Estimating the changing burden of disease attributable to childhood stunting, wasting and underweight in South Africa for 2000, 2006 and 2012
Background. National estimates of childhood undernutrition display uncertainty; however, it is known that stunting is the most prevalent deficiency. Child undernutrition is manifest in poor communities but is a modifiable risk factor. The intention of the study was to quantify trends in the...
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| Format: | Article |
| Language: | English |
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South African Medical Association
2022-09-01
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| Series: | South African Medical Journal |
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| Online Access: | https://samajournals.co.za/index.php/samj/article/view/202 |
| _version_ | 1827393619735085056 |
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| author | N Nannan R Laubscher J H Nel I Neethling M A Dhansay E B Turawa D Labadarios R Pacella D Bradshaw V Pillay van-Wyk |
| author_facet | N Nannan R Laubscher J H Nel I Neethling M A Dhansay E B Turawa D Labadarios R Pacella D Bradshaw V Pillay van-Wyk |
| author_sort | N Nannan |
| collection | DOAJ |
| description |
Background. National estimates of childhood undernutrition display uncertainty; however, it is known that stunting is the most prevalent deficiency. Child undernutrition is manifest in poor communities but is a modifiable risk factor. The intention of the study was to quantify trends in the indicators of child undernutrition to aid policymakers.
Objectives. To estimate the burden of diseases attributable to stunting, wasting and underweight and their aggregate effects in South African (SA) children under the age of 5 years during 2000, 2006 and 2012.
Methods. The study applied comparative risk assessment methodology. Data sources for estimates of prevalence and population distribution of exposure in children under 5 years were the National Food Consumption surveys and the SA National Health and Nutrition Examination Survey conducted close to the target year of burden. Childhood undernutrition was estimated for stunting, wasting and underweight and their combined ‘aggregate effect’ using the World Health Organization (WHO) 2006 standard. Population-attributable fractions for the disease outcomes of diarrhoea, lower respiratory tract infections, measles and protein-energy malnutrition were applied to SA burden of disease estimates of deaths, years of life lost, years lived with a disability and disability-adjusted life years for 2000, 2006 and 2012.
Results. Among children aged under 5 years between 1999 and 2012, the distribution of anthropometric measurements <‒2 standard deviations from the WHO median showed little change for stunting (28.4% v. 26.6%), wasting (2.6% v. 2.8%) and underweight (7.6% v. 6.1%). In the same age group in 2012, attributable deaths due to wasting and aggregated burden accounted for 21.4% and 33.2% of the total deaths, respectively. Attributable death rates due to wasting and aggregate effects decreased from ~310 per 100 000 in 2006 to 185 per 100 000 in 2012.
Conclusion. The study shows that reduction of childhood undernutrition would have a substantial impact on child mortality. We need to understand why we are not penetrating the factors related to nutrition of children that will lead to reducing levels of stunting.
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| first_indexed | 2024-03-08T17:52:44Z |
| format | Article |
| id | doaj.art-0327eab00830484faabf7db23f44f59d |
| institution | Directory Open Access Journal |
| issn | 0256-9574 2078-5135 |
| language | English |
| last_indexed | 2024-03-08T17:52:44Z |
| publishDate | 2022-09-01 |
| publisher | South African Medical Association |
| record_format | Article |
| series | South African Medical Journal |
| spelling | doaj.art-0327eab00830484faabf7db23f44f59d2024-01-02T06:43:45ZengSouth African Medical AssociationSouth African Medical Journal0256-95742078-51352022-09-011128B10.7196/SAMJ.2022.v112i8b.16497Estimating the changing burden of disease attributable to childhood stunting, wasting and underweight in South Africa for 2000, 2006 and 2012N Nannan0R Laubscher1J H Nel2I Neethling3M A Dhansay4E B Turawa5D Labadarios6R Pacella7D Bradshaw8V Pillay van-Wyk9Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South AfricaBiostatistics Unit, South African Medical Research Council, Cape Town, South AfricaDepartment of Logistics, Faculty of Economic and Management Sciences, Stellenbosch University, South AfricaBurden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa; Institute for Lifecourse Development, Faculty of Education, Health and Human Sciences, University of Greenwich, UKBurden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa; Division of Human Nutrition and Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, South AfricaBurden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa Professor Emeritus, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africanstitute for Lifecourse Development, Faculty of Education, Health and Human Sciences, University of Greenwich, UKBurden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa; School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, South AfricaBurden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa Background. National estimates of childhood undernutrition display uncertainty; however, it is known that stunting is the most prevalent deficiency. Child undernutrition is manifest in poor communities but is a modifiable risk factor. The intention of the study was to quantify trends in the indicators of child undernutrition to aid policymakers. Objectives. To estimate the burden of diseases attributable to stunting, wasting and underweight and their aggregate effects in South African (SA) children under the age of 5 years during 2000, 2006 and 2012. Methods. The study applied comparative risk assessment methodology. Data sources for estimates of prevalence and population distribution of exposure in children under 5 years were the National Food Consumption surveys and the SA National Health and Nutrition Examination Survey conducted close to the target year of burden. Childhood undernutrition was estimated for stunting, wasting and underweight and their combined ‘aggregate effect’ using the World Health Organization (WHO) 2006 standard. Population-attributable fractions for the disease outcomes of diarrhoea, lower respiratory tract infections, measles and protein-energy malnutrition were applied to SA burden of disease estimates of deaths, years of life lost, years lived with a disability and disability-adjusted life years for 2000, 2006 and 2012. Results. Among children aged under 5 years between 1999 and 2012, the distribution of anthropometric measurements <‒2 standard deviations from the WHO median showed little change for stunting (28.4% v. 26.6%), wasting (2.6% v. 2.8%) and underweight (7.6% v. 6.1%). In the same age group in 2012, attributable deaths due to wasting and aggregated burden accounted for 21.4% and 33.2% of the total deaths, respectively. Attributable death rates due to wasting and aggregate effects decreased from ~310 per 100 000 in 2006 to 185 per 100 000 in 2012. Conclusion. The study shows that reduction of childhood undernutrition would have a substantial impact on child mortality. We need to understand why we are not penetrating the factors related to nutrition of children that will lead to reducing levels of stunting. https://samajournals.co.za/index.php/samj/article/view/202underweightchildhood stuntingwasting |
| spellingShingle | N Nannan R Laubscher J H Nel I Neethling M A Dhansay E B Turawa D Labadarios R Pacella D Bradshaw V Pillay van-Wyk Estimating the changing burden of disease attributable to childhood stunting, wasting and underweight in South Africa for 2000, 2006 and 2012 South African Medical Journal underweight childhood stunting wasting |
| title | Estimating the changing burden of disease attributable to childhood stunting, wasting and underweight in South Africa for 2000, 2006 and 2012 |
| title_full | Estimating the changing burden of disease attributable to childhood stunting, wasting and underweight in South Africa for 2000, 2006 and 2012 |
| title_fullStr | Estimating the changing burden of disease attributable to childhood stunting, wasting and underweight in South Africa for 2000, 2006 and 2012 |
| title_full_unstemmed | Estimating the changing burden of disease attributable to childhood stunting, wasting and underweight in South Africa for 2000, 2006 and 2012 |
| title_short | Estimating the changing burden of disease attributable to childhood stunting, wasting and underweight in South Africa for 2000, 2006 and 2012 |
| title_sort | estimating the changing burden of disease attributable to childhood stunting wasting and underweight in south africa for 2000 2006 and 2012 |
| topic | underweight childhood stunting wasting |
| url | https://samajournals.co.za/index.php/samj/article/view/202 |
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