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Introduction <p>Severe acute malnutrition (SAM) in children is a life-threatening condition driven by complex socioeconomical and environmental factors. This study aims to identify the determinants of multidimensional poverty index (MPI) linked to SAM in critically ill children and assess their impact on mortality risk.</p> Methods <p>This retrospective cohort study analyzed critically ill children with SAM admitted to pediatric hospitals in Bolivia. SAM was diagnosed using WHO criteria, validated by a multidisciplinary team. MPI (health, education, living standards) and climate vulnerability were evaluated.</p> Results <p>Among 3,512 pediatric admissions, 319 were critically ill, of which 69 were diagnosed with SAM (21.6%). Analysis revealed that key MPI determinants – including low maternal education, unemployment, inadequate housing, familial vulnerabilities and extreme poverty – were strongly associated with SAM. These factors were exacerbated in rural settings, leading significant delays in care; and in climate-vulnerable regions, where they are associated to higher mortality. Crucially, the MPI demonstrated superior predictive value for mortality risk (pseudo-R² 0.198) compared to traditional income-based measures (pseudo-R² 0.0003).</p> Conclusion <p>This study demonstrates that the MPI is a critical and more accurate predictor of SAM-related mortality in critically ill children than income alone. The findings underscore the urgent need for multisectoral interventions. Specifically, the MPI should be integrated into a clinical risk stratification and public health policy to identify children early and targeted actions addressing healthcare access, maternal education, and climate resilience.</p>

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Multidimensional poverty index as a determinant of severe acute malnutrition in critically ill children

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月22日

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  • Raul Copana-Olmos,
  • Eduardo Luis Suarez-Barrientos,
  • Nils Casson,
  • Ada Armaza-Cespedes,
  • Juan Marcos Medina Bustos,
  • Paul Moscoso Mesias,
  • Santiago Campos-Miño,
  • Sebastián Peralta-Flores,
  • Pamela A. Sotomayor Canedo

摘要

Introduction

Severe acute malnutrition (SAM) in children is a life-threatening condition driven by complex socioeconomical and environmental factors. This study aims to identify the determinants of multidimensional poverty index (MPI) linked to SAM in critically ill children and assess their impact on mortality risk.

Methods

This retrospective cohort study analyzed critically ill children with SAM admitted to pediatric hospitals in Bolivia. SAM was diagnosed using WHO criteria, validated by a multidisciplinary team. MPI (health, education, living standards) and climate vulnerability were evaluated.

Results

Among 3,512 pediatric admissions, 319 were critically ill, of which 69 were diagnosed with SAM (21.6%). Analysis revealed that key MPI determinants – including low maternal education, unemployment, inadequate housing, familial vulnerabilities and extreme poverty – were strongly associated with SAM. These factors were exacerbated in rural settings, leading significant delays in care; and in climate-vulnerable regions, where they are associated to higher mortality. Crucially, the MPI demonstrated superior predictive value for mortality risk (pseudo-R² 0.198) compared to traditional income-based measures (pseudo-R² 0.0003).

Conclusion

This study demonstrates that the MPI is a critical and more accurate predictor of SAM-related mortality in critically ill children than income alone. The findings underscore the urgent need for multisectoral interventions. Specifically, the MPI should be integrated into a clinical risk stratification and public health policy to identify children early and targeted actions addressing healthcare access, maternal education, and climate resilience.