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dc.contributor.authorKinyoki, Damaris K.
dc.contributor.authorKandala, Ngianga-Bakwin
dc.contributor.authorManda, Samuel O.
dc.contributor.authorKrainski, Elias Teixeira
dc.contributor.authorFuglstad, Geir-Arne
dc.contributor.authorMoloney, Grainne M.
dc.contributor.authorBerkley, James A.
dc.contributor.authorNoor, Abdisalan M.
dc.description.abstractObjective: Wasting and stunting may occur together at the individual child level; however, their shared geographic distribution and correlates remain unexplored. Understanding shared and separate correlates may inform interventions. We aimed to assess the spatial codistribution of wasting, stunting and underweight and investigate their shared correlates among children aged 6–59 months in Somalia. Setting: Cross-sectional nutritional assessments surveys were conducted using structured interviews among communities in Somalia biannually from 2007 to 2010. A two-stage cluster sampling methodology was used to select children aged 6–59 months from households across three livelihood zones (pastoral, agropastoral and riverine). Using these data and environmental covariates, we implemented a multivariate spatial technique to estimate the codistribution and divergence of the risks and correlates of wasting and stunting at the 1×1 km spatial resolution. Participants: 73 778 children aged 6–59 months from 1066 survey clusters in Somalia. Results: Observed pairwise child level empirical correlations were 0.30, 0.70 and 0.73 between weight-for-height and height-for-age; height-for-age and weight-for-age, and weight-for-height and weight-for-age, respectively. Access to foods with high protein content and vegetation cover, a proxy of rainfall or drought, were associated with lower risk of wasting and stunting. Age, gender, illness, access to carbohydrates and temperature were correlates of all three indicators. The spatial codistribution was highest between stunting and underweight with relative risk values ranging between 0.15 and 6.20, followed by wasting and underweight (range: 0.18–5.18) and lowest between wasting and stunting (range: 0.26–4.32). Conclusions: The determinants of wasting and stunting are largely shared, but their correlation is relatively variable in space. Significant hotspots of different forms of malnutrition occurred in the South Central regions of the country. Although nutrition response in Somalia has traditionally focused on wasting rather than stunting, integrated programming and interventions can effectively target both conditions to alleviate common risk factors.nb_NO
dc.publisherBMJ Publishing Groupnb_NO
dc.rightsNavngivelse 4.0 Internasjonal*
dc.titleAssessing comorbidity and correlates of wasting and stunting among children in Somalia using cross-sectional household surveys: 2007 to 2010nb_NO
dc.typeJournal articlenb_NO
dc.typePeer reviewednb_NO
dc.source.journalBMJ Opennb_NO
dc.relation.projectNorges forskningsråd: 213921nb_NO
dc.description.localcodeCopyright 2016 the Author(s). Published by the BMJ Publishing Group Limited. This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See:
cristin.unitnameInstitutt for matematiske fag

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Navngivelse 4.0 Internasjonal
Except where otherwise noted, this item's license is described as Navngivelse 4.0 Internasjonal