Prevalence and predictors of undernutrition among preschool children (3 to 5 years) in Nigerian semi-urban community: conventional anthropometric indices versus composite index of anthropometric failure approach

Although numerous studies have been conducted on the predictors of undernutrition among children in Nigeria, none of them used composite index of anthropometric failure approach (CIAF). CIAF estimates accurately the actual burden and magnitude of undernutrition in children. Therefore, this study utilized both the conventional and CIAF approaches to determine the prevalence and predictors of undernutrition among preschool children in a semi-urban Nigerian community. Cross sectional survey design was adopted. Multistage sampling technique was used to select 492 children used for the study. Data was collected, between July and August 2025, through questionnaires and anthropometric measurements. Data obtained were analyzed using IBM SPSS Statistics, version 21.0. Chi square was used to establish relationships among categorical variables. Bivariate and multivariate logistic regression analysis were used to determine factors associated with undernutrition and significance was set at p < 0.05. The forms of malnutrition among the participants included stunting (26.2%), underweight (12.2%), wasting (7.7%) and overweight/obesity (25.4%). Using the CIAF approach, 67.9% had no failure at all, 1.0% experienced only wasting, 4.9% were wasted and underweight, 1.8% had all the 3 forms of undernutrition, 5.5% were stunted and underweight and 18.9% had stunting as a single manifest. Maternal educational level and monthly income, toilet facility used, and having been sick within 3 months prior to the study were significant predictors of stunting, underweight and wasting among the study population. Age of the children, maternal educational level and monthly income, number of under-five children in the household, dietary diversity score, type of toilet facility used, source of drinking water and recent illness were significant predictors of CIAF. Stunting index had the highest value (0.82). Children affected by undernutrition using the CIAF approach was more than that observed using the conventional approach. Government should, therefore, integrate the CIAF as a routine screening instrument at both primary healthcare facilities and community-level nutrition surveillance programmes, given its capacity to capture the magnitude and severity of malnutrition within the same individual.