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

Maternal and Child Nutrition

Mark Myatt¹  Joan Nakayaga Kalyango²  Gloria Adobea Odei Obeng‐Amoako²  Charles Amnon Sunday Karamagi²  Henry Wamani³  Isaac Okullo⁴  Ezekiel Mupere⁵  Andrew Livex Okwi⁶  Joel Conkle⁷  Brenda Kaijuka Muwaga⁸  André Briend⁹  Richmond Aryeetey^1,10 

[1] Brixton Health Powys UK;Clinical Epidemiology Unit, School of Medicine, College of Health Sciences Makerere University Kampala Uganda;Department of Community Health and Behavioural Sciences, School of Public Health, College of Health Sciences Makerere University Kampala Uganda;Department of Dentistry, School of Health Sciences, College of Health Sciences Makerere University Kampala Uganda;Department of Paediatrics and Child Health, College of Health Sciences Makerere University Kampala Uganda;Department of Pathology, School of Biomedical Sciences, College of Health Sciences Makerere University Kampala Uganda;Health and Nutrition Section UNICEF Windhoek Namibia;Independent Consultant Kampala Uganda;School of Medicine, Centre for Child Health Research University of Tampere Tampere Finland;School of Public Health University of Ghana Accra Ghana;

关键词: case detection;    concurrent wasting and stunting;    MUAC;    stunting;    Uganda;    wasting;   

DOI  :  10.1111/mcn.13000

来源: DOAJ

【 摘 要 】

Abstract 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.

【 授权许可】

Unknown