scholarly journals Prevalence and trends in the childhood dual burden of malnutrition in low- and middle-income countries, 1990–2012

2016 ◽  
Vol 19 (8) ◽  
pp. 1375-1388 ◽  
Author(s):  
Emma Tzioumis ◽  
Melissa C Kay ◽  
Margaret E Bentley ◽  
Linda S Adair
Keyword(s):  
Demographic And Health Surveys ◽  
Cross Sectional ◽  
Middle Income ◽  
Individual Level ◽  
Middle Income Countries ◽  
Country Level ◽  
Before And After ◽  
Dual Burden ◽  
Nationally Representative ◽  
Low And Middle Income

AbstractObjectiveTo describe trends in country- and individual-level dual burden of malnutrition in children <5 years, and age-stratified (<2 years, ≥2 years) country-level trends, in thirty-six low- and middle-income countries (LMIC).DesignUsing repeated cross-sectional nationally representative data, we calculated the prevalence of malnutrition (stunting, wasting, overweight) at each survey wave, annualized rates of prevalence change for each country over time, and trends before and after 2000, for all children <5 years and separately for those </≥2 years. We examined country- (ratio of stunting to overweight) and individual-level (coexistence of stunting and overweight) dual burden in children <5 years.SettingDemographic and Health Surveys from thirty-six LMIC between 1990 and 2012.SubjectsChildren <5 years.ResultsOverall malnutrition prevalence decreased in children <5 years, driven by stunting decreases. Stunting rates decreased in 78 % of countries, wasting rates decreased in 58 % of countries and overweight rates increased in 36 % of countries. Rates of change differed for children </≥2 years, with children <2 years experiencing decreases in stunting in fewer countries yet increases in overweight in more countries. Countries with nearly equal prevalences of stunting and overweight in children <5 years increased from 2000 to the final year. Within a country, 0·3–10·9 % of children <5 years were stunted and overweight, and 0·6–37·8 % of stunted children <5 years were overweight.ConclusionsThe dual burden exists in children <5 years on both country and individual levels, indicating a shift is needed in policies and programmes to address both sides of malnutrition. Children <2 years should be identified as a high-risk demographic.

scholarly journals Age patterns in overweight and wasting prevalence of under 5-year-old children from low- and middle-income countries

2021 ◽  
Author(s):  
Luiza I. C. Ricardo ◽  
Giovanna Gatica-Domínguez ◽  
Inácio Crochemore-Silva ◽  
Paulo A. R. Neves ◽  
Juliana dos Santos Vaz ◽  
...  
Keyword(s):  
Low Income ◽  
Age Groups ◽  
Demographic And Health Surveys ◽  
Older Children ◽  
Middle Income ◽  
Middle Income Countries ◽  
Multiple Indicator ◽  
Standard Deviations ◽  
Nationally Representative ◽  
Low And Middle Income

Abstract Objectives To describe how overweight and wasting prevalence varies with age among children under 5 years in low- and middle-income countries (LMICs). Methods We used data from nationally representative Demographic and Health Surveys and Multiple Indicator Cluster Surveys. Overweight and wasting prevalence were defined as the proportions of children presenting mean weight for length/height (WHZ) more than 2 standard deviations above or below 2 standard deviations from the median value of the 2006 WHO standards, respectively. Descriptive analyses include national estimates of child overweight and wasting prevalence, mean, and standard deviations of WHZ stratified by age in years. National results were pooled using the population of children aged under 5 years in each country as weight. Fractional polynomials were used to compare mean WHZ with both overweight and wasting prevalence. Results Ninety national surveys from LMICs carried out between 2010 and 2019 were included. The overall prevalence of overweight declined with age from 6.3% for infants (aged 0–11 months) to 3.0% in 4 years olds (p = 0.03). In all age groups, lower prevalence was observed in low-income compared to upper-middle-income countries. Wasting was also more frequent among infants, with a slight decrease between the first and second year of life, and little variation thereafter. Lower-middle-income countries showed the highest wasting prevalence in all age groups. On the other hand, mean WHZ was stable over the first 5 years of life, but the median standard deviation for WHZ decreased from 1.39 in infants to 1.09 in 4-year-old children (p < 0.001). For any given value of WHZ, both overweight and wasting prevalence were higher in infants than in older children. Conclusion The higher values of WHZ standard deviations in infants suggest that declining prevalence in overweight and wasting by age may be possibly due to measurement error or rapid crossing of growth channels by infants.

