Concurrently wasted and stunted children 6-59 months in Karamoja, Uganda: prevalence and case detection
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Concurrently wasted and stunted children 6-59 months in Karamoja, Uganda : prevalence and case detection. / Odei Obeng-Amoako, Gloria Adobea; Myatt, Mark; Conkle, Joel; Muwaga, Brenda Kaijuka; Aryeetey, Richmond; Okwi, Andrew Livex; Okullo, Isaac; Mupere, Ezekiel; Wamani, Henry; Briend, André; Karamagi, Charles Amnon Sunday; Kalyango, Joan Nakayaga.
In: Maternal and Child Nutrition, Vol. 16, No. 4, e13000, 2020.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Concurrently wasted and stunted children 6-59 months in Karamoja, Uganda
T2 - prevalence and case detection
AU - Odei Obeng-Amoako, Gloria Adobea
AU - Myatt, Mark
AU - Conkle, Joel
AU - Muwaga, Brenda Kaijuka
AU - Aryeetey, Richmond
AU - Okwi, Andrew Livex
AU - Okullo, Isaac
AU - Mupere, Ezekiel
AU - Wamani, Henry
AU - Briend, André
AU - Karamagi, Charles Amnon Sunday
AU - Kalyango, Joan Nakayaga
N1 - © 2020 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.
PY - 2020
Y1 - 2020
N2 - 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.
AB - 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.
KW - Faculty of Science
KW - Case detection
KW - Concurrent wasting and stunting
KW - MUAC
KW - Stunting
KW - Uganda
KW - Wasting
KW - WaSt
U2 - 10.1111/mcn.13000
DO - 10.1111/mcn.13000
M3 - Journal article
C2 - 32212249
VL - 16
JO - Maternal and Child Nutrition
JF - Maternal and Child Nutrition
SN - 1740-8695
IS - 4
M1 - e13000
ER -
ID: 240790108