Objective This study aimed to examine the association of regional disparity and socioeconomic determinants with acute malnutrition among children aged 6-59 months attending selected public hospitals in Karachi.

Methods A hospital-based unmatched case-control study was conducted on 394 participants with 197 cases and 197 controls. After developing a self-structured questionnaire based on maternal and child components, wealth quintiles were made using principal component analysis. A univariate and then a binary logistic regression was applied.

Results The odds of acute malnutrition were 1.2 times higher in male children. The variables significantly associated with childhood acute malnutrition were regional disparity [AOR=2.3, 95%, C. I (1.4-3.8), p-value <0.01], mother’s illiteracy [AOR = 3.6, 95% C. I (1.9-7), p-value <0.001], mother’s primary education [AOR =1.1, 95% C. I (0.5-2.2), p-value <0.01], father’s illiteracy [AOR= 2.4, 95% C. I (0.8-4.4), p-value 0.03], father’s primary education [AOR =1.1, 95% C. I (0.4-1.9), p-value <0.01], poorest households [AOR= 2.2, 95% C. I (1.07-4.7), p-value <0.01], and child’s age [AOR =0.945, 95% C. I (0.92-0.96), p-value <0.01].

Conclusion Regional disparity was found to be significantly associated with acute malnutrition among children along with household wealth status, mother’s illiteracy, and father’s illiteracy. Hence there is a need to direct the focus of policy makers to work on these factors to eradicate acute malnutrition among children.

The authors have declared no competing interest.

No funds were received for this study.

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethical approval for this study was granted by the Institutional Ethical Review Board of SZABIST University, Karachi (Ref No: IERB(18)/SZABIST-KHI(PH)/22104145/1240067). Data collection was conducted at Civil Hospital and the Public Health School, Karachi. Participation in the study was entirely voluntary, and no harm, penalty, or loss of benefits was incurred by participants who chose not to participate. Informed consent was obtained from all participants prior to data collection. All data were stored securely and used solely for research purposes, with strict measures in place to ensure confidentiality and anonymity.

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I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

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The data supporting the findings of this study are not publicly available due to institutional review board (IRB) and hospital policy restrictions regarding patient confidentiality.