Prevalence and factors associated with malnutrition among children living 1 with Down syndrome in Rwanda: A cross-sectional study

We assessed the prevalence and determinants of malnutrition among children with Down syndrome (DS) in Rwanda. A cross-sectional survey was conducted among 313 children with DS aged 6 months to 18 years using a structured questionnaire. Data were analyzed through univariate, bivariate, and multivariate regression analyses. Overall, 30% of children were overweight/obese, 72% stunted, 15% thin, and 47% underweight; 7% had the double burden of malnutrition. Underweight was less likely when fathers were casual laborers (AOR=0.38; CI: 0.18–0.82) but more likely in polygamous households (AOR=3.30; CI:1.26–8.62). Maternal illiteracy increased risks of both underweight (AOR=2.34; CI:1.01–5.40) and stunting (AOR=2.24; CI:1.02–4.92). Age was a strong predictor of malnutrition: children 24– 59 months (AOR=2.45; CI:1.12–5.35), 6–12 years (AOR=2.93; CI:1.41–6.10), and 13–18 years (AOR=5.52; CI:2.21–13.74) were more likely to be stunted or overweight. Conversely, younger children had lower odds of thinness compared to overweight: 6–23 months (AOR=0.24; CI:0.10–0.62), 24–59 months (AOR=0.40; CI:0.18–0.90), and 6–12 years (AOR=0.27; CI:0.14–0.50). Malnutrition, especially stunting, is highly prevalent among Rwandan children with DS. Socioeconomic conditions, parental education, and household characteristics strongly influence outcomes. Interventions should integrate nutrition, parental education, and inclusive healthcare strategies.