| Title: |
Child wasting and concurrent stunting in low- and middle-income countries |
| Authors: |
Mertens, A; Benjamin-Chung, J; Colford, JM; Hubbard, AE; van der Laan, MJ; Coyle, J; Sofrygin, O; Cai, W; Jilek, W; Rosete, S; Nguyen, A; Pokpongkiat, NN; Djajadi, S; Seth, A; Jung, E; Chung, EO; Malenica, I; Hejazi, N; Li, H; Hafen, R; Subramoney, V; Häggström, J; Norman, T; Christian, P; Brown, KH; Arnold, BF; Abbeddou, S; Adair, LS; Ahmed, T; Ali, A; Ali, H; Ashorn, P; Bahl, R; Barreto, ML; Begín, F; Bessong, PO; Bhan, MK; Bhandari, N; Bhargava, SK; Bhutta, ZA; Black, RE; Bodhidatta, L; Carba, D; Casanova, IG; Checkley, W; Crabtree, JE; Dewey, KG; Duggan, CP; Fall, CHD; Faruque, ASG; Fawzi, WW; da Silva Filho, JQ; Gilman, RH; Guerrant, RL; Haque, R; Hess, SY; Houpt, ER; Humphrey, JH; Iqbal, NT; Jimenez, EY; John, J; John, SM; Kang, G; Kosek, M; Kramer, MS; Labrique, A; Lee, NR; Lima, AÂM; Mahfuz, M; Mahopo, TC; Maleta, K; Manandhar, DS; Manji, KP; Martorell, R; Mazumder, S; Mduma, E; Mohan, VR; Moore, SE; Mostafa, I; Ntozini, R; Nyathi, ME; Olortegui, MP; Petri, WA; Premkumar, PS; Prentice, AM; Sachdev, HS; Sadiq, K; Sarkar, R; Saville, NM; Shaikh, S; Shrestha, BP; Shrestha, SK; Soares, AM; Sonko, B; Stein, AD; Svensen, E; Syed, S; Umrani, F; Ward, HD; West, KP |
| Source: |
Nature , 621 (7979) pp. 558-567. (2023) |
| Publisher Information: |
Springer Science and Business Media LLC |
| Publication Year: |
2023 |
| Collection: |
University College London: UCL Discovery |
| Subject Terms: |
Developing world; Epidemiology; Malnutrition; Paediatric research; Risk factors |
| Description: |
Sustainable Development Goal 2.2—to end malnutrition by 2030—includes the elimination of child wasting, defined as a weight-for-length z-score that is more than two standard deviations below the median of the World Health Organization standards for child growth 1. Prevailing methods to measure wasting rely on cross-sectional surveys that cannot measure onset, recovery and persistence—key features that inform preventive interventions and estimates of disease burden. Here we analyse 21 longitudinal cohorts and show that wasting is a highly dynamic process of onset and recovery, with incidence peaking between birth and 3 months. Many more children experience an episode of wasting at some point during their first 24 months than prevalent cases at a single point in time suggest. For example, at the age of 24 months, 5.6% of children were wasted, but by the same age (24 months), 29.2% of children had experienced at least one wasting episode and 10.0% had experienced two or more episodes. Children who were wasted before the age of 6 months had a faster recovery and shorter episodes than did children who were wasted at older ages; however, early wasting increased the risk of later growth faltering, including concurrent wasting and stunting (low length-for-age z-score), and thus increased the risk of mortality. In diverse populations with high seasonal rainfall, the population average weight-for-length z-score varied substantially (more than 0.5 z in some cohorts), with the lowest mean z-scores occurring during the rainiest months; this indicates that seasonally targeted interventions could be considered. Our results show the importance of establishing interventions to prevent wasting from birth to the age of 6 months, probably through improved maternal nutrition, to complement current programmes that focus on children aged 6–59 months. |
| Document Type: |
article in journal/newspaper |
| File Description: |
text |
| Language: |
English |
| Relation: |
https://discovery.ucl.ac.uk/id/eprint/10177618/ |
| Availability: |
https://discovery.ucl.ac.uk/id/eprint/10177618/1/s41586-023-06480-z.pdf; https://discovery.ucl.ac.uk/id/eprint/10177618/ |
| Rights: |
open |
| Accession Number: |
edsbas.A93B4566 |
| Database: |
BASE |