Concurrently wasted and stunted children 6-59 months in Karamoja, Uganda: prevalence and case detection
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Date
2020
Journal Title
Journal ISSN
Volume Title
Publisher
Maternal and Child Nutrition
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.
Description
Keywords
Case detection, Concurrent wasting and stunting, MUAC, Stunting, Uganda, Wasting, WaSt
Citation
Odei Obeng-Amoako GA, Myatt M, Conkle J, et al. Concurrently wasted and stunted children 6-59 months in Karamoja, Uganda: prevalence and case detection. Matern Child Nutr. 2020;e13000. https://doi.org/10.1111/ mcn.13000