131
JOURNAL OF SCIENCE, Hue University, N
0
61, 2010 MALNUTRITION STATUS AND RELATIVE FACTORS IN CHILDREN
UNDER 5 YEARS OLD IN KON TUM PROVINCE, 2008
Pham Thi Hai
College of Medicine and Pharmacy, Hue University
SUMMARY
In 2008, a study was conducted in a population of 1500 Children under 5 years old and
their mothers in Kon Tum Province using a cross-sectional method with two objectives: identify
the malnutrition rate in children under 5 years old in Kon Tum province, 2008 and find out the
factors related to the malnutrition situation in children under 5 years old in Kon tum province.
Results showed that the malnutrition rate was 30.2%, including 24.2% of malnutrition level I;
5.5% of level II and the remaining of level III. In terms of relative factors of malnutrition in
Children. There are many different factors contributing to malnutrition such as low birth-
weight (< 2500 gram); children with a history of diarrhea and acute respiratory infections;
mothers with low BMI (< less than 18.5); mothers with a poor diet and low weight of the
mothers during pregnancy; low education level of the mothers; mother’ age from 36-49 when
being pregnant; having a family of more than 3 children; and low family income. Other factors
regarding breastfeeding and complementary feeding were: a complete lack of breastfeeding in
the first six months of age; early weaning time (< 12 months); early initiation of complementary
diet (< 6 months); and a poor complementary diet consisting of only gruel with rice flour and
salt. The relationship between malnutrition in children and the factors such as breastfeeding
time after giving birth, and mother’s occupation has not been found.
Key words: malnutrition, weight, height, breast milk, weaning, related.


The sample size is calculated based on the formula, as following:
2
2/
2
)1(
d
pp
Zn




Where:
n: Number of researched children
Confident interval: 95%, Z /2 =1,96
p: Estimated malnutrition rate, p = 31,5% is malnutrition rate of the year
2007 in Kon Tum
3
.
d: Standard error, d = 0,25
Therefore, the minimum sample size is 1326 children.
Adding 15% for refusals and attrition, the study sample size is 1500 children.
2.2.2. Selecting the sample:
The study used a multi–stage random sampling method.
2.2.3. Collecting data:
- Children: date of birth, gender, birth-weight, breastfeeding status, 133
complementary diet, disease status, and anthropometric measurements


12 - < 24 354 138 39.0
24- < 36 305 118 38.7
36- < 48 212 68 32.1
48- < 60 297 87 29.3
Total 1500 453 30.2
The underweight malnutrition rate of children in Kom Tum, in 2008 is 30.2%,
which is still relatively high compared with 19.9% of the national malnutrition rate.
This figure is also considered as at very high level according to the WHO’s 134
classification. Therefore, to achieve the required target of the national nutrition strategy
of 2001-2010, it is necessary for Kon Tum province to improve the economic conditions
and education levels in the effort of reducing the malnutrition rate in children to 20% by
2010.

Figure 3.1. underweight-for-age malnutrition rate in children.
Malnutrition in children often happens in the first year of life (12.7%) and
increases in accordance with the age group. The highest malnutrition risk was found in
children within the age group of 12 to 36 months, which then continues at a high level
until under 60 months (29.3%). This finding is comparable with the investigation of the
Nutrition Institution and Phan Van Hai but different with the studies which were
implemented in plain areas, which showed that the highest malnutrition rate is at the
group of 48 to 60-month old.
Table 3.2. Stunting-for-age malnutrition rate
Age (month) n
Number of
Malnutrition
case

case
Percentage %

p
0- < 12 332 28 8.4
<0.001
12 - < 24 354 39 11.0
24- < 36 305 22 7.2
36- < 48 212 6 2.8
48- < 60 297 8 2.7
Total 1500 103 6.9
The highest wasting-for-age malnutrition rate is in the 12 to under 24-month-old
group. This figure will gradually decrease when children grow up. There is a statistical
difference with p<0.001. 136

