Causes and consequences of child growth faltering in low- and middle-income countries

Mertens, Andrew; Benjamin‐Chung, Jade; Colford, John M.; Coyle, Jeremy; Laan, Mark J. van der; Hubbard, Alan E; Rosete, Sonali; Malenica, Ivana; Hejazi, Nima S.; Sofrygin, Oleg; Cai, Wilson; Li, Haodong; Nguyen, Anna; Pokpongkiat, Nolan N; Djajadi, Stephanie; Seth, Anmol; Jung, Esther; Chung, Esther O.; Jilek, Wendy; Subramoney, Vishak; Hafen, Ryan; Häggström, Jonas; Norman, Thea; Brown, Kenneth H.; Christian, Parul; Arnold, Benjamin F.

doi:10.1101/2020.06.09.20127100

Cited by 33 publications

(52 citation statements)

References 154 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Even if preterm birth accounts for some of at-birth wasting, the small birth size -by any cause -documented in this analysis raises concern because of its consequences for child growth failure and mortality during the first 24 months. 57 Our results provide new insights into the dynamic process of child wasting with important implications for preventive interventions. WLZ varied dramatically by season in most cohorts, and in South Asia at-birth WLZ varied by 0.7 z-scores (95% CI: 0.4, 1.0) depending on birth month with consequences that persisted throughout the first 24 months (Fig 3, Extended Data Figure 5).…”

Section: Discussionmentioning

confidence: 79%

“…A companion article reports key determinants of persistent wasting and its consequences for mortality. 57 Wasted children who are simultaneously stunted (length-for-age Z < -2) are at substantially higher risk of mortality than all other growth phenotypes. 7 We characterized the epidemiology of concurrent wasting and stunting across cohorts and by region to understand when concurrent wasting and stunting first manifests and when it is most common among children under 24 months.…”

Section: Persistent and Concurrent Growth Failurementioning

confidence: 99%

“…A companion article reports the relationship between WLZ and risk of subsequent linear growth failure. 57…”

Section: Persistent and Concurrent Growth Failurementioning

confidence: 99%

“…A companion article reports key determinants of persistent wasting and its consequences for mortality. 57…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Child wasting and concurrent stunting in low- and middle-income countries

Mertens¹,

Benjamin‐Chung²,

Colford³

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

Acute malnutrition accounts for an immense disease burden and is implicated as a key, underlying cause of child mortality in low resource settings. Child wasting, defined as weight-for-length more than 2 standard deviations below international standards, is a leading indicator to measure the Sustainable Development Goal target to end malnutrition by 2030. Prevailing methods to measure wasting rely on cross-sectional surveys that are unable to measure onset, recovery, and persistence - key features of wasting epidemiology that could inform preventive interventions and disease burden estimates. Here, we show through an analysis of 18 longitudinal cohorts that child wasting is a highly dynamic process of incident onset and recovery, and that peak incidence is between birth and 3 months - far earlier than peak prevalence at 12-15 months. By age 24 months the proportion of children who had ever experienced a wasting episode (33%) was more than 5-fold higher than prevalence (6%), suggesting that the wasting burden is likely far higher than cross-sectional surveys suggest. Seasonally driven changes in population mean weight-for-length were large (>0.5 z in some cohorts) and were synchronous with rainfall across diverse settings, creating potential for seasonally targeted interventions. Our results motivate a new focus on extending preventive interventions for child wasting to pregnant and lactating mothers, and for preventive and therapeutic interventions to include children below age 6 months in addition to current targets of ages 6-59 months.

show abstract

Section: Discussionmentioning

confidence: 79%

Section: Persistent and Concurrent Growth Failurementioning

confidence: 99%

See 2 more Smart Citations

Child wasting and concurrent stunting in low- and middle-income countries

Mertens¹,

Benjamin‐Chung²,

Colford³

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

“…Available evidence shows that lower risk at the younger age may be due to the protective effects of being breastfed which mostly continues during the first year of life [ 61 – 63 ]. CGF appears to develop during the period of weaning and then rises sharply at a later age which may be due to cumulative undernutrition associated with poor child feeding practices, inadequate complementary food, household conditions, household food insecurity and interacting with unsafe environment [ 32 , 64 – 66 ].…”

