Match!

Concurrent wasting and stunting among under-five children in Niakhar Senegal.

Published on Apr 1, 2019in Maternal and Child Nutrition3.305
· DOI :10.1111/mcn.12736
Michel Garenne32
Estimated H-index: 32
,
Mark Myatt20
Estimated H-index: 20
+ 2 AuthorsAndré Briend24
Estimated H-index: 24
(UCPH: University of Copenhagen)
Sources
Abstract
The study describes the patterns of concurrent wasting and stunting (WaSt) among children age 6–59 months living in the 1980s in Niakhar a rural area of Senegal under demographic surveillance. Wasting and stunting were defined by z scores lower than -2 in weight for height and height for age. Both conditions were found to be highly prevalent wasting more so before age 30 months stunting more so after age 30 months. As a result concurrent WaSt peaked around age 18 months and its prevalence (6.2%) was primarily the product of the two conditions with an interaction term of 1.57 (p < 10-6). The interaction was due to the correlation between both conditions (more stunting if wasted more wasting if stunted). Before age 30 months boys were more likely to be concurrently wasted and stunted than girls (RR = 1.61) but the sex difference disappeared after 30 months of age. The excess susceptibility of younger boys could not be explained by muscle mass or fat mass measured by arm or muscle circumference triceps or subscapular skinfold. Concurrent WaSt was a strong risk factor for child mortality and its effect was the product of the independent effect of each component with no significant interaction. Key messages: 1) Prevalence of concurrent wasting and stunting (WaSt) among under-five children is the product of independent wasting and stunting plus an interaction term of 57%. Prevalence of WaSt peaks around age 18 months; 2) Prevalence of WaSt is about 50% higher among boys than among girls before age 30 months largely because their higher susceptibility to stunting but not higher thereafter; and 3) Excess mortality associated with WaSt is the product of that associated with wasting and that associated with stunting.
Figures & Tables
  • References (32)
  • Citations (1)
📖 Papers frequently viewed together
3 Citations
1 Citations
78% of Scinapse members use related papers. After signing in, all features are FREE.
References32
Newest
#1Jovana Dodos (Action Against Hunger)H-Index: 2
#2Chiara Altare (Action Against Hunger)H-Index: 3
Last. Mathias Altmann (Action Against Hunger)H-Index: 2
view all 9 authors...
Severe acute malnutrition (SAM) is one of the leading causes of morbidity and mortality in Chad. The reasons behind persistently high prevalence of SAM in the Kanem region are still poorly understood, leaving national and international partners without clearly identified drivers to address. Current knowledge of SAM determinants in this context is largely based on very limited data. The aim of this study was thus to investigate individual and household-level risk factors for SAM among under-five ...
2 CitationsSource
#1Tanya KharaH-Index: 6
#2Martha Mwangome (Wellcome Trust)H-Index: 11
Last. Carmel DolanH-Index: 6
view all 4 authors...
13 CitationsSource
#1Blessing J. Akombi (USYD: University of Sydney)H-Index: 4
#2Kingsley E Agho (USYD: University of Sydney)H-Index: 31
Last. John Hall (UNSW: University of New South Wales)H-Index: 17
view all 5 authors...
Background Sub-Saharan Africa has one of the highest levels of child malnutrition globally. Therefore, a critical look at the distribution of malnutrition within its sub-regions is required to identify the worst affected areas. This study provides a meta-analysis of the prevalence of malnutrition indicators (stunting, wasting and underweight) within four sub-regions of sub-Saharan Africa. Methods Cross-sectional data from the most recent Demographic and Health Surveys (2006–2016) of 32 countries...
43 CitationsSource
#1Chloe AngoodH-Index: 2
#2Tanya KharaH-Index: 6
Last. James A. Berkley (University of Oxford)H-Index: 41
view all 4 authors...
