PREVALENCE OF MALNUTRITION AMONG CHILDREN UNDER 5 YEARS IN THE MUNICIPALITIES OF 2KP (KÉROU, KOUANDÉ AND PÉHUNCO) IN NORTHERN BENIN

Marius Bio Bouko 1 , * Abdou Ganiou Yessoufou 1 , Justin Behanzin 1 , Abèbi Karimath Yessoufou 2 and Alphonse Sezan 1 . 1. Laboratoire de Biomembranes et de SignalisationCellulaire, Département de PhysiologieAnimale, Faculté des Sciences et Techniques, Universitéd’ Abomey-Calavi, BP : 526 Cotonou, République du Bénin. 2. Clinique de PédiatrieetNéonatologie de Sènadé 06 BP 601 Cotonou, République du Bénin. ...................................................................................................................... Manuscript Info Abstract ......................... ........................................................................ Manuscript History


ISSN: 2320-5407
Int. J. Adv. Res. 6(1), 1293-1298 1294 of chronic malnutrition is considered high and indicative of chronic food insecurity. Indeed, according to the report of the Global Analysis and Vulnerability in Food Security (AGVSA, 2014), 48% of households in the department of Atacora had inadequate food consumption that did not allow them to lead healthy and active lives while this problem affected only 23% of households nationally. In addition, Atacora is among the Departments with the highest rates of food insecurity (AGVSA, 2014). Also, it is not easy to see that all the strategies carried out on the ground to fight this scourge have remained vain because the prevalence of the various forms of malnutrition remain high in this zone.
In view of all the above, we proposed to evaluate the nutritional status of children under 5 years in three (03) Atacora Municipalities: Kérou, Kouandé and Péhunco (2KP), to identify the determinants of these malnutritions in order to improve the nutritional situation of the populations.

Material and Methods:-
The study was conducted in the communes of Kérou, Kouandé and Péhunco (2KP) located in northwestern Benin and more precisely in the Atacora department ( Figure 1). This is a prospective, descriptive and analytical study, which ran from July to October 2015, during which we collected the anthropometric measurements of 600 children under 5 years and submitted their mothers to a questionnaire. elaborated for this purpose. The size of the sample was determined from the Schwartz formula (1995). In the field, households are randomly determined in each district using the standard method. Demographic data for the identification of clusters in the area are provided by RGPH4 (2013)

Anthropometric measurements:-
The weight of the children was collected by means of a suspended scale of Salter WeghStonx type of 25kg range divided by 100 grams. The height was taken using a 0.1 cm precision Sonatometer for all children. For children under two, the board has been placed horizontally on a flat surface parallel to the floor. For children 2 to 5 years old, the measurement was done while standing. Age was determined from the birth certificate extracts, and especially the children's health notebooks and mother's maternity notebooks or using the method based on the chronology of births socio-cultural events. Anthropometric measurements are used to characterize the nutritional status of the study population.
Data analysis: Nutritional Status Assessment: The P / T (Weight for Height), T / A (Age Size), P / A (Weight for Age) Indices were calculated based on WHO references (ONIS and al., 2006). Thus, there is respectively emaciation, stunting or underweight when P / T is below -2 ET, T / A is below -2 ET, P / A is below -2 ET of the reference median. Note that when Z-score is below -3ET, the associated malnutrition problem is considered severe. Dietary diversity score: The dietary diversity score of the child was calculated according to the construction of the MOURSI et al (2008) and Fanta (2006) score. Thus, children were classified in low dietary diversity (score 1-2), average (score 3-4) and high (score 5-6 and above).
Statistical Processing and Analysis of Data: Data processing was done using Excel, WHO Anthro® Version 3.2.2, 2011 and SPSS. The chi-square test in uni-varied analysis was used to look for an association between the various factors and the nutritional status of the children. The higher the chi2 value, the less significant the test (p˂0, 05).
Ethical considerations: The investigation was carried out after the authorization of the politico-administrative officials of the concerned Communes. The people surveyed gave their consent orally for their participation in the study.

Results:-
Of a total of 600 predominantly male children under 5 years (sex ratio 1.08), 2% were wasted, 64.8% were stunted and 11% were underweight. In addition, 33% of children have a low dietary diversity score, 38% an average score and 29% have a high diversity score.
The distribution curves of the surveyed population compared to the respective reference curves are shifted to the left for the T / A and P / A curves (Figure 3, Figure 4) and to the right for the P / T curve (Figure 2). The different chisquare tests have showed a significant relationship between weaning practices, diseases, dietary diversity of children and the three forms of undernutrition. 1295

Discussion:-Nutritional status of the surveyed population:-
The results show that 64.8% of children are stunted, 11% are underweight and 2% are wasted. These results are superior to those obtained by Yessoufou and al. (2014) in the Communes of the Pendjari Plain (Cobly, Materi and Tanguieta) regarding stunting. On the other hand, the results are inferior to those obtained by these authors in the same area for emaciation and underweight. This difference could be explained by the survey period and / or the degree of food insecurity in each area of the Atacora Department. Moreover, the results are superior to those of the EMICOV (2010) and SMART (2015) surveys carried out in the Atacora Department with regard to stunting on the one hand, and lower on both (02) other forms of undernutrition. According to the WHO (2006), the prevalence thresholds for each of three forms of undernutrition must be less than: 20% for Growth retardation, 5% for wasting 1297 and finally 10% for PI, which makes think of a critical situation with regard to stunting and poor for underweight. On the other hand, the nutritional situation for emaciation is acceptable in 2KP. Therefore, it is not useful to point out that the low prevalence observed at the level of wasting could be justified by the period of food abundance of the survey.
The comparison of the different Z-score P / A, T / A distribution curves with the respective reference curves, showed that these curves were shifted to the left compared to the reference curves, which indicates a less satisfactory nutritional state. in relation to that of the reference population evoking a tendency to a state of under-nutrition, as several authors have pointed out (Yessoufou and al., 2015;Yessoufou and al., 2016). On the other hand, the distribution curve Z-score P / T is slightly shifted to the right at the reference curve, which is confirmed by a very low prevalence for this form of malnutrition in the study population.

Conclusion:-
In sum, the very high level of stunting is indicative of chronic food insecurity in the 2KP municipalities. This situation calls on all actors to enhance the benefits of appropriate actions aimed at considerably reducing the rate of this scourge.