Background: In Zambia, stunting and diarrhoea—largely avoidable conditions—are significant contributors to death in children under five years of age. Large-scale studies commonly compare these variables between urban and rural settings, although they frequently neglect to consider the substantial socio-economic differences present within urban populations. This study sought to investigate the prevalence and co-occurrence of stunting and diarrhoea in peri-urban regions of Lusaka.

Method: A cross-sectional study approach was utilized, focusing on 239 homes in Lusaka East, a peri-urban area of Zambia's capital city. The research concentrated on homes with a minimum of one kid between the ages of 6 and 23 months. Data collection utilized structured questionnaires distributed to guardians, documenting socio-demographic variables and sanitation practices. Children's anthropometric measures were standardized utilizing height-for-age z-scores (HAZ). The research employed bivariate and multivariable logistic regression analysis to investigate factors associated with malnutrition and diarrhoea.

Results: The study included 232 children, with 53.8% (n=125) identified as female and 46.2% (n=107) as male. The median age of the children was 13 months (IQR ±8), whereas the median age of their guardians was 26 years (IQR ±9.5). The prevalence of stunting and diarrhoea was 24.1% (95% CI: 18.7–30.2%) and 19.4% (95% CI: 14.5–25.1%), respectively, with the highest rates observed in children aged 12 to 23 months. Significant predictors of stunting were identified as child gender (aOR: 0.45, 95% CI: 0.23–0.89), sanitation type (aOR: 2.35, 95% CI: 1.08–4.52), and the marital status of the guardian (aOR: 1.17, 95% CI: 1.01–2.88). In children with diarrhoea, gender (aOR: 0.41, 95% CI: 0.18–0.89) and the guardian's marital status (aOR: 2.80, 95% CI: 1.14–6.89) were identified as significant predictors.

Conclusion: In conclusion, the study identified a significant prevalence of stunting, alongside a high incidence of diarrhoea in stunted children, potentially elevating the risk of childhood mortality. This highlights the necessity of strengthening primary healthcare services and improving community health education, with an emphasis on the early detection of stunting and the prevention of diarrhoea, especially in economically disadvantaged peri-urban areas in Zambia.