High Prevalence of Stunting, Wasting, and Underweight in Children Younger Than 5 Years Old in Mopeia District, Rural Mozambique.

Mozambique has stunting, wasting, and underweight rates of 37%, 15%, and 4%, respectively. In Zambézia Province, Mozambique, 44.6% of children younger than 5 years of age suffer from chronic malnutrition, which impairs physical and cognitive development and leads to long-term health and productivity issues. This study examines undernutrition, stunting, wasting, underweight, and their associations with socioeconomic status among children younger than 5 years old in Mopeia District, Zambézia Province (central Mozambique). We conducted a secondary analysis of data from the Broad One Health Endectocide-Based Malaria Intervention in Africa 2021 cluster randomized clinical trial, which included a cohort of 2,667 children younger than 5 years old. We calculated odds ratios and 95% confidence intervals to assess associations between risk factors and undernutrition. The prevalence rates of stunting, wasting, and underweight were 41.7%, 20.4%, and 24.3%, respectively; these numbers are among the highest globally. Lower wealth index showed an association with higher odds of stunting and underweight, whereas distance from tarmac roads showed a link to increased wasting. Key predictors of stunting included lack of electricity, long water-fetching times, and smaller household size; being underweight showed an association with the number of bed nets and housing type. These relationships reflect socioeconomic patterns rather than direct causality. Undernutrition among children younger than 5 years old in Mopeia District remains critically high and is strongly patterned by socioeconomic factors. Addressing structural determinants, such as household wealth, access to infrastructure, and living conditions, will be essential for reducing the burden of undernutrition in rural Mozambique.