Malnutrition among children under 60 months of age in two cities of the state of Acre, Brazil: prevalence and associated factors.

OBJECTIVE To investigate the prevalence of malnutrition and associated factors in children under the age of 60 months in two cities in the state of Acre, Brazil. METHODS A population-based cross-sectional study was carried out with 667 children living in urban areas of the cities of Acrelândia and Assis Brasil. The prevalence of malnutrition was calculated by height for age (stunting) and weight for height (W/H) indexes, which were calculated with a cutoff point of -2 for Z scores as determined by the 2006 World Health Organization child growth standards. A structured questionnaire was used to gather information on socioeconomic conditions, access to services and child care, birth weight and morbidity. Poisson regression was used to identify the factors associated with child malnutrition. RESULTS The prevalence of height-for-age and weight-for-height deficit was 9.9% and 4.1%, respectively. The factors associated with height-for-age deficit were low household wealth index (prevalence ratio [PR]: 1.74; 95% confidence interval [95% CI]: 0.95-3.18); having an illiterate father or stepfather (PR: 1.82; 95% CI: 1.01-3.27); having 2 or more younger siblings (PR: 2.88; 95% CI: 1.45-5.72); biological mother not living in the home (PR: 2.63; 95% CI: 1.32-5.24); and exposure to open wastewater near the home environment (PR: 2.46; 95% CI: 1.51-4.00). "Low weight at birth" was the only factor associated with weight-for-height deficit (PR: 2.91; CI95%: 1.16-7.24). CONCLUSIONS In the cities studied, malnutrition in children under 60 months is an important public health problem, and is associated with indicators of social inequality, access to health services and biological mother not living in the home.