Determinants of Wasting Among Under-Five Children in Internally Displaced Person Camps in North East Nigeria: A Multi-Site Cross-Sectional Study

Wasting, or acute malnutrition, poses an immediate threat to child survival and is particularly prevalent among displaced child populations in humanitarian settings. The North East Nigeria displacement crisis, one of the largest in sub-Saharan Africa, has created conditions of severe food and nutrition insecurity. This study identified determinants of wasting among children under five in internally displaced person camps in Borno, Adamawa, and Yobe States, North East Nigeria, using a multi-site cross-sectional design. A total of 420 children aged six to fifty-nine months were systematically recruited from eight IDP camps. Weight-for-height z-scores were calculated to classify wasting using WHO standards. Structured questionnaires collected data on household food access, child feeding practices, morbidity, water and sanitation conditions, and caregiver characteristics. Binary and multinomial logistic regression were used for analysis. Wasting prevalence was 21.4 percent overall, exceeding the emergency threshold. Determinants of wasting included recent diarrhoeal illness, non-exclusive breastfeeding in infancy, low dietary diversity, and poor household WASH access. Caregiver literacy and household humanitarian assistance receipt were protective factors. The study recommends urgent multi-sector nutrition responses integrating therapeutic feeding, WASH, caregiver education, and humanitarian food access in IDP camp settings in North East Nigeria. Keywords: wasting, acute malnutrition, IDP camps, North East Nigeria, humanitarian nutrition