scholarly journals The relationship between wasting and stunting in Cambodian children: Secondary analysis of longitudinal data of children below 24 months of age followed up until the age of 59 months

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259765
Author(s):  
Mueni Mutunga ◽  
Alexandra Rutishauser-Perera ◽  
Arnaud Laillou ◽  
Sophonneary Prak ◽  
Jacques Berger ◽  
...  
Keyword(s):  
Positive Relationship ◽  
Linear Growth ◽  
Secondary Analysis ◽  
Positive Association ◽  
Z Score ◽  
Arm Circumference ◽  
Unit Increase ◽  
Mid Upper Arm Circumference ◽  
The Relationship ◽  
Height For Age

The interrelationship between wasting and stunting has been poorly investigated. We assessed the association between two indicators of linear growth, height-for-age Z-score (HAZ) change and occurrence of accelerated linear growth, and selected indicators of wasting and wasting reversal in 5,172 Cambodian children aged less than 24 months at enrolment in the ‘MyHealth’ study. The specific objectives were to evaluate the relationship between temporal changes in wasting and 1) change in HAZ and 2) episodes of accelerated linear growth. At enrolment, the stunting and wasting prevalence were 22.2 (21.0;23.3) % and 9.1 (8.1;10.1) %, respectively, and reached 41.4 (39.3;43.6) %, and 12.4 (11.5;13.3) % respectively, two years later. Between 14–19% of stunted children were also wasted throughout the whole study period. For each centimetre increase in Mid-Upper Arm Circumference (MUAC) from the previous assessment, the HAZ increased by 0.162 (0.150; 0.174) Z-score. We also observed a delayed positive association between the weight for height Z score (WHZ) unit increase and HAZ change of +0.10 to +0.22 units consistent with a positive relationship between linear growth and an increase in WHZ occurring with a lag of approximately three months. A similar positive correlation was observed for the occurrence of an episode of accelerated linear growth. These results show that interventions to prevent and treat wasting can contribute to stunting reduction and call for integrated wasting and stunting programming.

scholarly journals Relationships between Wasting and Stunting and Their Concurrent Occurrence in Ghanaian Preschool Children

2016 ◽  
Vol 2016 ◽  
pp. 1-11 ◽  
Author(s):  
Mahama Saaka ◽  
Sylvester Zackaria Galaa
Keyword(s):  
Preschool Children ◽  
Linear Growth ◽  
Data Set ◽  
East Region ◽  
Low Weight ◽  
Study Results ◽  
Unit Increase ◽  
Upper East Region ◽  
The Relationship ◽  
Height For Age

Objective. The main aim of the study was to assess the magnitude of concurrent wasting and stunting among Ghanaian preschool children. Secondly, we investigated the relationship between wasting and stunting as well as factors associated with these conditions.Methods. This paper is based on reanalysis of anthropometric and other relevant data which was collected in the 2014 Ghana Demographic and Health Survey. The data set consisted of 2,720 preschool children aged 0–59 months. We conducted three-step moderated hierarchical multiple regression analyses to determine independent predictors and moderators of height-for-ageZ-score.Results. Nationally, the prevalence of concurrent wasting and stunting among children aged 0–59 months was low at 1.4% but it varied geographically with the Upper East Region having the highest prevalence of 3.2% (95% CI: 1.7–5.8). Children who had low weight-for-heightZ-scores were at a higher risk of linear growth retardation (stunting) especially among children aged less than three years. A 1-unit increase in weight-for-heightZ-score (WHZ) was associated with 0.07 standard units’ increase in height-for-ageZ-score (HAZ) [β= 0.071 (95% CI: 0.03, 0.15)].Conclusions. The study results suggest that weight-for-height relates to linear growth but this relationship is moderated by age of child. Stunting and wasting share some common risk factors. Therefore, measures to prevent wasting may positively influence linear growth.

scholarly journals Child-Sensitive WASH Composite Score and the Nutritional Status in Cambodian Children

Nutrients ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 2142 ◽  
Author(s):  
Giulia Manzoni ◽  
Arnaud Laillou ◽  
Chea Samnang ◽  
Rathmony Hong ◽  
Frank T. Wieringa ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Composite Score ◽  
Z Score ◽  
Upper Arm ◽  
Sanitation And Hygiene ◽  
Arm Circumference ◽  
Direct Association ◽  
Nutritional Status Of Children ◽  
Mid Upper Arm Circumference ◽  
Height For Age

