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Matern Child Nutr. 2018 Oct 26:e12736. doi: 10.1111/mcn.12736. [Epub ahead of print]

Concurrent wasting and stunting among under-five children in Niakhar, Senegal.

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Institut de Recherche pour le Développement (IRD), Unité Mixte Internationale (UMI) Résiliences, Paris, France.
Institut Pasteur, Epidémiologie des Maladies Emergentes, Paris, France.
Senior Fellow, FERDI, Université d'Auvergne, Clermont-Ferrand, France.
MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Brixton Health, Llawryglyn, Powys, Wales.
Emergency Nutrition Network, Oxford, England.
School of Medicine, Centre for Child Health Research, University of Tampere, Tampere, Finland.
Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark.


The study describes the patterns of concurrent wasting and stunting (WaSt) among children age 6-59 months living in the 1980s in Niakhar, a rural area of Senegal under demographic surveillance. Wasting and stunting were defined by z scores lower than -2 in weight for height and height for age. Both conditions were found to be highly prevalent, wasting more so before age 30 months, stunting more so after age 30 months. As a result, concurrent WaSt peaked around age 18 months and its prevalence (6.2%) was primarily the product of the two conditions, with an interaction term of 1.57 (p < 10-6 ). The interaction was due to the correlation between both conditions (more stunting if wasted, more wasting if stunted). Before age 30 months, boys were more likely to be concurrently wasted and stunted than girls (RR = 1.61), but the sex difference disappeared after 30 months of age. The excess susceptibility of younger boys could not be explained by muscle mass or fat mass measured by arm or muscle circumference, triceps, or subscapular skinfold. Concurrent WaSt was a strong risk factor for child mortality, and its effect was the product of the independent effect of each component, with no significant interaction.


Senegal; anthropometry; child survival; concurrent wasting & stunting; stunting; wasting


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