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Nature. 2020 Jan;577(7789):231-234. doi: 10.1038/s41586-019-1878-8. Epub 2020 Jan 8.

Mapping child growth failure across low- and middle-income countries.

Collaborators (288)

Kinyoki DK, Osgood-Zimmerman AE, Pickering BV, Schaeffer LE, Marczak LB, Lazzar-Atwood A, Collison ML, Henry NJ, Abebe Z, Adamu AA, Adekanmbi V, Ahmadi K, Ajumobi O, Al-Eyadhy A, Al-Raddadi RM, Alahdab F, Alijanzadeh M, Alipour V, Altirkawi K, Amini S, Andrei CL, Antonio CAT, Arabloo J, Aremu O, Asadi-Aliabadi M, Atique S, Ausloos M, Avila M, Awasthi A, Quintanilla BPA, Azari S, Badawi A, Bärnighausen TW, Bassat Q, Baye K, Bedi N, Bekele BB, Bell ML, Bhattacharjee NV, Bhattacharyya K, Bhattarai S, Bhutta ZA, Biadgo B, Bikbov B, Briko AN, Britton G, Burstein R, Butt ZA, Car J, Castañeda-Orjuela CA, Castro F, Cerin E, Chipeta MG, Chu DT, Cork MA, Cromwell EA, Cuevas-Nasu L, Dandona L, Dandona R, Daoud F, Gupta RD, Weaver ND, Leo D, Neve JW, Deribe K, Desalegn BB, Deshpande A, Desta M, Diaz D, Dinberu MT, Doku DT, Dubey M, Durães AR, Dwyer-Lindgren L, Earl L, Effiong A, Zaki MES, Tantawi ME, El-Khatib Z, Eshrati B, Fareed M, Faro A, Fereshtehnejad SM, Filip I, Fischer F, Foigt NA, Folayan MO, Fukumoto T, Gebrehiwot TT, Gezae KE, Ghajar A, Gill PS, Gona PN, Gopalani SV, Grada A, Guo Y, Haj-Mirzaian A, Haj-Mirzaian A, Hall JB, Hamidi S, Henok A, Prado BH, Herrero M, Herteliu C, Hoang CL, Hole MK, Hossain N, Hosseinzadeh M, Hu G, Islam SMS, Jakovljevic M, Jha RP, Jonas JB, Jozwiak JJ, Kahsay A, Kanchan T, Karami M, Kasaeian A, Khader YS, Khan EA, Khater MM, Kim YJ, Kimokoti RW, Kisa A, Kochhar S, Kosen S, Koyanagi A, Krishan K, Defo BK, Kumar GA, Kumar M, Lad SD, Lami FH, Lee PH, Levine AJ, Li S, Linn S, Lodha R, El Razek HMA, Abd El Razek MM, Majdan M, Majeed A, Malekzadeh R, Malta DC, Mamun AA, Mansournia MA, Martins-Melo FR, Masaka A, Massenburg BB, Mayala BK, Mejia-Rodriguez F, Melku M, Mendoza W, Mensah GA, Miazgowski T, Miller TR, Mini GK, Mirrakhimov EM, Moazen B, Darwesh AM, Mohammed S, Mohebi F, Mokdad AH, Moodley Y, Moradi G, Moradi-Lakeh M, Moraga P, Morrison SD, Mosser JF, Mousavi SM, Mueller UO, Murray CJL, Mustafa G, Naderi M, Naghavi M, Najafi F, Nangia V, Ndwandwe DE, Negoi I, Ngunjiri JW, Nguyen HLT, Nguyen LH, Nguyen SH, Nie J, Nnaji CA, Noubiap JJ, Shiadeh MN, Nyasulu PS, Ogbo FA, Olagunju AT, Olusanya BO, Olusanya JO, Ortiz-Panozo E, Otstavnov SS, P A M, Pana A, Pandey A, Pati S, Patil ST, Patton GC, Perico N, Pigott DM, Pirsaheb M, Piwoz EG, Postma MJ, Pourshams A, Prakash S, Quintana H, Radfar A, Rafiei A, Rahimi-Movaghar V, Rai RK, Rajati F, Rawaf DL, Rawaf S, Rawat R, Remuzzi G, Renzaho AMN, Rios-González C, Roever L, Ross JM, Rostami A, Sadat N, Safari Y, Safdarian M, Sahebkar A, Salam N, Salamati P, Salimi Y, Salimzadeh H, Samy AM, Sartorius B, Sathian B, Schipp MF, Schwebel DC, Senbeta AM, Sepanlou SG, Shaikh MA, Levy TS, Shamsi M, Sharafi K, Sharma R, Sheikh A, Shil A, Silva DAS, Singh JA, Sinha DN, Soofi M, Sudaryanto A, Sufiyan MB, Tabarés-Seisdedos R, Tadesse BT, Temsah MH, Terkawi AS, Tessema ZT, Thorne-Lyman AL, Tovani-Palone MR, Tran BX, Tran KB, Ullah I, Uthman OA, Vaezghasemi M, Vaezi A, Valdez PR, Vanderheide J, Veisani Y, Violante FS, Vlassov V, Vu GT, Vu LG, Waheed Y, Walson JL, Wang Y, Wang YP, Wangia EN, Werdecker A, Xu G, Yamada T, Yisma E, Yonemoto N, Younis MZ, Yousefifard M, Yu C, Zaman SB, Zamani M, Zhang Y, Kassebaum NJ, Hay SI.

Abstract

Childhood malnutrition is associated with high morbidity and mortality globally1. Undernourished children are more likely to experience cognitive, physical, and metabolic developmental impairments that can lead to later cardiovascular disease, reduced intellectual ability and school attainment, and reduced economic productivity in adulthood2. Child growth failure (CGF), expressed as stunting, wasting, and underweight in children under five years of age (0-59 months), is a specific subset of undernutrition characterized by insufficient height or weight against age-specific growth reference standards3-5. The prevalence of stunting, wasting, or underweight in children under five is the proportion of children with a height-for-age, weight-for-height, or weight-for-age z-score, respectively, that is more than two standard deviations below the World Health Organization's median growth reference standards for a healthy population6. Subnational estimates of CGF report substantial heterogeneity within countries, but are available primarily at the first administrative level (for example, states or provinces)7; the uneven geographical distribution of CGF has motivated further calls for assessments that can match the local scale of many public health programmes8. Building from our previous work mapping CGF in Africa9, here we provide the first, to our knowledge, mapped high-spatial-resolution estimates of CGF indicators from 2000 to 2017 across 105 low- and middle-income countries (LMICs), where 99% of affected children live1, aggregated to policy-relevant first and second (for example, districts or counties) administrative-level units and national levels. Despite remarkable declines over the study period, many LMICs remain far from the ambitious World Health Organization Global Nutrition Targets to reduce stunting by 40% and wasting to less than 5% by 2025. Large disparities in prevalence and progress exist across and within countries; our maps identify high-prevalence areas even within nations otherwise succeeding in reducing overall CGF prevalence. By highlighting where the highest-need populations reside, these geospatial estimates can support policy-makers in planning interventions that are adapted locally and in efficiently directing resources towards reducing CGF and its health implications.

PMID:
31915393
DOI:
10.1038/s41586-019-1878-8

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