Quantifying the increased risk of illness in malnourished children:a global meta-analysis and propensity score matching approach  

作　　者：Mukhtar A.Ijaiya Seun Anjorin Olalekan A.Uthman 

机构地区：[1]Jhpiego,Plot 971,Rueben Okoya Crescent,Off Okonjo Iweala Street,Wuye District,Abuja,FCT,Nigeria [2]Big Data Institute,Nuffield Department of Population Health,University of Oxford,Oxford,UK [3]Warwick Centre for Global Health,Division of Health Sciences,Warwick Medical School,University of Warwick,Coventry CV47AL,UK

出　　处：《Global Health Research and Policy》2024年第1期299-314,共16页全球健康研究与政策(英文)

摘　　要：Background Childhood morbidity and mortality continue to be major public health challenges.Malnutri-tion increases the risk of morbidity and mortality from illnesses such as acute respiratory infections,diarrhoea,fever,and perinatal conditions in children.This study explored and estimated the magnitude of the associations between childhood malnutrition forms and child morbidity.Methods We performed an individual participant data(IPD)meta-analysis and employed propensity score match-ing to examine crude(unadjusted)and adjusted associations.Our analysis utilized demographic and health data-sets from surveys conducted between 2015 and 2020 in 27 low-and middle-income countries.Our objective was to quantify the risk of morbidity in malnourished children and estimate the population-attributable fraction(PAF)using a natural experimental design with a propensity score-matched cohort.Results The IPD meta-analysis of child morbidity across three childhood malnutrition forms presented nuanced results.Children with double-burden malnutrition had a 5%greater risk of morbidity,which was not statistically sig-nificant.In contrast,wasted children had a 28%greater risk of morbidity.Overweight children exhibited a 29%lower risk of morbidity.Using the matched sample,children with double-burden malnutrition and overweight children had lower morbidity risks(1.7%,RR:0.983(95%CI,0.95 to 1.02)and 20%,RR:0.80(95%CI,0.76 to 0.85),respectively),while wasting was associated with a 1.1 times(RR:1.094(95%CI,1.05 to 1.14))greater risk of morbidity.Eliminating double-burden malnutrition and wasting in the four and seven countries with significant positive risk differences could reduce the child morbidity burden by an estimated average of 2.8%and 3.7%,respectively.Conclusions Our study revealed a correlation between specific childhood malnutrition subtypes—double-burden malnutrition and wasting—and increased risks of morbidity.Conversely,overweight children exhibited a lower risk of immediate morbidity,yet they may face potential long-term

关 键 词：MALNUTRITION MORBIDITY CHILDHOOD META-ANALYSIS Propensity score matching 

分 类 号：R72[医药卫生—儿科]