Figure 3.3.Wasting-for-age malnutrition rate
According to Ha Huy Khoi, the wasting malnutrition rate is often at the highest
level when children are 2 years old. This is an age group which is weaning and
switching to the diet of an adult person. Therefore, poor diet along with diseases can
lead to wasting in children.
Table 3.4. Classification of malnutrition according to level
Malnutrition level Level 1 Level 2 Level 3
Underweight (%) 24.2 5.5 0.5
Stunting (%) 28.8 15.7
Almost malnourished children is in level 1; Malnutrition level is just 0.5%.
Table 3.5. Classification of stunting- for-gender malnutrition rate
Gender n

The malnutrition rate in ethnic minority children is much higher than than in
Kinh children in all 3 types of malnutrition. This difference is statistically significant
with p<0.001. This result is similar to Phan Van Hai’s study and other researchers.
Table 3.7. Malnutrition rate of the combination of HFA and WFH
Indicators HFA WFH WFH & HFA
Malnutrition rate 707 103 37
Percentage % 47.1 6.9 2.5
There are 2.5% of children in malnutrition status of stunting and wasting
symptom.
3.2. Factors relative to malnutrition status
Table 3.8. The relationship between studied factors and malnutrition status
Studied factors
%
Malnut
rition
rate
%
nutrition
rate
p
Mother’s diet during
pregnancy
Lack of food 37.1 62.9
<0.001
normal & greater than 27.9 72.1
Weight increase of
mother during
pregnancy
<10kg 35.9 64.1
<0.001

<12 months 52.2 47.8 <0.001
12 months 32.9 67.1
Malnutrition is associated with diet and the weight increase of mother during
pregnancy, birth-weight, completely breastfed within 6 months of age, complementary
diet, early weaning (p<0.001). Our outcomes are rational with the researchers.
Table 3.9. The relationship between children with medical history of diarrhea and fever along
with bad cough and malnutrition
Medical history
Malnutrition
rate %
Nutrition rate % p
Diarrhoea
Yes 39.6 60.4
p <0.001
No 28.2 71.8
Fever and cough
Yes 38.5 61.5
p <0.001
No 26.9 73.1
Malnutrition is notably related to children with a medical history of diarrhea and
fever along with bad cough (p < 0.001). This result is in accordance with other research.
Table 3.10. Other relative factors and malnutrition rates in Children
Factors
Malnutriti
on rate %
Nutrition
rate %
p
Education level of
mother

Our results are comparable with other research.
The occupation of mothers is statistically linked with malnutrition in children in,
which is also reported by other researchers.
4. Conclusion
Through the study of a population of 1500 under 5-year-old children and their
mothers of in Kon Tum, we found the following results:
Malnutrition status in Children:
The malnutrition rate is 30.2%, including 24.2% of malnutrition level ®, 5.5%
of level II and the remaining of level III.
The group of babies from 12 to less than 24 month-old occupies the highest
malnutrition rate, consisting of types of stunting, underweight and wasting.
The height-for-age malnutrition rate is at a very high level of 44.5% and weight-
for-height malnutrition rate is 6.9%; the malnutrition rate of children who contract both
stunting and wasting symptom is 2.5%. 140
There was indifferences between malnutrition rate of boys and girls (p>0.05).
The malnutrition rate was significantly different in statistics between Kinh
children and ethnic minority children. The underweight malnutrition rate of Kinh
children and ethnic minority children is 18.6% and 31.8% respectively (p <0.001). The
stunting malnutrition rate is 31.6% for the former and 46.3% for the latter (p<0.001)
Malnutrition-related factors in Children
There are many different factors contributing to malnutrition such as birth-
weight of children under 2500 gram; children with history of diarrhea and acute
respiratory infection; mothers’ BMI of less than 18.5; poor diet of the mother and low
weight of the mothers during pregnancy; low education level of the mothers; mothers’
age from 36-49 when being pregnant; having a family of more than 3 children and low
family income. Other factors about breastfeeding and complementary diet such as a
complete lack of breastfeeding in the first six months of age; weaning time is less than

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