Section: Discussionmentioning

confidence: 99%

Trends in child growth failure among children under five years of age in Ethiopia: Evidence from the 2000 to 2016 Demographic and Health Surveys

Bekele

Rawstorne²,

Rahman³

2021

PLoS ONE

View full text Add to dashboard Cite

Introduction In a majority of low- and middle-income countries (LMICs), levels of child growth failure (CGF) have steadily declined since 2000. However, some countries show a different trend. Despite continued investment from the government of Ethiopia as well as donors, CGF levels are still high in Ethiopia. This study aimed to assess trends in CGF and associated sociodemographic, economic and water, sanitation, and hygiene (WASH) factors from 2000 to 2016 in Ethiopia. Methods Data were taken from four rounds of the Ethiopia Demographic and Health Survey (EDHS). Children aged between 0 to 59 months were included. CGF indicators were categorised based on height-for-age z-score (HAZ) < -2 Standard deviation (SD), weight-for-age z-score (WAZ) < -2 SD and weight-for-height z-score (WHZ) < -2 SD. CGF trends were estimated for predicted probabilities and odds ratios (ORs) between 2000 and 2016. Results A total sample size of 31978 for HAZ, 32045 for WAZ and 32246 for WHZ were included in the current study. Stunting decreased from an adjusted odds ratio (AOR) = 0.77 (95% CI: 0.67 to 0.88) in 2005 to an AOR = 0.45 (95% CI: 0.39 to 0.53) in 2016 compared with the year 2000. Compared with data in 2000, underweight decreased from an AOR of 0.70 (95% CI: 0.61 to 0.80) in 2005 to an AOR of 0.43 (95% CI: 0.36 to 0.50) in 2016. Wasting declined from an AOR of 0.91 (95% CI: 0.75 to 1.10) in 2005 to an AOR of 0.76 (95% CI: 0.61 to 0.94) in 2016, compared with data in 2000. Conclusions Between 2000 to 2016, there was a decline in CGF levels albeit the levels are still relatively high compared with the World Health Organization (WHO) cut-off levels for public health concern. Observed rates of change varied across sociodemographic, economic and WASH factors which suggest that interventions tailored towards addressing the imbalances across those factors are required.

show abstract

Secular trends in the anthropometric characteristics of children in a rural community in Yucatan, Mexico

Azcorra,

Castillo‐Burguete,

Lara‐Riegos

et al. 2023

American J Hum Biol

View full text Add to dashboard Cite

ObjectiveTo analyze changes in height, weight, and body mass index (BMI = kg/m2) from 1986 to 2022 in 3–11 year old children from Dzeal, a rural Maya community in Yucatan, Mexico.Materials and MethodsFrom October‐2022 to February‐2023 (third‐wave survey), we obtained anthropometric measurements of children (n = 80) and family socioeconomic data and compared them with data obtained in 1986 (n = 38) and 2000 (n = 76). Comparisons of anthropometric parameters by sex between years of measurement were performed graphically and through one‐way ANOVA, splitting children into two age groups: 3–7 and 8–11. Bonferroni adjustments for multiple comparisons were used when ANOVAs were statistically significant (p < .05).ResultsIn girls, significant increases in height and weight between surveys were found in 3–7 and 8–11 age groups; in boys, significant increases were only found in the 8–11 age group. Regarding BMI, there were increases in 2022 compared with 1986/2000 in both sexes from 8 years onwards. Differences indicate increases of 3.9 and 4.4 cm per decade in girls aged 3–7 and 8–11, respectively, and increases in weight of 1.1 and 3.3 kg per decade, respectively. Increases in boys 8–11 years were 2.3 cm and 2.4 kg per decade.ConclusionSignificant increases in growth parameters were observed in specific‐age children in the community studied in the context of changes in livelihoods and improvements in household material conditions.

show abstract

Causes and consequences of child growth faltering in low- and middle-income countries

Cited by 33 publications

References 154 publications

Child wasting and concurrent stunting in low- and middle-income countries

Child wasting and concurrent stunting in low- and middle-income countries

Trends in child growth failure among children under five years of age in Ethiopia: Evidence from the 2000 to 2016 Demographic and Health Surveys

Secular trends in the anthropometric characteristics of children in a rural community in Yucatan, Mexico

Contact Info

Product

Resources

About