Progress in health has occurred in the past decades in Cambodia, in terms of health service access and interventions, but several indicators, including the prevalence of malnourished children, remain alarming. The causes of undernutrition are often linked to inadequate access to water, sanitation and hygiene services but limited evidence exists on the direct association between poor WASH practices and children’s’ nutritional statuses. This study investigates the relationship between water, sanitation and hygiene practices, defined as the child-sensitive composite score, and the nutritional status of children under five years old, measured as the weight-for-height z-score, mid-upper arm circumference or height-for-age z-score in six districts of Cambodia. The analysis used data from a longitudinal study, comprising extensive data collection on anthropometry, health, nutrition, WASH, and cognitive development. Chronological trends in wasting and stunting were described cross-sectionally, whereas the effect of WASH practices on the nutritional status of children over up to three consecutive study visits was examined with a linear mixed-effects model. The prevalence of wasting decreased during the study while stunting prevalence increased. A small, but significant, association was found between the WASH child-sensitive composite scores and the wasting child anthropometry indicators: weight-for-height z-score or mid-upper arm circumference. Evidence for an association with height-for-age z-score, detecting stunted children, was found when the independent variable was quantified according to global, but not national, guidelines. This study reinforces discordant existing evidence towards a direct association between WASH practices and children’s nutritional status, suggesting the need to align nutrition and WASH programmes.

Mid upper arm circumference as an alternative measure to assess the nutritional status of adolescents: a study in India based on NFHS-4 data

2021 ◽  
pp. 1-12
Author(s):  
Aparna Roy ◽  
T. V. Sekher
Keyword(s):  
Nutritional Status ◽  
Sensitivity And Specificity ◽  
Measurement Data ◽  
Anthropometric Measurement ◽  
Alternative Measure ◽  
Upper Arm ◽  
Male Adolescents ◽  
Arm Circumference ◽  
Mid Upper Arm Circumference ◽  
The Relationship

Abstract Use of body mass index (BMI) to assess the nutritional status of adolescents requires many resources, especially for country-level assessment. This study aimed to determine the relationship between BMI and mid upper arm circumference (MUAC) among adolescent males and females in India and to examine whether MUAC effectively represents the nutritional status of adolescents. The study utilized anthropometric measurement data collected by India’s National Family Health Survey-4 (2015–16). The weighted sample for analysis included 91,315 female and 14,893 male adolescents. The BMI and MUAC measurements showed a positive correlation in both female and male adolescents. Using BMI-for-age Z-score classifications, 12.7% of the adolescents were undernourished. Using MUAC (in cm) as per NACS (Nutrition Assessment, Counselling, and Support) guidelines and Mramba et al. (2017) classified 22.9% and 3.7% of the adolescents as undernourished respectively. Finally, using the MUAC-for-age Z-score classification, 98.4% of adolescents were determined to be normal and 1.7% undernourished. Sensitivity and specificity tests of the MUAC cut-offs, in comparison with BMI cut-offs, showed that all three MUAC cut-off classifications had high specificity (NACS cut-off: 81.3%; Mramba et al. cut-off (cm): 97.7%; Mramba et al. cut-off (Z-score): 99.1%). The NACS cut-off had moderately high sensitivity (52.2%) but the Mramba et al. cut-offs had low sensitivity (13.3% for the centimetre cut-off and 6.6% for the Z-score cut-off). Sensitivity and specificity tests proved the relationship between BMI and MUAC, and that MUAC represents adolescent nutritional status with considerable efficiency. With further research, it may be established that MUAC is a better and promising measure of adolescent nutrition, having the advantage of needing fewer resources for data collection. The MUAC has the potential to offer a simple and low-resource alternative to BMI to assess nutritional status among adolescents in poor countries.

scholarly journals User-Informed Medical Device Development: A Case Study for Pediatric Malnutrition Assessment

2019 ◽  
Vol 6 ◽  
pp. 2333794X1986157 ◽  
Author(s):  
Kristi Thaete ◽  
Kasey Rowzer ◽  
Karen Stephens ◽  
Susan M. Abdel-Rahman
Keyword(s):  
Nutritional Assessment ◽  
Z Score ◽  
Device Development ◽  
Nutrition Services ◽  
Arm Circumference ◽  
Single Center Study ◽  
Device Use ◽  
And Shifts ◽  
Mid Upper Arm Circumference

