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Influence of malnutrition upon all-cause mortality among children in Swaziland
Paula Acevedo1, María Teresa García Esteban2, Noemí Lopez-Ejeda3
1Department of Biology, Faculty of Sciences, Autonomous University of Madrid, Spain.
Insights
Malnutrition type, severe edema, and sex significantly impact mortality risk in children under five. Wasting and underweight combined pose the highest mortality risk, especially in older children.
Area of Science:
- Pediatrics
- Public Health
- Nutrition Science
Background:
- Malnutrition remains a critical global health issue, particularly affecting children under five years of age.
- Understanding the specific types of malnutrition and their association with mortality is crucial for targeted interventions.
Purpose of the Study:
- To investigate the influence of malnutrition type, sex, age, and the presence of severe edema on all-cause mortality in children under five.
- To identify key predictors of mortality in this vulnerable population.
Main Methods:
- A cross-sectional study was conducted in Swaziland (2010-2011) with 553 children under five.
- Nutritional status was classified using WHO 2006 growth standards: stunting, wasting, and underweight.
- Cox regression analysis was employed to assess mortality risk.
Main Results:
- Mortality risk was lower in females under one year and increased with severe edema.
- Wasting combined with underweight elevated mortality risk 5-fold in children under 12 months and 11-fold in older children.
- The combination of stunting, wasting, and underweight was strongly linked to mortality; stunting alone did not significantly increase risk.
Conclusions:
- Sex, severe edema, and wasting are significant predictors of mortality in malnourished children.
- Children with combined weight-for-height and weight-for-age deficiencies face higher mortality risks than those with stunting alone.
Objective:
To analyze the effect of the type of malnutrition, sex, age and the presence of edema upon all-cause mortality in children under 5 years of age.
Material And Methods:
A cross-sectional study was conducted during 2010 and 2011 in Swaziland. Sex, age, weight and height were taken to classify nutritional status according to the 2006 WHO growth standards: stunting (low height for age), wasting (low weight for height or low body mass index for age) and underweight (low weight for age). The sample (309 boys and 244 girls under 5 years of age) was analyzed by sex and age groups (under and equal/over 12 months). The association between variables was evaluated using the χ2 test. Cox regression analysis (HR, 95% CI) was used to assess the likelihood of mortality.
Results:
The mortality risk in malnourished children under one year of age was lower among females and increased in the presence of severe edema. Wasting combined with underweight increased the mortality risk in children under 12 months of age 5-fold, versus 11-fold in older children. The combination of stunting, wasting and underweight was closely associated to mortality. Stunting alone (not combined with wasting) did not significantly increase the mortality risk.
Conclusions:
Sex, severe edema and wasting are predictors of mortality in malnourished children. Regardless of these factors, children with deficiencies referred to weight for height and weight for age present a greater mortality risk in comparison with children who present stunting only.