Background
Methods
Data management
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Wasted : WHZ < -2.0
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Stunted : HAZ < -2.0
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Underweight : WAZ < -2.0
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Wasted and stunted (WaSt) : WHZ < -2.0 and HAZ < -2.0
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Wasted but not stunted (wasted only) : WHZ < -2.0 and HAZ ≥ -2.0
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Stunted but not wasted (stunted only) : WHZ ≥ -2.0 and HAZ < -2.0
The degree of overlap between wasting, stunting, and underweight in surveys
The maximum possible WAZ in children with WaSt using the WHO growth standards
The association between being wasted and being stunted
The severity of wasting and stunting in WaSt cases
The prevalence of WaSt by age and sex
Using weight-for-age and mid-upper arm circumference to detect cases of WaSt
Results
Datasetsa | Number of surveysa | 2426 surveys from 51 countries | |
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Country (number)b | Afghanistan (43), Albania (1), Angola (22), Bangladesh (28), Benin (7), Burkina Faso (55), Burundi (25), Cameroon (10), Central African Republic (58), Chad (243), Congo - Kinshasa (266), Cote d’Ivoire (49), Djibouti (14), Eritrea (4), Ethiopia (265), Gambia (8), Guatemala (2), Guinea (12), Guinea Bissau (13), Haiti (49), India (8), Indonesia (3), Jordan (4), Kenya (132), Liberia (55), Madagascar (4), Malawi (16), Mali (14), Mauritania (57), Mozambique (13), Myanmar (22), Nepal (15), Niger (38), Nigeria (107), Pakistan (18), Philippines (12), Rwanda (26), Senegal (7), Sierra Leone (58), Somalia (227), South Sudan (140), Sri Lanka (3), Sudan (144), Tajikistan (5), Tanzania (8), Thailand (2), Togo (18), Uganda (84), Yemen (5), Zambia (6), Zimbabwe (1) | ||
Year of survey (number) | 1992 (3), 1993 (15), 1994 (35), 1995 (39), 1996 (27), 1997 (33), 1998 (21), 1999 (26), 2000 (39), 2001 (41), 2002 (55), 2003 (54), 2004 (76), 2005 (99), 2006 (70), 2007 (83), 2008 (143), 2009 (155) 2010 (201), 2011 (773), 2012 (261), 2013 (250) 2014 (340), 2015 (79), Unknown (7) | ||
Agency (number) | ACF (802), CONCERN (108), FSNAU (207), GOAL (141), IMC (15), IRC (3), MSF (95), Plan International (2), SC (58), TDH (7), UNHCR (347), UNICEF (622), World Vision (18), Zerca y Lejos (1) | ||
Childrenc | Number of children | 1,796,991 | |
Sex | Males | 909,099 (50.6%) | |
Females | 887,892 (49.4%) | ||
Age | Minimum | 06 months | |
1st Quartile | 18 months | ||
Median | 30 months | ||
Mean | 31 months | ||
3rd Quartile | 44 months | ||
Maximum | 59 months | ||
Country (number)a | Afghanistan (47,813), Albania (892), Angola (17,191), Bangladesh (14,554), Benin (7841), Burkina Faso (41,467), Burundi (14,604), Cameroon (8530), Central African Republic (36,161), Chad (145,506), Congo (Kinshasa) (226,767), Cote d’Ivoire (23,990), Djibouti (5257), Eritrea (2281), Ethiopia (167,368), Gambia (6721), Guatemala (608), Guinea (9487), Guinea Bissau (7131), Haiti (39,465), India (5145), Indonesia (1735), Jordan (1517), Kenya (86,018), Liberia (32,686), Madagascar (3156), Malawi (15,998), Mali (10,901), Mauritania (36,617), Mozambique (4417), Myanmar (14,322), Nepal (8844), Niger (48,995), Nigeria (65,738), Pakistan (14,098), Philippines (6095), Rwanda (15,559), Senegal (8421), Sierra Leone (62,914), Somalia (234,982), South Sudan (96,225), Sri Lanka (2573), Sudan (114,113), Tajikistan (4297), Tanzania (5290), Thailand (1795), Togo (11,835), Uganda (54,236), Yemen (1781), Zambia (2364), Zimbabwe (690) |
Country | Odds ratio [95% CI]b | Country | Odds ratio [95% CI]b |
