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Child wasting before and after age two years: A cross-sectional study of 94 countries

Karlsson, Omar LU ; Kim, Rockli ; Guerrero, Saul ; Hasman, Andreas and Subramanian, S.v. (2022) In EClinicalMedicine 46.
Abstract
Background
Wasting reflects infections and poor nutrition and affects almost 50 million children at any given time. Wasting comes with immediate risk of mortality and increased risks for long-term negative consequences for development. Children under two are particularly sensitive to undernutrition and infections. We estimated the age patterning in wasting prevalence.

Methods
We calculated wasting prevalence and used Poisson regression models to estimate prevalence ratios comparing prevalence in children under and over two years using data from Demographic and Health Surveys and Multiple Indicator Cluster Surveys from 94 mostly low- and middle-income countries, including 804,172 children under five, born to a nationally... (More)
Background
Wasting reflects infections and poor nutrition and affects almost 50 million children at any given time. Wasting comes with immediate risk of mortality and increased risks for long-term negative consequences for development. Children under two are particularly sensitive to undernutrition and infections. We estimated the age patterning in wasting prevalence.

Methods
We calculated wasting prevalence and used Poisson regression models to estimate prevalence ratios comparing prevalence in children under and over two years using data from Demographic and Health Surveys and Multiple Indicator Cluster Surveys from 94 mostly low- and middle-income countries, including 804,172 children under five, born to a nationally representative sample of women 15–49 years old. Wasting prevalence was defined as the percentage of children with weight-for-height below –2 z-score from the median of the WHO 2006 growth standard.

Findings
Wasting prevalence for children under two was 14% (95% CI: 13, 14) while it was 9% (95% CI: 9, 9) for children 2–4 years old—leading to a prevalence ratio of 0·66 (95% CI: 0·64, 0·67) in our pooled sample. Prevalence ratios were less than one, indicating lower prevalence in children over two, in 87 countries and statistically significantly lower than one at a 5% level (non-adjusted) in 68 countries. Wasting prevalence was generally lower in children under two for males and females and the wealthiest and poorest households.

Interpretation
Since wasting prevalence was observed to be greater among children 0–2 years, and adverse exposure to undernutrition and infections are particularly harmful and interventions are more effective during the 1000 days from conception until age two, nutrition interventions should ensure coverage of children under two through programmatic measures to increase detection and enrollment in wasting programs. (Less)
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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Wasting, Children under five, Children under two, First 1000 days
in
EClinicalMedicine
volume
46
article number
101353
publisher
Lancet Publishing Group
external identifiers
  • scopus:85126914957
  • pmid:35360149
ISSN
2589-5370
DOI
10.1016/j.eclinm.2022.101353
language
English
LU publication?
yes
id
de15bde9-0c5f-4d20-917b-142731091183
date added to LUP
2022-03-30 22:06:18
date last changed
2022-07-13 10:55:51
@article{de15bde9-0c5f-4d20-917b-142731091183,
  abstract     = {{Background<br/>Wasting reflects infections and poor nutrition and affects almost 50 million children at any given time. Wasting comes with immediate risk of mortality and increased risks for long-term negative consequences for development. Children under two are particularly sensitive to undernutrition and infections. We estimated the age patterning in wasting prevalence.<br/><br/>Methods<br/>We calculated wasting prevalence and used Poisson regression models to estimate prevalence ratios comparing prevalence in children under and over two years using data from Demographic and Health Surveys and Multiple Indicator Cluster Surveys from 94 mostly low- and middle-income countries, including 804,172 children under five, born to a nationally representative sample of women 15–49 years old. Wasting prevalence was defined as the percentage of children with weight-for-height below –2 z-score from the median of the WHO 2006 growth standard.<br/><br/>Findings<br/>Wasting prevalence for children under two was 14% (95% CI: 13, 14) while it was 9% (95% CI: 9, 9) for children 2–4 years old—leading to a prevalence ratio of 0·66 (95% CI: 0·64, 0·67) in our pooled sample. Prevalence ratios were less than one, indicating lower prevalence in children over two, in 87 countries and statistically significantly lower than one at a 5% level (non-adjusted) in 68 countries. Wasting prevalence was generally lower in children under two for males and females and the wealthiest and poorest households.<br/><br/>Interpretation<br/>Since wasting prevalence was observed to be greater among children 0–2 years, and adverse exposure to undernutrition and infections are particularly harmful and interventions are more effective during the 1000 days from conception until age two, nutrition interventions should ensure coverage of children under two through programmatic measures to increase detection and enrollment in wasting programs.}},
  author       = {{Karlsson, Omar and Kim, Rockli and Guerrero, Saul and Hasman, Andreas and Subramanian, S.v.}},
  issn         = {{2589-5370}},
  keywords     = {{Wasting; Children under five; Children under two; First 1000 days}},
  language     = {{eng}},
  month        = {{04}},
  publisher    = {{Lancet Publishing Group}},
  series       = {{EClinicalMedicine}},
  title        = {{Child wasting before and after age two years: A cross-sectional study of 94 countries}},
  url          = {{http://dx.doi.org/10.1016/j.eclinm.2022.101353}},
  doi          = {{10.1016/j.eclinm.2022.101353}},
  volume       = {{46}},
  year         = {{2022}},
}