Wasting and stunting in young children in developing countries

ISRCTN	ISRCTN89017827
DOI	https://doi.org/10.1186/ISRCTN89017827
Protocol serial number	N/A
Sponsor	Emergency Nutrition Network
Funders	United States Agency for International Development, 295 Grant Number: ENN AID-OFDA-G-15-00190 , Irish Aid

Submission date: 21/08/2017
Registration date: 21/08/2017
Last edited: 26/11/2019

Recruitment status: No longer recruiting
Overall study status: Completed
Condition category: Nutritional, Metabolic, Endocrine

Prospectively registered

Protocol

Statistical analysis plan

Results

Individual participant data

Plain English summary of protocol

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

Contact information

Ms Carmel Dolan
Scientific

32 Leopold Street
Oxford
OX4 1TW
United Kingdom

Study information

Primary study design	Observational
Study design	Observational cross-sectional study
Secondary study design	Cross sectional study
Study type	Participant information sheet
Scientific title	Children who are both wasted and stunted are also underweight and have a high risk of death – policy implications
Study objectives	This study examined the magnitude of overlap between wasted and stunted children to determine the degree of overlap and the association with underweight children.
Ethics approval(s)	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.
Health condition(s) or problem(s) studied	Nutrition
Intervention	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.
Intervention type	Other
Primary outcome measure(s)	Overlap between wasted, stunted and underweight children as measured by <-2SD WHZ, HAZ, WAZ
Key secondary outcome measure(s)	Degree of concurrence i.e. <-2SDWHZ AND ,-2SDHAZ in children and by age (6-59 months) and by sex (male/female)
Completion date	01/12/2015

Eligibility

Participant type(s)	All
Age group	Child
Lower age limit	6 Months
Upper age limit	59 Months
Sex	All
Target sample size at registration	1796991
Total final enrolment	1796991
Key inclusion criteria	1. 6-59 month old children 2. Males and females
Key exclusion criteria	Children over 59 months of age
Date of first enrolment	01/01/1992
Date of final enrolment	01/12/2015

Locations

Countries of recruitment

Afghanistan
Albania
Algeria
American Samoa
Angola
Bahrain
Bangladesh
Benin
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Central African Republic
Chad
Congo
Congo, Democratic Republic
Côte d'Ivoire
Djibouti
Ecuador
Equatorial Guinea
Eritrea
Ethiopia
Gabon
Gambia
Ghana
Guinea-Bissau
Haiti
India
Indonesia
Kenya
Lao People's Democratic Republic
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

Study participating centre

-
Chad

Results and Publications

Individual participant data (IPD) Intention to share	Yes
IPD sharing plan summary	Stored in repository
IPD sharing plan	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.

Study outputs

Output type	Details	Date created	Date added	Peer reviewed?	Patient-facing?
Results article	results	16/07/2018	26/11/2019	Yes	No
Participant information sheet	Participant information sheet	11/11/2025	11/11/2025	No	Yes

Editorial Notes

26/11/2019: The following changes have been made:
1. Publication reference added.
2. The final enrolment number was added from the reference.