scholarly journals New estimations of child marriage: Evidence from 98 low- and middle-income countries

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0258378
Author(s):  
Mengjia Liang ◽  
Sandile Simelane ◽  
Satvika Chalasani ◽  
Rachel Snow
Keyword(s):  
Survival Analysis ◽  
Child Marriage ◽  
Demographic And Health Surveys ◽  
Hazard Rates ◽  
Middle Income ◽  
The Sustainable Development ◽  
Marriage Rates ◽  
Middle Income Countries ◽  
Nationally Representative ◽  
Low And Middle Income

The Sustainable Development Goals include a target on eliminating child marriage, a human rights abuse. Yet, the indicator used in the SDG framework is a summary statistic and does not provide a full picture of the incidence of marriage at different ages. This paper aims to address this limitation by providing an alternative method of measuring child marriage. The paper reviews recent data on nuptiality and captures evidence of changes in the proportion married and in the age at marriage, in 98 low- and middle-income countries (LMICs). Using data collected from nationally representative Demographic and Health Surveys and Multiple Indicator Cluster Surveys, survival analysis is applied to estimate (a) age-specific marriage hazard rates among girls before age 18; and (b) the number of girls that were married before age 18 in 2020. Results show that the vast majority of girls remain unmarried until age 10. Child marriage rates increase gradually until age 14 and accelerate significantly thereafter at ages 15–17. By accounting for both single-year-age-specific child marriage hazard rates and the age structure of the population with a survival analysis approach, lower estimates in countries with a rapid decrease in child marriage and higher estimates in countries with constant or slightly rising child marriage rates relative to the direct approach are obtained.

scholarly journals Mapping access to basic hygiene services in low- and middle-income countries: A cross-sectional case study of geospatial disparities

2020 ◽  
Author(s):  
Weiyu Yu ◽  
Robert E. S. Bain ◽  
Jie Yu ◽  
Victor Alegana ◽  
Winfred Dotse-Gborgbortsi ◽  
...  
Keyword(s):  
Random Forest ◽  
Scale Up ◽  
Random Forest Model ◽  
Demographic And Health Surveys ◽  
Ensemble Model ◽  
Cross Sectional ◽  
Middle Income ◽  
Forest Model ◽  
Middle Income Countries ◽  
Low And Middle Income

Handwashing with water and soap, is among the most a cost-effective interventions to improve public health. Yet billions of people globally lacking handwashing facilities with water and soap on premises, with gaps particularly found in low- and middle-income countries. Targeted efforts to expand access to basic hygiene services require data at geospatially explicit scales. Drawing on country-specific cross-sectional Demographic and Health Surveys with georeferenced hygiene data, we developed an ensemble model to predict the prevalence of basic hygiene facilities in Malawi, Nepal, Nigeria, Pakistan and Uganda. The ensemble model was based on a multiple-level stacking structure, where five predictive modelling algorithms were used to produce sub-models, and a random forest model was used to generalise the final predictions. An inverse distance weighted interpolation was incorporated in the random forest model to account for spatial autocorrelation. Local coverage and a local dissimilarity index were calculated to examine the geographic disparities in access. Our methodology produced robust outputs, as evidenced by performance evaluations (all R2 were above 0.8 with the exception of Malawi where R2 = 0.6). Among the five study countries, Pakistan had the highest overall coverage, whilst Malawi had the poorest coverage. Apparent disparities in basic hygiene services were found across geographic locations and between urban and rural settings. Nigeria had the highest level of inequalities in basic hygiene services, whilst Malawi showed the least segregation between populations with and without basic hygiene services. Both educational attainment and wealth were important predictors of the geospatial distribution of basic hygiene services. By producing geospatially explicit estimates of the prevalence of handwashing facilities with water and soap, this study provides a means of identifying geographical disparities in basic hygiene services. The method and outputs can be useful tools to identify areas of low coverage and to support efficient and precise targeting of efforts to scale up access to handwashing facilities and shift social and cultural norms on handwashing.

