Concurrently wasted and stunted children 6-59 months in Karamoja, Uganda: prevalence and case detection.

Autor: Odei Obeng-Amoako GA; Clinical Epidemiology Unit, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda., Myatt M; Brixton Health, Powys, UK., Conkle J; Health and Nutrition Section, UNICEF, Windhoek, Namibia., Muwaga BK; Independent Consultant, Kampala, Uganda., Aryeetey R; School of Public Health, University of Ghana, Accra, Ghana., Okwi AL; Department of Pathology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda., Okullo I; Department of Dentistry, School of Health Sciences, College of Health Sciences, Makerere University, Kampala, Uganda., Mupere E; Department of Paediatrics and Child Health, College of Health Sciences, Makerere University, Kampala, Uganda., Wamani H; Department of Community Health and Behavioural Sciences, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda., Briend A; School of Medicine, Centre for Child Health Research, University of Tampere, Tampere, Finland.; Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark., Karamagi CAS; Clinical Epidemiology Unit, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.; Department of Paediatrics and Child Health, College of Health Sciences, Makerere University, Kampala, Uganda., Kalyango JN; Clinical Epidemiology Unit, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.; Department of Pharmacy, College of Health Sciences, Makerere University, Kampala, Uganda.
Jazyk: angličtina
Zdroj: Maternal & child nutrition [Matern Child Nutr] 2020 Oct; Vol. 16 (4), pp. e13000. Date of Electronic Publication: 2020 Mar 25.
DOI: 10.1111/mcn.13000
Abstrakt: We assessed prevalence of concurrently wasted and stunted (WaSt) and explored the overlaps between wasted, stunted, underweight and low mid-upper arm circumference (MUAC) among children aged 6-59 months in Karamoja, Uganda. We also determined optimal weight-for-age (WAZ) and MUAC thresholds for detecting WaSt. We conducted secondary data analysis with 2015-2018 Food Security and Nutrition Assessment (FSNA) cross-sectional survey datasets from Karamoja. Wasting, stunting and underweight were defined as <-2.0 z-scores using WHO growth standards. Low MUAC was defined as <12.5 cm. We defined WaSt as concurrent wasting and stunting. Prevalence of WaSt was 4.96% (95% CI [4.64, 5.29]). WaSt was more prevalent in lean than harvest season (5.21% vs. 4.53%; p = .018). About half (53.92%) of WaSt children had low MUAC, and all were underweight. Younger children aged <36 months had more WaSt, particularly males. Males with WaSt had higher median MUAC than females (12.50 vs. 12.10 cm; p < .001). A WAZ <-2.60 threshold detected WaSt with excellent sensitivity (99.02%) and high specificity (90.71%). MUAC threshold <13.20 cm had good sensitivity (81.58%) and moderate specificity (76.15%) to detect WaSt. WaSt prevalence of 5% is a public health concern, given its high mortality risk. All children with WaSt were underweight and half had low MUAC. WAZ and MUAC could be useful tools for detecting WaSt. Prevalence monitoring and prospective studies on WAZ and MUAC cut-offs for WaSt detection are recommended. Future consideration to integrate WAZ into therapeutic feeding programmes is recommended to detect and treat WaSt children.
(© 2020 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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