Browsing by Author "Myatt, M."
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Item Concurrently wasted and stunted 6-59 months children admitted to the outpatient therapeutic feeding programme in Karamoja, Uganda: Prevalence, characteristics, treatment outcomes and response(PLOS ONE, 2020-03-20) Aryeetey, R.; Obeng-Amoako, G.A.O.; Wamani, H.; Conkle, J.; Nangendo, J.; Mupere, E.; Kalyango, J.N.; Myatt, M.; Briend, A.; Karamagi, C.A.S.This study assessed the prevalence of concurrently wasted and stunted (WaSt) children, their characteristics, treatment outcomes and response; and factors associated with time to recovery among children aged 6–59 months admitted to Outpatient Therapeutic Care (OTC) in Karamoja, Uganda. We conducted a retrospective cohort study with data from January 2016 to October 2017 for children admitted to nine OTCs in Karamoja. We defined wasted, stunted and underweight as 2.0 Z-scores below the median per WHO growth standards and < 12.5 cm for low Mid-Upper Arm Circumference (MUAC). WaSt was defined as concurrently wasted and stunted. Out of 788 eligible children included in the analysis; 48.7% (95% CI; 45.2–52.2) had WaSt. WaSt was common among males; 56.3% (95% CI; 51.3–61.3). Median age was 18 months in WaSt versus 12 months in non-WaSt children (p < 0.001). All WaSt children were underweight; and more severely wasted than non-WaSt children. During recovery, WaSt children gained weight more rapidly than non-WaSt children (2.2g/kg/day vs. 1.7g/kg/day). WaSt children had lower recovery rate (58.0% vs. 65.4%; p = 0.037). The difference in median time of recovery between WaSt and non-WaSt children (63 days vs. 56 days; p = 0.465) was not significant. Factors associated with time to recovery were children aged 24–59 months (aHR = 1.30; 95% CI;1.07–1.57;), children with MUAC 10.5–11.4 cm (aHR = 2.03; 95% CI; 1.55–2.66), MUAC ≥ 11.5 cm at admission (aHR = 3.31; 95% CI; 2.17–5.02) and living in Moroto (aHR = 3.34; 95% CI; 2.60–4.30) and Nakapiripirit (aHR = 1.95; 95% CI; 1.51–2.53) districts. The magnitude of children with WaSt in OTC shows that existing therapeutic feeding protocols could be used to detect and treat WaSt children. Further research is needed to identify and address the factors associated with sub-optimal recovery in WaSt children for effective OTC programming in Karamoja.Item Concurrently wasted and stunted children 6-59 months in Karamoja, Uganda: prevalence and case detection(Maternal & Child Nutrition, 2020-03-25) Aryeetey, R.; Obeng-Amoako, G.A.O.; Myatt, M.; Conkle, J.; Muwaga, B.K.; Okwi, A.L.; Okullo, I.; Mupere, E.; Wamani, H.; Briend, A.; Karamagi, C.A.S.; Kalyango, J.N.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.