scholarly journals Association of Undernutrition and Neonatal, Infant and Under-5 Mortality: Evidence from 62 Low-Income and Middle-Income Countries

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 911-911
Author(s):  
Paddy Ssentongo ◽  
Joseph Lewcun ◽  
Anna Ssentongo ◽  
Djibril Ba ◽  
Claudio Fronterre ◽  
...  
Keyword(s):  
Infant Mortality ◽  
Neonatal Mortality ◽  
Child Mortality ◽  
Low Income ◽  
Household Survey ◽  
Cross Sectional ◽  
Middle Income ◽  
Middle Income Countries ◽  
Country Level ◽  
Nationally Representative

Abstract Objectives During the Millennium Development Goals (MDG) era, many low- and middle-income countries (LMICs) failed to achieve the MDG 4 of reducing neonatal, infant, and under-5 mortality. In this study, we aimed to assess whether reductions in early childhood undernutrition is associated with a reduction in neonatal, infant and under-5 mortality rate in LMICs. Methods We analyzed demographic and health household survey data from 62 LMICs collected between 2006 and 2018. The sample consisted of nationally representative cross-sectional surveys of children aged 0–59 months (n = 600,390). We examined country-level prevalence of stunting, wasting and underweight (based on z scores &lt; −2 per the WHO Growth Standard) each as predictors of neonatal, infant and under-5 mortality incidence using multivariate Poisson regression models adjusted for country-level mean duration of breastfeeding and gross domestic product per capita. We also examined the association between breastfeeding and mortality. Results Overall, 28.4% (95% CI: 26.3%, 30.7%) of young children were stunted, 5.4% (95% CI: 4.5%, 6.6%) were wasted, 12.3% (95% CI: 10.4%, 14.6%) were underweight. Per 1000 live births, neonatal mortality was 23.6 (95% CI: 19.3–27.1), infant mortality was 43.4 (95% CI: 30.2–50.1) and under-5 mortality was 61.6 (95% CI: 55.3- 68.3). At the country level, a 10-fold decrease in stunting was associated with a relative risk (RR) of 0.81 (95% CI 0.66–0.98; P &lt; 0.001) for neonatal mortality, 0.66 (95% CI 0.55–0.80; P &lt; 0.001) for infant mortality, and 0.63 (95% CI 0.52–0.76; P &lt; 0.001) for under-5 mortality. No association was seen between wasting or underweight and child mortality. Breastfeeding was associated with lower rates of child mortality. A one standard deviation (16 months) increase in breastfeeding was associated with a RR of 0.86 (95% CI 0.76–0.97; P = 0.015) for neonatal mortality, 0.79 (95% CI 0.70–0.89; P &lt; 0.001) for infant mortality, and 0.75 (95% CI 0.67–0.85; P &lt; 0.001) for under-5 mortality. Conclusions In a very large, multi-country sample of nationally-representative surveys in LMICs, stunting was strongly associated with child mortality from birth to 5 years. Stunting should be a focus in the effort to achieve the Sustainable Development Goal 3.2 target to reduce neonatal and under-5 mortality in all countries by 2030. Funding Sources National Institute of Health.

scholarly journals Influence of contextual socioeconomic position on hypertension risk in low- and middle-income countries: disentangling context from composition

