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Seasonality of underweight among infants 1-11 months old in Niger: an exploratory analysis of data from a

Brittany Peterson1, Ahmed Mamane Arzika2, Ramatou Maliki3

  • 1Francis I. Proctor Foundation, University of California San Francisco, San Francisco, California, USA.

BMJ Global Health
|March 28, 2025
PubMed

Insights

Child malnutrition in Niger shows seasonal patterns, peaking in February and May. Understanding this weight-for-age z-score (WAZ) seasonality is crucial for timing child health programs effectively.

Area of Science:

  • Pediatrics
  • Global Health
  • Nutritional Epidemiology

Background:

  • Malnutrition significantly contributes to child mortality globally, accounting for approximately 45% of deaths in children under five.
  • Existing research on malnutrition seasonality primarily focuses on wasting and stunting in older children (6-59 months), overlooking younger infants.
  • Underweight, indicated by weight-for-age z-score (WAZ), is an underappreciated predictor of mortality in young children.

Purpose of the Study:

  • To investigate the seasonal patterns of weight-for-age z-score (WAZ) in infants aged 1-11 months in Niger.
  • To identify the timing of peak and nadir WAZ to inform public health interventions.

Main Methods:

  • Utilized data from the cluster-randomised AVENIR trial, including biannual census data from 2904 communities in Niger.
  • Included 133,781 infants aged 1-11 months, with weight-for-age z-score (WAZ) calculated at each census.
  • Employed harmonic regression to analyze the temporal trends and identify seasonal peaks and nadirs of WAZ.

Main Results:

  • The primary peak in WAZ was observed in late February, followed by a primary nadir in mid-May, coinciding with pre-rainy season temperature increases.
  • A secondary WAZ peak occurred in August, with a secondary nadir in November, aligning with the post-rainy season period.
  • These findings reveal distinct seasonal fluctuations in infant nutritional status within the study population.

Conclusions:

  • The identified seasonality of WAZ in infants 1-11 months in Niger has significant implications for the strategic timing of malnutrition reduction programs.
  • Optimizing program delivery based on seasonal WAZ patterns can potentially enhance their effectiveness in combating child malnutrition.
Abstract

Keywords:
Child healthCluster randomized trialGlobal Health

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