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

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posted on 2020-02-04, 15:12 authored by Damaris K Kinyoki, Aaron E Osgood-Zimmerman, Brandon V Pickering, Lauren E Schaeffer, Laurie B Marczak, Alice Lazzar-Atwood, Michael L Collison, Nathaniel J Henry, Zegeye Abebe, Abdu A Adamu, Victor Adekanmbi, Keivan Ahmadi, Olufemi Ajumobi, Ayman Al-Eyadhy, Rajaa M Al-Raddadi, Fares Alahdab, Mehran Alijanzadeh, Vahid Alipour, Khalid Altirkawi, Saeed Amini, Catalina Liliana Andrei, Carl Abelardo T Antonio, Jalal Arabloo, Olatunde Aremu, Mehran Asadi-Aliabadi, Suleman Atique, Marcel Ausloos, Marco Avila, Ashish Awasthi, Beatriz Paulina Ayala Quintanilla, Samad Azari, Alaa Badawi, Till Winfried Baernighausen, Quique Bassat, Kaleab Baye, Neeraj Bedi, Bayu Begashaw Bekele, Michelle L Bell, Natalia V Bhattacharjee, Krittika Bhattacharyya, Suraj Bhattarai, Zulfiqar A Bhutta, Belete Biadgo, Boris Bikbov, Andrey Nikolaevich Briko, Gabrielle Britton, Roy Burstein, Zahid A Butt, Josip Car, Carlos A Castaneda-Orjuela, Franz Castro, Ester Cerin, Michael G Chipeta, Dinh-Toi Chu, Michael A Cork, Elizabeth A Cromwell, Lucia Cuevas-Nasu, Lalit Dandona, Rakhi Dandona, Farah Daoud, Rajat Das Gupta, Nicole Davis Weaver, Diego De Leo, Jan-Walter De Neve, Kebede Deribe, Beruk Berhanu Desalegn, Aniruddha Deshpande, Melaku Desta, Daniel Diaz, Mesfin Tadese Dinberu, David Teye Doku, Manisha Dubey, Andre R Duraes, Laura Dwyer-Lindgren, Lucas Earl, Andem Effiong, Maysaa El Sayed Zaki, Maha El Tantawi, Ziad El-Khatib, Babak Eshrati, Mohammad Fareed, Andre Faro, Seyed-Mohammad Fereshtehnejad, Irina Filip, Florian Fischer, Nataliya A Foigt, Morenike Oluwatoyin Folayan, Takeshi Fukumoto, Tsegaye Tewelde Gebrehiwot, Kebede Embaye Gezae, Alireza Ghajar, Paramjit Singh Gill, Philimon N Gona, Sameer Vali Gopalani, Ayman Grada, Yuming Guo, Arvin Haj-Mirzaian, Arya Haj-Mirzaian, Jason B Hall, Samer Hamidi, Andualem Henok, Bernardo Hernandez Prado, Mario Herrero, Claudiu Herteliu, Chi Linh Hoang, Michael K Hole, Naznin Hossain, Mehdi Hosseinzadeh, Guoqing Hu, Sheikh Mohammed Shariful Islam, Mihajlo Jakovljevic, Ravi Prakash Jha, Jost B Jonas, Jacek Jerzy Jozwiak, Amaha Kahsay, Tanuj Kanchan, Manoochehr Karami, Amir Kasaeian, Yousef Saleh Khader, Ejaz Ahmad Khan, Mona M Khater, Yun Jin Kim, Ruth W Kimokoti, Adnan Kisa, Sonali Kochhar, Soewarta Kosen, Ai Koyanagi, Kewal Krishan, Barthelemy Kuate Defo, G Anil Kumar, Manasi Kumar, Sheetal D Lad, Faris Hasan Lami, Paul H Lee, Aubrey J Levine, Shanshan Li, Shai Linn, Rakesh Lodha, Hassan Magdy Abd El Razek, Muhammed Magdy Abd El Razek, Marek Majdan, Azeem Majeed, Reza Malekzadeh, Deborah Carvalho Malta, Abdullah A Mamun, Mohammad Ali Mansournia, Francisco Rogerlandio Martins-Melo, Anthony Masaka, Benjamin Ballard Massenburg, Benjamin K Mayala, Fabiola Mejia-Rodriguez, Mulugeta Melku, Walter Mendoza, George A Mensah, Tomasz Miazgowski, Ted R Miller, GK Mini, Erkin M Mirrakhimov, Babak Moazen, Aso Mohammad