Background Wasting and stunting are global public health problems that frequently co-exist. However, they are usually separated in terms of policy, guidance, programming and financing. Though both wasting and stunting are manifestations of undernutrition caused by disease and poor diet, there are critical gaps in our understanding of the physiological relationship between them, and how interventions for one may affect the other. The aim of this exercise was to establish research priorities in th...
16 CitationsSource
#1Signe Marie Jensen (UCPH: University of Copenhagen)H-Index: 17
#2Christian Mølgaard (UCPH: University of Copenhagen)H-Index: 47
Last. André Briend (UTA: University of Tampere)H-Index: 20
view all 6 authors...
Nutritional status of children is commonly assessed by anthropometry both in under and overnutrition. The link between anthropometry and body fat the body compartment most affected by overnutrition is well known but the link with muscle mass the body compartment most depleted in undernutrition associated with infections remains unknown. In this study we examined the relationship between common anthropometric indices and body composition measured by dual-energy X-ray absorptiometry (DEXA) in a sa...
20 CitationsSource
#1Marko KeracH-Index: 18
#2Martha MwangomeH-Index: 11
Last. James A. BerkleyH-Index: 41
view all 5 authors...
Background. Globally, some 4.7 million infants aged under 6 months are moderately wasted and 3.8 million are severely wasted. Traditionally, they have been overlooked by clinicians, nutritionists, and policy makers. Objective. To present evidence and arguments for why treating acute malnutrition in infants under 6 months of age is important and outline some of the key debates and research questions needed to advance their care. Methods. Narrative review. Results and conclusions. Treating malnour...
14 CitationsSource
#1André BriendH-Index: 24
#2Tanya KharaH-Index: 6
Last. Carmel DolanH-Index: 6
view all 3 authors...
Wasting and stunting are often presented as two separate forms of malnutrition requiring different interventions for prevention and/or treatment. These two forms of malnutrition, however, are closely related and often occur together in the same populations and often in the same children. Wasting and stunting are both associated with increased mortality, especially when both are present in the same child. A better understanding of the pathophysiology of these two different forms of malnutrition i...
50 CitationsSource
To the Editor—The journal's recent supplement on sex differences in susceptibility and response to infectious diseases was an excellent initiative for promoting research on a neglected topic of major interest [1–8]. If, in general, males show a higher susceptibility to many infectious diseases, the reviews displayed a number of infectious and autoimmune diseases for which females are more vulnerable. Differential vulnerability between males and females may come from exposure, infection (local or...
12 CitationsSource
#1Tanya KharaH-Index: 4
#2Carmel DolanH-Index: 6
This paper is a narrative review of the available literature on the relationship between wasting and stunting. It was born out of previous work carried out by the ENN which illustrated the divide at programme, policy and financing level between wasting and stunting. This divide ultimately has profound implications for how children worldwide receive nutrition interventions and services and, may well contribute to the lack of nutritional impact seen in programmes only addressing one part of the u...
26 Citations
#2Ulla SankilampiH-Index: 16
Last. Leo DunkelH-Index: 53
view all 3 authors...
The hypothalamic-pituitary-gonadal (HPG) axis is active in the midgestational foetus but silenced towards term because of the negative feedback effects mediated by the placental hormones. This restrai
124 CitationsSource
Cited By1
Newest
#1Rajkumar Hemalatha (ICMR: Indian Council of Medical Research)H-Index: 1
#2Anamika Pandey (Public Health Foundation of India)H-Index: 3
Last. Subodh S. Gupta (Mahatma Gandhi Institute of Medical Sciences)H-Index: 8
view all 53 authors...
Abstract Background To inform actions at the district level under the National Nutrition Mission (NNM), we assessed the prevalence trends of child growth failure (CGF) indicators for all districts in India and inequality between districts within the states. Methods We assessed the trends of CGF indicators (stunting, wasting and underweight) from 2000 to 2017 across the districts of India, aggregated from 5 × 5 km grid estimates, using all accessible data from various surveys with subnational geo...
