Scientific Publications Database

Article Title: Variation in Anthropometric Status and Growth Failure in Low- and Middle-Income Countries
Authors: Mejia-Guevara, Ivan; Corsi, Daniel J.; Perkins, Jessica M.; Kim, Rockli; Subramanian, S. V.
Journal: PEDIATRICS Volume 141 Issue 3
Date of Publication:2018
Abstract:
BACKGROUND: Addressing anthropometric failure in low-and middle-income countries can have 2 targets of inference: addressing differences between individuals within populations (W-pop) or differences between populations (B-pop). We present a multilevel framework to apply both targets of inference simultaneously and quantify the extent to which variation in anthropometric status and growth failure is reflective of undernourished children or undernourished populations.METHODS: Cross-sectional data originated from the Demographic and Health Surveys program, covering children under age 5 from 57 countries surveyed between 2001 and 2015.RESULTS: A majority of variation in child anthropometric status and growth failure was attributable to W-pop-associated differences, accounting for 89%, 83%, and 85% of the variability in z scores for height for age, weight for age, and weight for height. B-pop-associated differences (communities, regions, and countries combined) were associated with 11%, 17%, and 15% of the variation in height-for-age z score, weight-for-age z score, and weight-for-height z score. Prevalence of anthropometric failure was closely correlated with mean levels of height and weight. Approximately 1% of W-pop variability, compared with 30% to 50% of the B-pop variability, was explained by mean values of maternal correlates of anthropometric status and failure. Although there is greater explanatory power B-pop, this varied because of modifiability of what constitutes population.CONCLUSIONS: Our results suggest that universal strategies to prevent future anthropometric failure in populations combined with targeted strategies to address both the impending and existing burden among children are needed.