Preventive small-quantity lipid-based nutrient supplements reduce severe wasting and severe stunting among young children: an individual participant data meta-analysis of randomized controlled trials-Reference-Cited by-同舟云学术

Preventive small-quantity lipid-based nutrient supplements reduce severe wasting and severe stunting among young children: an individual participant data meta-analysis of randomized controlled trials

Published:2022-06-17 Issue: Volume: Page:
ISSN:
Container-title:
language:
Short-container-title:

Author:

Dewey Kathryn G.^ORCID,Arnold Charles D.^ORCID,Wessells K. Ryan^ORCID,Prado Elizabeth L.^ORCID,Abbeddou Souheila^ORCID,Adu-Afarwuah Seth^ORCID,Ali Hasmot^ORCID,Arnold Benjamin F.^ORCID,Ashorn Per^ORCID,Ashorn Ulla^ORCID,Ashraf Sania^ORCID,Becquey Elodie^ORCID,Brown Kenneth H.^ORCID,Christian Parul^ORCID,Colford John M.^ORCID,Dulience Sherlie J. L.,Fernald Lia C.H.^ORCID,Galasso Emanuela^ORCID,Hallamaa Lotta^ORCID,Hess Sonja Y.^ORCID,Humphrey Jean H.^ORCID,Huybregts Lieven^ORCID,Iannotti Lora L.^ORCID,Jannat Kaniz^ORCID,Lartey Anna^ORCID,Port Agnes Le^ORCID,Leroy Jef L.^ORCID,Luby Stephen P.^ORCID,Maleta Kenneth^ORCID,Matias Susana L.^ORCID,Mbuya Mduduzi NN^ORCID,Mridha Malay K.^ORCID,Nkhoma Minyanga^ORCID,Null Clair^ORCID,Paul Rina R.^ORCID,Okronipa Harriet^ORCID,Ouédraogo Jean-Bosco^ORCID,Pickering Amy J.^ORCID,Prendergast Andrew J.^ORCID,Ruel Marie^ORCID,Shaikh Saijuddin^ORCID,Weber Ann M.^ORCID,Wolff Patricia^ORCID,Zongrone Amanda^ORCID,Stewart Christine P.^ORCID

Abstract

ABSTRACTBackgroundMeta-analyses show that small-quantity lipid-based nutrient supplements (SQ- LNS) reduce child wasting and stunting. There is little information regarding effects on severe wasting or stunting.ObjectiveWe aimed to identify the effect of SQ-LNS on severe wasting (weight-for-length z- score < −3) and severe stunting (length-for-age z-score < −3).MethodsWe conducted a two-stage meta-analysis of individual participant data from 14 randomized controlled trials of SQ-LNS provided to children 6 to 24 mo of age. We generated study-specific and subgroup estimates of SQ-LNS vs. control and pooled the estimates using fixed-effects models. We used random effects meta-regression to examine study-level effect modifiers. In sensitivity analyses, we examined whether results differed depending on study arm inclusion criteria and types of comparisons.ResultsQ-LNS provision led to a relative reduction of 31% in severe wasting (Prevalence Ratio, PR 0.69 (0.55, 0.86), n=34,373) and 17% in severe stunting (PR 0.83 (95% CI: 0.78, 0.90), n=36,795). Results were similar in most of the sensitivity analyses but somewhat attenuated when comparisons using passive control arms were excluded: PR 0.74 (0.57, 0.96), n=26,327 for severe wasting and PR 0.88 (0.81, 0.95), n=28,742 for severe stunting. Study-level characteristics generally did not significantly modify the effects of SQ-LNS, but results suggested greater effects of SQ-LNS in sites with greater burdens of wasting or stunting, or with poorer water quality or sanitation.ConclusionsIncluding SQ-LNS in preventive interventions to promote healthy child growth and development is likely to reduce rates of severe wasting and stunting. Registered atwww.crd.york.ac.uk/PROSPEROas CRD42019146592.

Publisher

Cold Spring Harbor Laboratory

Reference59 articles.

1. United Nations Children’s Fund (UNICEF), World Health Organization, International Bank for Reconstruction and Development/The World Bank. Levels and trends in child malnutrition: key findings of the 2021 edition of the joint child malnutrition estimates. Geneva: World Health Organization; 2021.

2. Trends in mild, moderate, and severe stunting and underweight, and progress towards MDG 1 in 141 developing countries: a systematic analysis of population representative data

3. United Nations Children’s Fund (UNICEF). Guidance for estimating the number of children in need of treatment for wasting. New York: UNICEF Nutiriton; 2021.

4. Incidence Correction Factors for Moderate and Severe Acute Child Malnutrition From 2 Longitudinal Cohorts in Mali and Burkina Faso;Am J Epidemiol,2020

5. Wali N, K EA , Renzaho AMN . Wasting and Associated Factors among Children under 5 Years in Five South Asian Countries (2014-2018): Analysis of Demographic Health Surveys. Int J Environ Res Public Health 2021;18.