1 CitationsSource
#1Gloria Adobea Odei Obeng‐Amoako (College of Health Sciences, Bahrain)H-Index: 1
#2Mark MyattH-Index: 20
Last. André Briend (UCPH: University of Copenhagen)H-Index: 24
view all 12 authors...
We assessed prevalence of concurrently wasted and stunted (WaSt) and explored the overlaps between wasted, stunted, underweight and low mid-upper arm circumference (MUAC) among children aged 6-59 months in Karamoja, Uganda. We also determined optimal weight-for-age (WAZ) and MUAC thresholds for detecting WaSt. We conducted secondary data analysis with 2015-2018 Food Security and Nutrition Assessment (FSNA) cross-sectional survey datasets from Karamoja. Wasting, stunting and underweight were defi...
Source
#1Gloria Adobea Odei Obeng‐Amoako (College of Health Sciences, Bahrain)H-Index: 1
#2Henry Wamani (College of Health Sciences, Bahrain)H-Index: 17
Last. Charles A. S. Karamagi (University of Ghana)H-Index: 1
view all 10 authors...
This study assessed the prevalence of concurrently wasted and stunted (WaSt) children, their characteristics, treatment outcomes and response; and factors associated with time to recovery among children aged 6–59 months admitted to Outpatient Therapeutic Care (OTC) in Karamoja, Uganda. We conducted a retrospective cohort study with data from January 2016 to October 2017 for children admitted to nine OTCs in Karamoja. We defined wasted, stunted and underweight as 2.0 Z-scores below the median per...
1 CitationsSource
#1Haroldo da Silva Ferreira (UFAL: Federal University of Alagoas)H-Index: 18
BACKGROUND: The methodology currently used for nutritional assessment of populations classifies children according to four conditions: eutrophy, wasting, stunting, and overweight. However, children can be stunted and wasted concomitantly. Similarly, they can be stunted and overweight. These conditions are associated with greater susceptibility to mortality or chronic diseases, respectively. This work presents an adaptation of Waterlow's classification (AWC), which discriminates six nutritional c...
Source
#1Sanni Yaya (U of O: University of Ottawa)H-Index: 13
#2Olanrewaju Oladimeji (Walter Sisulu University)H-Index: 17
Last. Ghose Bishwajit (U of O: University of Ottawa)H-Index: 10
view all 4 authors...
BACKGROUND: Adequate nutrition in early childhood is a necessity to achieve healthy growth and development, as well as a strong immune system and good cognitive development. The period from conception to infancy is especially vital for optimal physical growth, health and development. In this study we examined the influence of household structure on stunting in children <5 yrs of age in sub-Saharan Africa (SSA) countries. METHODS: Demographic and Health Survey data from birth histories in 35 SSA ...
Source
OBJECTIVE: To investigate trends in child anthropometry in Senegal between 1990 and 2015 and relate them with potential causes. Several hypotheses were tested: changes in health status, income, diet and socio-economic status. DESIGN: Statistical analysis of trends in anthropometric data: height, weight, BMI and associated Z-scores calculated with the CDC-2000 standard (Centers for Disease Control and Prevention): height-for-age (HAZ), weight-for-age (WAZ) and weight-for-height (WHZ). Trends were...
Source
#1Catherine Schwinger (University of Bergen)H-Index: 3
#2Michael H. N Golden (Aberd.: University of Aberdeen)H-Index: 43
Last. Benjamin Guesdon (Action Against Hunger)H-Index: 3
view all 5 authors...
Objectives This study aims to describe the mortality risk of children in the community who had severe acute malnutrition (SAM) defined by either a mid-upper arm circumference (MUAC) <115mm, a low weight-for-height Z-score (WHZ) <-3 or both criteria. Methods We pooled individual-level data from children aged 6–59 months enrolled in 3 community-based studies in the Democratic Republic of the Congo (DRC), Senegal and Nepal. We estimate the mortality hazard using Cox proportional hazard models in gr...
Source