Background. Mid-upper arm circumference (MUAC) has been extensively used to classify pediatric malnutrition. Recently, MUAC z score was recommended; however, the logistics of implementation were not addressed. This study examines the usability of a device that provides MUAC and corresponding z score range in a single device. Methods. This was a single-center study of nutrition services providers. The device was applied to children aged 2 months to 18 years admitted as inpatients or seen as outpatients. Surveys incorporated benchmarking questions, assessed the ease with which respondents could perform 6 critical tasks, and provided an open-ended question to elicit feedback. Users were surveyed monthly until saturation was reached. Survey data were analyzed in aggregate and cross-tabulated by the respondents’ experience with the device. Thematic analysis of the open-ended responses followed a structured approach. Results. Sixty device users responded to the survey 280 times. Respondents were female (100%) with a mean age of 45.2 ± 13.2 years and 9.6 ± 8.0 years in practice. Increasing device use was accompanied by significantly shortened measuring times ( P < .001) and shifts in ease of performance for 5 of 6 critical tasks ( P < .05). Open-ended response themes related largely to design and materials. These were used to iteratively refine the device. Conclusions. The active engagement of end users in the real-world testing of our nutritional assessment device allowed us to refine the innovation with special attention paid to the needs of dietitians. The result is a device the majority of dietitians found easy to use, efficient, convenient, and preferable to alternative measurement options.

scholarly journals Comparison of anthropometric indicators to predict mortality in a population-based prospective study of children under 5 years in Niger

2019 ◽  
Vol 23 (3) ◽  
pp. 538-543 ◽  
Author(s):  
Kieran S O’Brien ◽  
Abdou Amza ◽  
Boubacar Kadri ◽  
Beido Nassirou ◽  
Sun Y Cotter ◽  
...  
Keyword(s):  
Cluster Randomized Trial ◽  
Population Based ◽  
Community Based ◽  
Anthropometric Indicators ◽  
Arm Circumference ◽  
Cluster Randomized ◽  
Mid Upper Arm Circumference ◽  
Height For Age ◽  
Weight For Age ◽  
Children Under 5

AbstractObjective:In the present study, we aimed to compare anthropometric indicators as predictors of mortality in a community-based setting.Design:We conducted a population-based longitudinal study nested in a cluster-randomized trial. We assessed weight, height and mid-upper arm circumference (MUAC) on children 12 months after the trial began and used the trial’s annual census and monitoring visits to assess mortality over 2 years.Setting:Niger.Participants:Children aged 6–60 months during the study.Results:Of 1023 children included in the study at baseline, height-for-age Z-score, weight-for-age Z-score, weight-for-height Z-score and MUAC classified 777 (76·0 %), 630 (61·6 %), 131 (12·9 %) and eighty (7·8 %) children as moderately to severely malnourished, respectively. Over the 2-year study period, fifty-eight children (5·7 %) died. MUAC had the greatest AUC (0·68, 95 % CI 0·61, 0·75) and had the strongest association with mortality in this sample (hazard ratio = 2·21, 95 % CI 1·26, 3·89, P = 0·006).Conclusions:MUAC appears to be a better predictor of mortality than other anthropometric indicators in this community-based, high-malnutrition setting in Niger.

scholarly journals Incidence and duration of severe wasting in two African populations

2009 ◽  
Vol 12 (11) ◽  
pp. 1974-1982 ◽  
Author(s):  
Michel Garenne ◽  
Douladel Willie ◽  
Bernard Maire ◽  
Olivier Fontaine ◽  
Roger Eeckels ◽  
...  
Keyword(s):  
Democratic Republic Of Congo ◽  
Secondary Analysis ◽  
Case Fatality ◽  
Severe Anaemia ◽  
First Case ◽  
Long Duration ◽  
Arm Circumference ◽  
Control And Prevention ◽  
Age Profile ◽  
Mid Upper Arm Circumference

