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. 2021 Nov 17:16:100965.
doi: 10.1016/j.ssmph.2021.100965. eCollection 2021 Dec.

Associations of single versus multiple anthropometric failure with mortality in children under 5 years: A prospective cohort study

Jewel Gausman  1 , Rockli Kim  2   3   4 , S V Subramanian  4   5
Affiliations

Associations of single versus multiple anthropometric failure with mortality in children under 5 years: A prospective cohort study

Jewel Gausman et al. SSM Popul Health. .

Abstract

Background/objectives: Stunting, underweight, and wasting are used to monitor nutritional status in children, but they do not identify children with concurrent anthropometric failures (AF). Our study estimates the association between AF and mortality in children with single versus multiple failures, then calculates the percentage of child deaths attributable to AF.

Subjects/methods: Using data from a prospective, longitudinal study of 3605 children from age 1 to age 5 years in Ethiopia and India, we estimate the association between AF and mortality using conventional definitions (stunting, underweight, and wasting) and the mutually exclusive categories of stunted only underweight only, wasted only, stunted and underweight (SU), underweight and wasted, and stunted, underweight, and wasted (SUW), adjusting for socioeconomic status and other demographic variables. Last, we calculate the population attributable fraction.

Results: Children who were SU and SUW had 3.20 (95% CI: 1.69, 6.06; p < 0.001) and 5.52 (95% CI: 2.25, 13.56; p < 0.001) times the odds of death in fully adjusted models by Round 2 compared to children with no failure, while no increased mortality risk was found among children with other categories of failure. We estimate that 42.69% of child deaths can be attributed to children who are SUW (17.02%) or SU (25.67%), accounting for nearly 80% of child deaths from AF.

Conclusions: This study provides new insight to programs and policy to better identify children most at risk of malnutrition-related mortality.

Keywords: Anthropometric failure; Categories of anthropometric failure; Child health; Child mortality; Comprehensive index of anthropometric failure; Ethiopia; India; Low and middle income countries; Nutrition; Social disparities; Stunting; Underweight; Wasting; Young lives.

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Figures

Fig. 1
Fig. 1
Percentage of deaths in children under-5 years attributable to different categories of anthropometric failure (AF).
See this image and copyright information in PMC

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