The Hidden Burden of Malnutrition among Children with Cerebral Palsy in Malawi: A Cross-Sectional Study

Introduction: Cerebral palsy (CP) increases the risk of undernutrition. In Malawi, little is known about the nutritional status and risk factors for malnutrition among children with CP. This study aimed to determine the prevalence of undernutrition and its associated risk factors among children with CP attending the Zomba Central Hospital Physiotherapy clinic in Southern Malawi. Methods This cross-sectional study was conducted between July and October 2024. A total of 123 children with CP, aged between 6 months to 18 years, were enrolled. Data on socio-demographic characteristics and comorbidities were collected through an interviewer-administered questionnaire. Anthropometric measurements were performed. Nutritional status was evaluated using both the World Health Organization (WHO) growth charts and the CP-specific growth charts. Statistical analyses included descriptive statistics, simple logistic regression and multivariate logistic regression to assess associations and determinants of undernutrition status. Results The prevalence rates of stunting, wasting, and underweight were 71.6%, 37.4%, and 62.7%, respectively. Children with feeding difficulties were more likely to be underweight (AOR = 2.79; CI: 1.18, 6.59; p = 0.019) and wasted (AOR = 3.84; CI: 1.38–10.67; p = 0.010). Frequent utilisation of nutritional health services positively predicted wasting; monthly (AOR = 8.70; CI: 2.50–30.24; p = 0.004) and weekly (AOR = 6.48; CI: 2.25–18.66; p = 0.001). Additionally, children aged 5–18 years had significantly greater odds of being wasted than those under 5 years (AOR = 3.23; CI: 1.02, 10.19; p = 0.046). Conclusion For children with CP in Malawi, feeding difficulties, frequent use of nutritional health services, and older age are significant predictors of malnutrition. There is, therefore, a need for context-specific, evidence-based and targeted nutritional interventions to address these critical risk factors to improve health outcomes and quality of life.