AbstractObjectiveThe present study aimed to compare two situations of endemic malnutrition among <5-year-old African children and to estimate the incidence, the duration and the case fatality of severe wasting episodes.DesignSecondary analysis of longitudinal studies, conducted several years ago, which allowed incidence and duration to be calculated from transition rates. The first site was Niakhar in Senegal, an area under demographic surveillance, where we followed a cohort of children in 1983–5. The second site was Bwamanda in the Democratic Republic of Congo, where we followed a cohort of children in 1989–92. Both studies enrolled about 5000 children, who were followed by routine visits and systematic anthropometric assessment, every 6 months in the first case and every 3 months in the second case.ResultsNiakhar had less stunting, more wasting and higher death rates than Bwamanda. Differences in cause-specific mortality included more diarrhoeal diseases, more marasmus, but less malaria and severe anaemia in Niakhar. Severe wasting had a higher incidence, a higher prevalence and a more marked age profile in Niakhar. However, despite the differences, the estimated mean durations of episodes of severe wasting, calculated by multi-state life table, were similar in the two studies (7·5 months). Noteworthy were the differences in the prevalence and incidence of severe wasting depending on the anthropometric indicator (weight-for-height Z-score ≤–3.0 or mid upper-arm circumference <110 mm) and the reference system (National Center for Health Statistics 1977, Centers for Disease Control and Prevention 2000 or Multicentre Growth Reference Study 2006).ConclusionsSevere wasting appeared as one of the leading cause of death among under-fives: it had a high incidence (about 2 % per child-semester), long duration of episodes and high case fatality rates (6 to 12 %).

scholarly journals The association between mandatory financial restatements and the turnover of firm executives

2008 ◽  
Vol 6 (1-4) ◽  
pp. 467-474
Author(s):  
Jo Ting Wei
Keyword(s):  
Developing Countries ◽  
Financial Reporting ◽  
Positive Relationship ◽  
Positive Association ◽  
Past Research ◽  
Developed Countries ◽  
Normal Operation ◽  
Financial Restatement ◽  
Financial Restatements ◽  
The Relationship

Prior studies have examined the relationship between financial restatements and the turnover of firm executives and find that financial restatements lead to the turnover of firm executives. They often concern the above effects in developed countries such as America rather than those in developing countries. Besides, financial restatements externally prompted are more serious. However, past research little explores this type of financial restatement. Therefore, this study aims to examine the association between mandatory financial restatements and the turnover of firm executives—the chairman and the CEO in Taiwan. The findings show that there is positive relationship between mandatory financial restatements and the turnover of the CEO. However, we do not find there is positive association between mandatory financial restatements and the turnover of the chairman. The implications are as follows. As the CEO has power to make firm major decisions, including financial reporting, he should be responsible for financial restatements. The chairman is the leader of a firm. Replacing the chairman may significantly affect firm normal operation. Hence, firms are not easily to replace the chairman unless there is concrete evidence showing that he should be responsible for the financial restatements.

scholarly journals Mid-upper arm circumference measurement for severe malnutrition screening in underfives

2020 ◽  
Vol 60 (1) ◽  
pp. 42-52
Author(s):  
Stephanie Adelia ◽  
Johannes Capistrano Susanto
Keyword(s):  
Screening Method ◽  
Cross Sectional Study ◽  
Severe Malnutrition ◽  
Z Score ◽  
Upper Arm ◽  
Cross Sectional ◽  
Kappa Test ◽  
Arm Circumference ◽  
Significant Difference ◽  
Mid Upper Arm Circumference

Background Severe malnutrition in Indonesia remains abundant. Severe malnutrition has been assessed by several methods, including mid–upper arm circumference (MUAC) and weight-for-height z-score (WHZ). As a screening method, MUAC is expected to be useful for identifying malnutrition in communities. Objective To determine whether MUAC measurements can be used for screening severe malnutrition at the community level in Indonesia. Method A cross-sectional study was conducted in 853 children aged 6 – 59 months who came to an  integrated health service post (Posyandu) in Semarang, Central Java. Anthropometric measurements were performed by cadres and researchers and included MUAC and WHZ. Statistical analysis was done by McNemar test; results with P values >0.05 indicated no significant difference. Sensitivity and specificity were determined by 2 x 2 tables. The MUAC cut-off values were determined by receiver-operating characteristic (ROC) curve. Results Eight hundred fifty-three out of 1,115 children met the inclusion criteria, consisting of 419 (49.1%) boys, with most over the age of 2 years (57.2%). Kappa test revealed good inter-rater reliability in measurements between the cadre and researchers (Kappa=0.726). There were significant differences between MUAC (by cadres) and below red line status as well as WHZ, between MUAC (by researchers) and WHZ, as well as MUAC (by cadre and researchers) with WHZ and height-for-age z-score/HAZ . Sensitivity, specificity, PPV, and NPV of MUAC (by cadre) were 12.5%, 99.9%, 75%, and 97.5%, respectively, while those by the researchers were 16.7%, 99.6%, 57%, and 97.6%, respectively. In this study, MUAC of 14 cm was the best cut-off for severe malnutrition. Conclusion The MUAC measurement of 14 cm can be used for screening severe malnutrition in underfives at community.

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