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Child wasting and concurrent stunting in low- and middle-income countries.
- Source :
-
Nature [Nature] 2023 Sep; Vol. 621 (7979), pp. 558-567. Date of Electronic Publication: 2023 Sep 13. - Publication Year :
- 2023
-
Abstract
- 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 <superscript>1</superscript> . 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.<br /> (© 2023. The Author(s).)
- Subjects :
- Child, Preschool
Humans
Infant
Infant, Newborn
Cross-Sectional Studies
Incidence
Longitudinal Studies
Rain
Seasons
Cachexia epidemiology
Cachexia mortality
Cachexia prevention & control
Developing Countries
Growth Disorders epidemiology
Growth Disorders mortality
Growth Disorders prevention & control
Malnutrition epidemiology
Malnutrition mortality
Malnutrition prevention & control
Subjects
Details
- Language :
- English
- ISSN :
- 1476-4687
- Volume :
- 621
- Issue :
- 7979
- Database :
- MEDLINE
- Journal :
- Nature
- Publication Type :
- Academic Journal
- Accession number :
- 37704720
- Full Text :
- https://doi.org/10.1038/s41586-023-06480-z