Risk factors for severe acute malnutrition among children aged 6–59 months enrolled in the CMAM program at Al-Sabeen Hospital, Sana’a City, Yemen

Severe acute malnutrition (SAM) remains a major public health problem among children under five years of age in Yemen. Evidence on factors associated with SAM in Sana’a City, particularly among children enrolled in community-based management of acute malnutrition (CMAM) program is limited. The aim of this study is to assess factors associated with SAM among children aged 6–59 months at Al-Sabeen Hospital, Sana’a City, Yemen. A facility-based frequency-matched case–control study was conducted among 194 children aged 6–59 months (65 cases and 129 controls). Cases were children diagnosed with SAM and enrolled in the CMAM program, while controls were non-malnourished children attending routine services at the same hospital. Data were collected using caregiver interviews and medical record review. Bivariate and multivariable logistic regression analyses were performed. Crude odds ratios(CORs) and adjusted odds ratios(AORs) with 95% confidence intervals (CIs) were estimated. P-value < 0.05 was significant. Several factors were independently associated with higher odds of SAM. Children living in rural areas (AOR = 4.62; 95%CI: 2.03–10.51), those with low birth weight (LBW) (AOR = 3.48; 95%CI:1.67–7.26). Recurrent diarrhoea (AOR = 3.11; 95%CI: 1.51–6.41), anorexia (AOR = 8.71; 95%CI: 3.11–24.42), and intractable vomiting (AOR = 4.92; 95%CI: 2.03–11.91) had higher odds of SAM. Non-exclusive breastfeeding (AOR = 2.47; 95%CI: 1.21–5.05), low dairy intake (AOR = 2.95; 95%CI: 1.44–6.07), inadequate vegetable consumption (AOR = 2.44; 95%CI: 1.12–5.31), lack of caregiver handwashing after handling child feces (AOR = 5.86; 95%CI: 1.41–24.39), and incomplete pentavalent vaccination (AOR = 3.21; 95%CI: 1.44–7.14) were also independently associated with SAM. SAM among children in this setting was independently associated with rural residence, LBW, suboptimal feeding practices, poor hygiene practices, incomplete vaccination, and selected clinical conditions identified at the time of assessment. These findings highlight the need for integrated nutrition, health, and preventive interventions in high-burden settings.