Plain English Summary
Background and study aims
Wasting (having a low weight-for-height) and stunting (having a low height-for-age) are common and are implicated in the deaths of almost two million children each year. Wasting and stunting tend to be addressed as separate issues despite evidence of common causes and the fact that many children suffer simultaneously from both conditions. The aim of this study is to examine the size of the overlap between wasted and stunted children to determine the degree of overlap and the association with underweight children.
Who can participate?
Children aged 6-59 months
What does the study involve?
A database of surveys is created containing data for almost 1.8 million children. This is analysed to determine the overlap between sets of wasted, stunted, and underweight children; the association between being wasted and being stunted; the severity of wasting and stunting; and the prevalence of wasting and stunting by age and sex.
What are the possible benefits and risks of participating?
There are no benefits or risks to the children who are measured. The benefit is to the international community concerned with addressing all forms of child undernutrition.
Where is the study run from?
Emergency Nutrition Network (UK)
When is the study starting and how long is it expected to run for?
January 1992 to December 2015
Who is funding the study?
1. US Agency for International Development (USA)
2. Irish Aid (Ireland)
Who is the main contact?
Ms Carmel Dolan
Children who are both wasted and stunted are also underweight and have a high risk of death – policy implications
This study examined the magnitude of overlap between wasted and stunted children to determine the degree of overlap and the association with underweight children.
This is an observational study so does not need ethical approval. All data was anonymous and was secondary and readily available for further analysis. There were no human or animal subjects.
Observational cross-sectional study
Primary study design
Secondary study design
Cross sectional study
Patient information sheet
Not available in web format, please use the contact details to request a patient information sheet
A database of cross-sectional survey datasets containing data for almost 1.8 million children was compiled. This was analysed to determine the intersection between sets of wasted, stunted, and underweight children; the association between being wasted and being stunted; the severity of wasting and stunting in WaSt children; and the prevalence of WaSt by age and sex. An additional analysis of the WHO Growth Standards sought the maximum possible weight-for-age z-score for WaSt children.
Primary outcome measure
Overlap between wasted, stunted and underweight children as measured by <-2SD WHZ, HAZ, WAZ
Secondary outcome measures
Degree of concurrence i.e. <-2SDWHZ AND ,-2SDHAZ in children and by age (6-59 months) and by sex (male/female)
Overall trial start date
Overall trial end date
Reason abandoned (if study stopped)
Participant inclusion criteria
1. 6-59 month old children
2. Males and females
Target number of participants
Total final enrolment
Participant exclusion criteria
Children over 59 months of age
Recruitment start date
Recruitment end date
Countries of recruitment
Afghanistan, Albania, Algeria, American Samoa, Angola, Bahrain, Bangladesh, Benin, Burkina Faso, Burundi, Cambodia, Cameroon, Cape Verde, Central African Republic, Chad, Congo, Congo, Democratic Republic, Cote d'Ivoire, Djibouti, Ecuador, Equatorial Guinea, Eritrea, Ethiopia, Gabon, Gambia, Ghana, Guinea-Bissau, Haiti, India, Indonesia, Kenya, Laos, Lesotho, Liberia, Madagascar, Malawi, Mali, Mauritania, Mozambique, Myanmar, Namibia, Nepal, Niger, Nigeria, Pakistan, Rwanda, Senegal, Sierra Leone, Somalia, South Sudan, Sudan, Tajikistan, Tanzania, Timor-Leste, Uganda, Yemen, Zambia, Zimbabwe
Trial participating centre
Emergency Nutrition Network
32 Leopold Street
United States Agency for International Development, 295 Grant Number: ENN AID-OFDA-G-15-00190
U.S. Agency for International Development, USAID
Funding Body Type
Funding Body Subtype
United States of America
Funding Body Type
Funding Body Subtype
Results and Publications
Publication and dissemination plan
The study is being submitted to a high impact peer reviewed journal and once accepted the trialists will ensure open access and at a later stage disseminate through their organization's global network and via international meetings/conferences.
IPD sharing statement
These are merged datasets which many international organisations feed into when the surveys are complete. The data is anonymous so there is no risk of invading confidentiality. These are quite old SMART surveys that might not be used again. The agencies also have the data and the source agency is acknowledged in the paper. The data is officially ‘owned’ by the donors who funded the surveys originally and they insist on open access data exactly for the purpose of further analysis. The lead author is a senior analyst who has access to the datasets and has used the data for previous well known peer reviewed publications.
Intention to publish date
Participant level data
Stored in repository
Basic results (scientific)
2018 results in https://www.ncbi.nlm.nih.gov/pubmed/30026945 (added 26/11/2019)