Analysis on the association among stunting, wasting and underweight in Malawi: an application of a log-linear model for the three-way table

Ngwira, Alfred; Munthali, Eddons C.S.; Vwalika, Kondwani D.

doi:10.4081/jphia.2017.620

Cited by 18 publications

(18 citation statements)

References 12 publications

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“…It also shows underweight and wasting are significantly interrelated (P-value< 0.001). These two findings are in line with previous studies conducted by Ngwira, Gupta and Borkotoky [13, 14]. In addition, this result is agreed on the fact that underweight is a composite measure of stunting and wasting [20, 21].…”

Section: Discussionsupporting

confidence: 92%

“…They are useful when all the three factors can be treated as response [15]. Consequently, in this study the three factors (underweight, stunting and wasting) were treated as response and the focus is on their structure of association by fitting 2 3 + 1 = 9 log-linear possible models [14]. Therefore, the nine log-linear models of the mean cell count from the three factors are given bellow.…”

Section: Methodsmentioning

confidence: 99%

“…Several studies have assessed determinants of childhood undernutrition [10–12] and have not focused on the association of stunting, wasting and underweight. A few studies tried to explore pair wise association and the three dimension association of stunting, wasting and underweight [13, 14]. Exploring the three dimension association is useful to check whether stunting, wasting and underweight have valid multidimensional nature or not.…”

Section: Introductionmentioning

confidence: 99%

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Exploring the association of anthropometric indicators for under-five children in Ethiopia

Kassie

Workie

2019

BMC Public Health

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Background Child undernutrition is a global health concern. Many studies have focused on the association of childhood undernutrition indicators with their predictors. A few studies have looked at relationship between the undernutrition indicators. This study aimed at investigating the possible association structures of childhood undernutrition indicators. Methods A log-linear model of cell counts of a three way table of stunting, wasting, and underweight was fitted based on the 2016 Ethiopia demographic health survey data. The variables of interest were generated based on the 2006 WHO Child Growth Standards as: stunted, wasted and underweight if z-scores of height-for-age, weight-for-height and weight-for age are below-2, respectively; otherwise not stunted, wasted and underweight. Results This study showed that 36.34, 12.09 and 24.87% were stunted, wasted and underweight out of sampled children respectively and the prevalence of total undernutrition in children was about 45.96%.The fitted log-linear model showed that underweight was associated with both stunting ( P -value< 0.001), and wasting ( P -value< 0.001). There was no association between stunting and wasting ( P -value = 0.999). Furthermore, the model showed that there is no a three way interaction among stunting, wasting, and underweight ( P -value = 1.000). Conclusion The authors conclude that there is lack of three way association of stunting, wasting, and underweight. This confirms that the three anthropometric indicators of children have multi-dimensional nature. Thus, the concerned body should consider the three undernutrition indicators simultaneously to estimate the actual burden of childhood undernourishment as they are not redundant of each other.

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Section: Discussionsupporting

confidence: 92%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Exploring the association of anthropometric indicators for under-five children in Ethiopia

Kassie

Workie

2019

BMC Public Health

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“…Due to the low number of dropouts (<10%) and missing values (i.e., those mother-child pairs with some but not all outcomes at follow-up) completers-only analysis was found to be sufficient to assess the research question. Acute malnourishment (wasting indicator status) was used as the primary endpoint measure, while the additional outcome measures underweight and stunting have been confirmed to measure independently more long-term aspects of child development and growth [49]. Nonetheless, the short follow-up period implies that the long-term effects of the smartphone-based maternal education on undernourishment and linear growth need to be studied further.…”

Section: Discussionmentioning

confidence: 99%

Smartphone-Based Maternal Education for the Complementary Feeding of Undernourished Children Under 3 Years of Age in Food-Secure Communities: Randomised Controlled Trial in Urmia, Iran

et al. 2020

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The mothers’ nutritional literacy is an important determinant of child malnourishment. We assessed the effect of a smartphone-based maternal nutritional education programme for the complementary feeding of undernourished children under 3 years of age in a food-secure middle-income community. The study used a randomised controlled trial design with one intervention arm and one control arm (n = 110; 1:1 ratio) and was performed at one well-child clinic in Urmia, Iran. An educational smartphone application was delivered to the intervention group for a 6-month period while the control group received treatment-as-usual (TAU) with regular check-ups of the child’s development at the well-child centre and the provision of standard nutritional information. The primary outcome measure was change in the indicator of acute undernourishment (i.e., wasting) which is the weight-for-height z-score (WHZ). Children in the smartphone group showed greater wasting status improvement (WHZ +0.65 (95% Confidence Interval (CI) ± 0.16)) than children in the TAU group (WHZ +0.31 (95% CI ± 0.21); p = 0.011) and greater reduction (89.6% vs. 51.5%; p = 0.016) of wasting caseness (i.e., WHZ < −2; yes/no). We conclude that smartphone-based maternal nutritional education in complementary feeding is more effective than TAU for reducing undernourishment among children under 3 years of age in food-secure communities.

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“…Malnutrition is the main cause of mortality and morbidity among children below 5 years old; furthermore, this condition affects the physical and cognitive developments of children and reduces their academic performance [ 1 ]. Wasting and underweight are two main indicators of undernutrition in children [ 6 ]. The term underweight in children refers to a child whose weight for age is less than -2 standard deviation (SD) of the World Health Organization (WHO)’s child growth standard median [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of underweight and wasting in Iranian children aged below 5 years: a systematic review and meta-analysis

et al. 2018

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Purpose Wasting and underweight are the 2 main indicators of children’s undernutrition. We aimed to estimate the prevalence of undernutrition at the national level in Iran.Methods We performed a search for original articles published in international and Iranian databases including MEDLINE, Web of Science, Google Scholar, Scopus, CINHAL (Cumulative Index to Nursing and Allied Health Literature), Scientific Information Database, Irandoc, Iranmedex, and Magiran during January 1989–August 2017. Seven keywords, in English and Persian, including malnutrition, protein energy malnutrition, growth disorders, underweight wasting, weight loss, children below 5 years old, and children, were used to search the databases.Results Finally, 17 articles were included in the meta-analysis, based on which the prevalence of underweight and wasting in Iranian children were estimated to be 11% and 5%, respectively. The prevalence rates of underweight among children in the central, western, southern, and northern parts of Iran and at the national level were 24%, 5%, 20%, 17%, and 6%, respectively. The prevalence rates of wasting in the central, western, southern, and northern parts of Iran and at the national level were 9%, 4%, 11%, 5%, and 4%, respectively.Conclusion Although the prevalence of underweight and wasting in Iran was low, some parts of the country showed high prevalence. The main reason behind this difference in the prevalence of malnutrition may be due to the level of development in different regions.

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Analysis on the association among stunting, wasting and underweight in Malawi: an application of a log-linear model for the three-way table

Cited by 18 publications

References 12 publications

Exploring the association of anthropometric indicators for under-five children in Ethiopia

Exploring the association of anthropometric indicators for under-five children in Ethiopia

Smartphone-Based Maternal Education for the Complementary Feeding of Undernourished Children Under 3 Years of Age in Food-Secure Communities: Randomised Controlled Trial in Urmia, Iran

Prevalence of underweight and wasting in Iranian children aged below 5 years: a systematic review and meta-analysis

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