Concurrently wasted and stunted children 6-59 months in Karamoja, Uganda: prevalence and case detection

Research output: Contribution to journalJournal articleResearchpeer-review

  • Gloria Adobea Odei Obeng-Amoako
  • Mark Myatt
  • Joel Conkle
  • Brenda Kaijuka Muwaga
  • Richmond Aryeetey
  • Andrew Livex Okwi
  • Isaac Okullo
  • Ezekiel Mupere
  • Henry Wamani
  • André Briend
  • Charles Amnon Sunday Karamagi
  • Joan Nakayaga Kalyango

We assessed prevalence of concurrently wasted and stunted (WaSt) and explored the overlaps between wasted, stunted, underweight and low mid-upper arm circumference (MUAC) among children aged 6-59 months in Karamoja, Uganda. We also determined optimal weight-for-age (WAZ) and MUAC thresholds for detecting WaSt. We conducted secondary data analysis with 2015-2018 Food Security and Nutrition Assessment (FSNA) cross-sectional survey datasets from Karamoja. Wasting, stunting and underweight were defined as <-2.0 z-scores using WHO growth standards. Low MUAC was defined as <12.5 cm. We defined WaSt as concurrent wasting and stunting. Prevalence of WaSt was 4.96% (95% CI [4.64, 5.29]). WaSt was more prevalent in lean than harvest season (5.21% vs. 4.53%; p = .018). About half (53.92%) of WaSt children had low MUAC, and all were underweight. Younger children aged <36 months had more WaSt, particularly males. Males with WaSt had higher median MUAC than females (12.50 vs. 12.10 cm; p < .001). A WAZ <-2.60 threshold detected WaSt with excellent sensitivity (99.02%) and high specificity (90.71%). MUAC threshold <13.20 cm had good sensitivity (81.58%) and moderate specificity (76.15%) to detect WaSt. WaSt prevalence of 5% is a public health concern, given its high mortality risk. All children with WaSt were underweight and half had low MUAC. WAZ and MUAC could be useful tools for detecting WaSt. Prevalence monitoring and prospective studies on WAZ and MUAC cut-offs for WaSt detection are recommended. Future consideration to integrate WAZ into therapeutic feeding programmes is recommended to detect and treat WaSt children.

Original languageEnglish
Article numbere13000
JournalMaternal and Child Nutrition
Volume16
Issue number4
Number of pages11
ISSN1740-8695
DOIs
Publication statusPublished - 2020

Bibliographical note

© 2020 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.

    Research areas

  • Faculty of Science - Case detection, Concurrent wasting and stunting, MUAC, Stunting, Uganda, Wasting, WaSt

ID: 240790108