Darwesh, Shafiu Mohammed, Farnam Mohebi, Ali H Mokdad, Yoshan Moodley, Ghobad Moradi, Maziar Moradi-Lakeh, Paula Moraga, Shane Douglas Morrison, Jonathan F Mosser, Seyyed Meysam Mousavi, Ulrich Otto Mueller, Christopher JL Murray, Ghulam Mustafa, Mehdi Naderi, Mohsen Naghavi, Farid Najafi, Vinay Nangia, Duduzile Edith Ndwandwe, Ionut Negoi, Josephine W Ngunjiri, Lan Thi Nguyen Huong, Long Hoang Nguyen, Hoang Nguyen Son, Jing Nie, Chukwudi A Nnaji, Jean Jacques Noubiap, Malihe Nourollahpour Shiadeh, Peter S Nyasulu, Felix Akpojene Ogbo, Andrew T Olagunju, Bolajoko Olubukunola Olusanya, Jacob Olusegun Olusanya, Eduardo Ortiz-Panozo, Stanislav S Otstavnov, PA Mahesh, Adrian Pana, Anamika Pandey, Sanghamitra Pati, Snehal T Patil, George C Patton, Norberto Perico, David M Pigott, Meghdad Pirsaheb, Ellen G Piwoz, Maarten J Postma, Akram Pourshams, Swayam Prakash, Hedley Quintana, Amir Radfar, Alireza Rafiei, Vafa Rahimi-Movaghar, Rajesh Kumar Rai, Fatemeh Rajati, David Laith Rawaf, Salman Rawaf, Rahul Rawat, Giuseppe Remuzzi, Andre MN Renzaho, Carlos Rios-Gonzalez, Leonardo Roever, Jennifer M Ross, Ali Rostami, Nafis Sadat, Yahya Safari, Mahdi Safdarian, Amirhossein Sahebkar, Nasir Salam, Payman Salamati, Yahya Salimi, Hamideh Salimzadeh, Abdallah M Samy, Benn Sartorius, Brijesh Sathian, Megan F Schipp, David C Schwebel, Anbissa Muleta Senbeta, Sadaf G Sepanlou, Masood Ali Shaikh, Teresa Shamah Levy, Mohammadbagher Shamsi, Kiomars Sharafi, Rajesh Sharma, Aziz Sheikh, Apurba Shil, Diego Augusto Santos Silva, Jasvinder A Singh, Dhirendra Narain Sinha, Moslem Soofi, Agus Sudaryanto, Mu'awiyyah Babale Sufiyan, Rafael Tabares-Seisdedos, Birkneh Tilahun Tadesse, Mohamad-Hani Temsah, Abdullah Sulieman Terkawi, Zemenu Tadesse Tessema, Andrew L Thorne-Lyman, Marcos Roberto Tovani-Palone, Bach Xuan Tran, Khanh Bao Tran, Irfan Ullah, Olalekan A Uthman, Masoud Vaezghasemi, Afsane Vaezi, Pascual R Valdez, John Vanderheide, Yousef Veisani, Francesco S Violante, Vasily Vlassov, Giang Thu Vu, Linh Gia Vu, Yasir Waheed, Judd L Walson, Yafeng Wang, Yuan-Pang Wang, Elizabeth N Wangia, Andrea Werdecker, Gelin Xu, Tomohide Yamada, Engida Yisma, Naohiro Yonemoto, Mustafa Z Younis, Mahmoud Yousefifard, Chuanhua Yu, Sojib Bin Zaman, Mohammad Zamani, Yunquan Zhang, Nicholas J Kassebaum, Simon I Hay
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.

Funding

This work was primarily supported by grant OPP1132415 from the Bill & Melinda Gates Foundation.

History

Citation

Nature 577, 231–234 (2020). https://doi.org/10.1038/s41586-019-1878-8

Author affiliation

School of Business

Version

  • VoR (Version of Record)

Published in

NATURE

Volume

577

Issue

7789

Pagination

231 - + (21)

Publisher

NATURE PUBLISHING GROUP

issn

0028-0836

eissn

1476-4687

Acceptance date

2019-11-14

Copyright date

2020

Publisher version

https://www.nature.com/articles/s41586-019-1878-8

Spatial coverage

England

Language

English

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