relapse, severe acute malnutrition, children, Mbujimayi

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