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      Concurrent wasting and stunting among under‐five children in Niakhar, Senegal

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          Abstract

          The study describes the patterns of concurrent wasting and stunting (WaSt) among children age 6–59 months living in the 1980s in Niakhar, a rural area of Senegal under demographic surveillance. Wasting and stunting were defined by z scores lower than −2 in weight for height and height for age. Both conditions were found to be highly prevalent, wasting more so before age 30 months, stunting more so after age 30 months. As a result, concurrent WaSt peaked around age 18 months and its prevalence (6.2%) was primarily the product of the two conditions, with an interaction term of 1.57 ( p < 10 −6). The interaction was due to the correlation between both conditions (more stunting if wasted, more wasting if stunted). Before age 30 months, boys were more likely to be concurrently wasted and stunted than girls (RR = 1.61), but the sex difference disappeared after 30 months of age. The excess susceptibility of younger boys could not be explained by muscle mass or fat mass measured by arm or muscle circumference, triceps, or subscapular skinfold. Concurrent WaSt was a strong risk factor for child mortality, and its effect was the product of the independent effect of each component, with no significant interaction.

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          Synergism of nutrition, infection, and immunity: an overview

          Infections, no matter how mild, have adverse effects on nutritional status. The significance of these effects depends on the previous nutritional status of the individual, the nature and duration of the infection, and the diet during the recovery period. Conversely, almost any nutrient deficiency, if sufficiently severe, will impair resistance to infection. Iron deficiency and protein-energy malnutrition, both highly prevalent, have the greatest public health importance in this regard. Remarkable advances in immunology of recent decades have increased insights into the mechanisms responsible for the effects of infection. These include impaired antibody formation; loss of delayed cutaneous hypersensitivity; reduced immunoglobulin concentrations; decreased thymic and splenic lymphocytes; reduced complement formation, secretory immunoglobulin A, and interferon; and lower T cells and T cells subsets (helper, suppressor-cytotoxic, and natural killer cells) and interleukin 2 receptors. The effects observed with single or multiple nutrient deficiencies are due to some combination of these responses. In general, cell-mediated and nonspecific immunity are more sensitive than humoral immunity.
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            Child malnutrition in sub-Saharan Africa: A meta-analysis of demographic and health surveys (2006-2016)

            Background Sub-Saharan Africa has one of the highest levels of child malnutrition globally. Therefore, a critical look at the distribution of malnutrition within its sub-regions is required to identify the worst affected areas. This study provides a meta-analysis of the prevalence of malnutrition indicators (stunting, wasting and underweight) within four sub-regions of sub-Saharan Africa. Methods Cross-sectional data from the most recent Demographic and Health Surveys (2006–2016) of 32 countries in sub-Saharan Africa were used. The countries were grouped into four sub-regions (East Africa, West Africa, Southern Africa and Central Africa), and a meta-analysis was conducted to estimate the prevalence of each malnutrition indicator within each of the sub-regions. Significant heterogeneity was detected among the various surveys (I2 >50%), hence a random effect model was used, and sensitivity analysis was performed, to examine the effects of outliers. Stunting was defined as HAZ<-2; wasting as WHZ<-2 and underweight as WAZ<-2. Results Stunting was highest in Burundi (57.7%) and Malawi (47.1%) in East Africa; Niger (43.9%), Mali (38.3%), Sierra Leone (37.9%) and Nigeria (36.8%) in West Africa; Democratic Republic of Congo (42.7%) and Chad (39.9%) in Central Africa. Wasting was highest in Niger (18.0%), Burkina Faso (15.50%) and Mali (12.7%) in West Africa; Comoros (11.1%) and Ethiopia (8.70%) in East Africa; Namibia (6.2%) in Southern Africa; Chad (13.0%) and Sao Tome & Principle (10.5%) in Central Africa. Underweight was highest in Burundi (28.8%) and Ethiopia (25.2%) in East Africa; Niger (36.4%), Nigeria (28.7%), Burkina Faso (25.7%), Mali (25.0%) in West Africa; and Chad (28.8%) in Central Africa. Conclusion The prevalence of malnutrition was highest within countries in East Africa and West Africa compared to the WHO Millennium development goals target for 2015. Appropriate nutrition interventions need to be prioritised in East Africa and West Africa if sub-Saharan Africa is to meet the WHO global nutrition target of improving maternal, infant and young child nutrition by 2025.
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              Selective Discrimination against Female Children in Rural Punjab, India

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                Author and article information

                Contributors
                michel.garenne@pasteur.fr
                Journal
                Matern Child Nutr
                Matern Child Nutr
                10.1111/(ISSN)1740-8709
                MCN
                Maternal & Child Nutrition
                John Wiley and Sons Inc. (Hoboken )
                1740-8695
                1740-8709
                25 November 2018
                April 2019
                : 15
                : 2 ( doiID: 10.1111/mcn.2019.15.issue-2 )
                : e12736
                Affiliations
                [ 1 ] Institut de Recherche pour le Développement (IRD) Unité Mixte Internationale (UMI) Résiliences Paris France
                [ 2 ] Institut Pasteur, Epidémiologie des Maladies Emergentes Paris France
                [ 3 ] Senior Fellow, FERDI Université d'Auvergne Clermont‐Ferrand France
                [ 4 ] MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
                [ 5 ] Brixton Health, Llawryglyn Powys Wales
                [ 6 ] Emergency Nutrition Network Oxford England
                [ 7 ] School of Medicine, Centre for Child Health Research University of Tampere Tampere Finland
                [ 8 ] Department of Nutrition, Exercise and Sports University of Copenhagen Copenhagen Denmark
                Author notes
                [*] [* ] Correspondence

                M. Michel Garenne, Institut Pasteur, Epidémiologie des Maladies Emergentes, 25 rue du Docteur Roux, 75005, Paris, France.

                Email: michel.garenne@ 123456pasteur.fr

                Author information
                http://orcid.org/0000-0001-6073-7803
                http://orcid.org/0000-0003-1119-1474
                http://orcid.org/0000-0002-6251-0052
                http://orcid.org/0000-0003-1130-6948
                http://orcid.org/0000-0001-9390-8541
                Article
                MCN12736 MCN-05-18-OA-3230.R2
                10.1111/mcn.12736
                6587969
                30367556
                1b8cadcd-2bda-40f0-b89c-4cf7d3ef2139
                © 2018 The Authors. Maternal and Child Nutrition Published by John Wiley & Sons, Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 09 May 2018
                : 08 October 2018
                : 15 October 2018
                Page count
                Figures: 5, Tables: 5, Pages: 0, Words: 3641
                Funding
                Funded by: Institut de Recherche pour le Développement (IRD), formerly ORSTOM
                Funded by: European Union, Grant number TD R‐36
                Funded by: Irish Aid
                Award ID: HQPU/2018/ENN
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                mcn12736
                April 2019
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.6.4 mode:remove_FC converted:21.06.2019

                anthropometry,child survival,concurrent wasting & stunting,senegal,stunting,wasting

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