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Afghanistan | 1.22 [1.14, 1.29] | Malawi | 1.03 [0.90, 1.17] |
Albania | 0.78 [0.32, 1.89] | Mali | 1.53 [1.36, 1.73] |
Angola | 1.37 [1.22, 1.53] | Mauritania | 1.35 [1.25, 1.45] |
Bangladesh | 1.37 [1.24, 1.51] | Mozambique | 1.31 [1.02, 1.69] |
Benin | 1.72 [1.45, 2.05] | Myanmar | 1.14 [1.03, 1.25] |
Burkina Faso | 1.74 [1.63, 1.85] | Nepal | 1.62 [1.43, 1.85] |
Burundi | 1.66 [1.45, 1.90] | Niger | 1.46 [1.38, 1.54] |
Cameroon | 1.36 [1.17, 1.59] | Nigeria | 1.49 [1.41, 1.57] |
Central African Republic | 1.59 [1.46, 1.73] | Pakistan | 1.00 [0.91, 1.11] |
Chad | 1.31 [1.27, 1.35] | Philippines | 1.53 [1.26, 1.85] |
Congo - Kinshasa | 0.99 [0.96, 1.02] | Rwanda | 1.13 [1.00, 1.27] |
Cote d’Ivoire | 2.50 [2.24, 2.80] | Senegal | 1.76 [1.53, 2.04] |
Djibouti | 1.31 [1.11, 1.54] | Sierra Leone | 1.42 [1.35, 1.50] |
Eritrea | 0.87 [0.67, 1.13] | Somalia | 1.01 [0.98, 1.03] |
Ethiopia | 1.19 [1.15, 1.22] | South Sudan | 1.05 [1.01, 1.09] |
Gambia | 2.04 [1.73, 2.40] | Sri Lanka | 1.84 [1.49, 2.27] |
Guatemala | 4.97 [0.61,40.62] | Sudan | 1.28 [1.24, 1.32] |
Guinea | 1.71 [1.42, 2.06] | Tajikistan | 1.30 [1.07, 1.59] |
Guinea Bissau | 2.33 [1.90, 2.85] | Tanzania | 1.17 [0.91, 1.49] |
Haiti | 2.27 [2.06, 2.51] | Thailand | 1.45 [0.99, 2.12] |
India | 1.41 [1.22, 1.63] | Togo | 2.01 [1.72, 2.35] |
Indonesia | 1.45 [1.07, 1.97] | Uganda | 1.48 [1.38, 1.57] |
Jordan | 3.42 [1.27, 9.23] | Yemen | 1.12 [0.72, 1.72] |
Kenya | 0.93 [0.89, 0.97] | Zambia | 0.80 [0.53, 1.21] |
Liberia | 1.41 [1.30, 1.53] | Zimbabwe | 1.11 [0.50, 2.47] |
Madagascar | 1.86 [1.45, 2.38] | Pooled ORc | 1.40 [1.32, 1.49] |
Country | M:F prevalence ratio [95% CI]b | Country | M:F prevalence ratio [95% CI]b |
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Afghanistan | 1.39 [1.28,1.50] | Malawi | 1.45 [1.23,1.71] |
Angola | 1.60 [1.39,1.85] | Mali | 1.69 [1.40,2.05] |
Bangladesh | 1.36 [1.20,1.53] | Mauritania | 1.70 [1.50,1.93] |
Benin | 1.44 [1.12,1.85] | Mozambique | 2.00 [1.36,2.99] |
Burkina Faso | 1.85 [1.70,2.03] | Myanmar | 1.45 [1.28,1.65] |
Burundi | 1.49 [1.29,1.71] | Nepal | 1.36 [1.17,1.59] |
Cameroon | 1.93 [1.56,2.40] | Niger | 1.49 [1.39,1.60] |
Central African Republic | 1.57 [1.39,1.76] | Nigeria | 1.41 [1.32,1.51] |
Chad | 1.59 [1.52,1.66] | Pakistan | 1.70 [1.48,1.95] |
Congo - Kinshasa | 1.72 [1.65,1.80] | Philippines | 1.54 [1.19,2.01] |
Cote d’Ivoire | 1.94 [1.66,2.26] | Rwanda | 1.44 [1.22,1.69] |
Djibouti | 1.62 [1.27,2.07] | Senegal | 1.87 [1.48,2.37] |
Eritrea | 1.70 [1.12,2.63] | Sierra Leone | 1.53 [1.42,1.66] |
Ethiopia | 1.87 [1.78,1.97] | Somalia | 1.86 [1.78,1.94] |
Gambia | 2.11 [1.63,2.76] | South Sudan | 1.73 [1.62,1.85] |
Guinea | 1.66 [1.28,2.17] | Sri Lanka | 1.02 [0.76,1.37] |
Guinea Bissau | 1.63 [1.21,2.21] | Sudan | 1.71 [1.62,1.79] |
Haiti | 1.74 [1.51,1.99] | Tajikistan | 1.32 [0.99.1.77] |
India | 1.12 [0.94,1.33] | Tanzania | 2.65 [1.80,3.98] |
Indonesia | 1.35 [0.91,2.02] | Thailand | 1.46 [0.84,2.56] |
Kenya | 1.74 [1.62,1.88] | Togo | 1.71 [1.35,2.18] |
Liberia | 1.58 [1.41,1.77] | Uganda | 1.65 [1.50,1.82] |
Madagascar | 2.47 [1.74,3.54] | Zambia | 1.17 [0.59,2.32] |
Pooled PRc | 1.63 [1.60,1.65] |
Case-definitiona | Sensitivity (%)b | Specificity (%)b |
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WAZ < − 2.6 | 98.47 [98.39, 98.56] | 91.07 [91.03, 91.11] |
MUAC < 133 mm | 81.03 [80.76, 81.30] | 79.52 [79.46, 79.58] |
Discussion
Anthropometric status | Hazard ratioa |
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Stunted only | 1.47 [1.21, 1.78] |
Wasted only | 2.30 [1.47, 3.60] |
Both wasted and stunted (WaSt) | 12.25 [7.67,19.58] |