Abstract / Summary
Abstract Background Single anthropometric indicators, stunting, wasting, and underweight, are the standard tools used to assess undernutrition among children in humanitarian settings, yet each captures only one dimension of nutritional failure. Objective To determine the prevalence of anthropometric failure among under-five children in two IDP camps in Sokoto metropolis using the Composite Index of Anthropometric Failure (CIAF), and compare this against conventional single-indicator estimates. Methods A cross-sectional study assessed 263 children across two IDP camps. Following a biological-plausibility screen, 219 children were classified into CIAF sub-groups. CIAF prevalence was compared against stunting, wasting, and underweight using McNemar's exact test. Results CIAF identified anthropometric failure in 68.5% of children, significantly exceeding stunting (47.1%), wasting (38.8%), and underweight (53.7%) prevalence considered individually (p < 0.001 for all three comparisons). Nearly one-quarter of children (24.2%) failed all three indicators simultaneously. Conclusion Reliance on any single conventional indicator substantially underestimates the true burden of undernutrition among displaced children. CIAF-based surveillance would identify considerably more at-risk children than current single-indicator approaches.