The prevalence of stunting among children and adolescents living in the Middle East and North Africa region (MENA): A systematic review and meta-analysis

Abstract

Background Given the strategic importance of the MENA, the state of war and inequity in the region and its effect on malnutrition which leads to mortality and reduced economic development in this region, the current study purposed to examine the prevalence of stunting as an indicator of chronic malnutrition in the MENA region, with consideration given HDI, rural/urban area, and war-involved countries. Methods The electronic databases of PubMed, SCOPUS, Web of science, and Embase were systematically searched, and English-language articles published between January 1, 2009 and December 31, 2019 were included in this study. The POLIS (population, outcome, location, indicator, study design) criteria were used to perform the systematic review, and studies involving children 2 to 18 years of age were selected. Results Fifty-eight (n = 2 202 869) were included based on the study's inclusion criteria. The prevalence of stunting in children in the total MENA region was 22.0% (95% confidence interval (CI) = 20.4-23.6; I 2 = 99.92%, P < 0.0001). The studies included in the meta-analysis were analyzed by subgroups. The pooled prevalence of stunting in children aged 2-5 years old and children aged 6 and older was 25.7% and 16.5%, respectively. The pooled prevalence of stunting was 34.1% in rural and 12.4% in urban areas. The pooled prevalence of stunting according to HDI was 30.1%, 28.5%, 13.1%, in low, medium, and high HDI countries, respectively. Furthermore, the pooled prevalence of stunting according to war status was 28.5% in war-involved countries vs 20.6% in others. Conclusions High prevalence of malnutrition was seen based on stunting indicator in the meta-analysis study in the MENA region, and this issue became more pronounced when the data was divided into subgroups based on age, residential area, and HDI. Inequality regarding social, economic, and political factors leads to significant malnutrition in the mentioned region.

A systematic review and meta-analysis of the prevalence of childhood undernutrition in North Africa

“…The results are consistent with a study by by Akombi et al [ 60 ]. Our results are also consistent with the study of Joulaei et al [ 17 ] that focused on children 2–18 years in Middle East and North African countries, and found high stunting rates among children [ 17 ]. Finally, our results agree with the 2021 WHO report which observed that stunting was prevalent and increasing in the North African region [ 1 ].…”

“…Previous studies on child undernutrition, carried out in various individual North African countries, namely Tunisia [ 11 ]; Egypt [ 12 ]; Sudan [ 13 ]; Algeria [ 14 ]; Morocco [ 15 ] and Western Sahara [ 16 ], highlighted the prevalence of undernutrition among children under five. Joulaei et al [ 17 ]. conducted a review to examine the prevalence of stunting among children and adolescences aged 2–18 in 24 countries in the Middle Eastern and North African regions [ 17 ].…”

“…Joulaei et al [ 17 ]. conducted a review to examine the prevalence of stunting among children and adolescences aged 2–18 in 24 countries in the Middle Eastern and North African regions [ 17 ]. Apart from including a wide range of children ages with different growth requirements and health needs which affects the validity and generalizability of the results to all age groups, there was no information on Libya, Algeria, or Tunisia.…”

Total Usual Nutrient Intakes and Nutritional Status of United Arab Emirates Children (4 Years–12.9 Years): Findings from the Kids Nutrition and Health Survey (KNHS) 2021

“…In addition to overweight and obesity, the study has also investigated anthropometric indicators of undernutrition. The estimated stunting prevalence within our total sample (4.2%) was found to be lower than the global prevalence of 21.3% and lower than the regional prevalence of 16.5% in children aged 6 and older [ 53 , 54 ]. The prevalence of wasting in our sample (8%) was also found to be lower than the global levels (11%) while being similar to that reported from other oil-rich countries (e.g., 8% in Saudi Arabia, 5% in Qatar) [ 55 ].…”

Prevalence of Stunting and its Biosocial Determinants among Young Children Enrolled at Urban Anganwadi Centers in Rishikesh, Uttarakhand

“…Meta-analysis conducted by Joulaei H et al . [ 21 ] (2021) found that 25.7% of children in the 2–5 age group were stunted in the Middle East north region. Unlike the present study, a study conducted by Gaidhane A. et al .…”