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mustapha S. Abba ◽  
Chidozie U. Nduka ◽  
Seun Anjorin ◽  
Shukri F. Mohamed ◽  
Emmanuel Agogo ◽  
...  
Keyword(s):  
Kyrgyz Republic ◽  
Lifestyle Behaviour ◽  
Middle Income ◽  
Individual Level ◽  
Middle Income Countries ◽  
Country Level ◽  
Resource Limited ◽  
The Individual ◽  
Low And Middle Income ◽  
Deprived Areas

Abstract Background Hypertension has emerged as the single most significant modifiable risk factor for cardiovascular disease and death worldwide. Resource-limited settings are currently experiencing the epidemiological transition from infectious diseases to chronic non-communicable diseases, primarily due to modifications in diet and lifestyle behaviour. The objective of this study was to examine the influence of individual-, community- and country-level factors associated with hypertension in low- and middle-income countries (LMICs). Methods Multivariable multi-level logistic regression analysis was applied using 12 Demographic and Health Survey (DHS) datasets collected between 2011 and 2018 in LMICs. We included 888,925 respondents (Level 1) nested within 33,883 neighbourhoods (Level 2) from 12 LMICs (Level 3). Results The prevalence of hypertension ranged from 10.3% in the Kyrgyz Republic to 52.2% in Haiti. After adjusting for the individual-, neighbourhood- and country-level factors, we found respondents living in the least deprived areas were 14% more likely to have hypertension than those from the most deprived areas (OR = 1.14, 95% CI 1.10 to 1.17). We observed a significant variation in the odds of hypertension across the countries and the neighbourhoods. Approximately 26.3 and 47.6% of the variance in the odds of hypertension could be attributed to country- and neighbourhood-level factors, respectively. We also observed that respondents moving to a different neighbourhood or country with a higher risk of hypertension had an increased chance of developing hypertension, the median increase in their odds of hypertension was 2.83-fold (95% CI 2.62 to 3.07) and 4.04- fold (95% CI 3.98 to 4.08), respectively. Conclusions This study revealed that individual compositional and contextual measures of socioeconomic status were independently associated with the risk of developing hypertension. Therefore, prevention strategies should be implemented at the individual level and the socioeconomic and contextual levels to reduce the burden of hypertension.

scholarly journals The double burden of malnutrition in under-five children at national and individual levels: observed and expected prevalence in ninety-three low- and middle-income countries

2020 ◽  
pp. 1-8
Author(s):  
Beatriz Raffi Lerm ◽  
Inácio Crochemore-Silva ◽  
Janaína Calu Costa ◽  
Cesar Gomes Victora
Keyword(s):  
National Level ◽  
Wealth Quintile ◽  
Household Wealth ◽  
Double Burden ◽  
Middle Income ◽  
Individual Level ◽  
Middle Income Countries ◽  
Double Burden Of Malnutrition ◽  
Nationally Representative ◽  
Low And Middle Income

Abstract Objective: To assess whether the observed prevalence of the double burden of malnutrition (DBM) would be higher than expected on the basis of chance, through analyses at national, wealth quintile and individual child levels. Design: We selected nationally representative surveys from low- and middle-income countries (LMIC) carried out since 2005 with anthropometric measures on children under 5 years of age. Household wealth was assessed through asset indices. The expected prevalence of DBM was estimated by multiplying the prevalence of stunting (low height/length for age) and overweight (high weight for height/length). The WHO recommended cut-offs (20% for stunting and 10% for overweight) that were used to define DBM at national level. DBM at individual level was defined as co-occurrence of stunting and overweight in the same child. Setting: Nationally representative surveys from ninety-three LMIC. Participants: A total of 825 633 children were studied. Results: DBM at national level was observed in five countries, whereas it would be expected to occur in eleven countries. Six countries did not present evidence of DBM at national level but did so in at least one wealth quintile. At individual level, thirty countries (32·3%) showed higher prevalence of DBM than would be expected, but most differences were small except for Syria, Azerbaijan, Albania and Egypt. Conclusions: The observed number of countries or socio-economic subgroups within countries with the DBM using recommended thresholds was below what would be expected by chance. However, individual-level analyses showed that one-third of countries presented higher prevalence of DBM than would be expected.

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