Wasting and stunting, physical growth manifestations of child undernutrition, have historically been considered separately with distinct interventions at the program, policy, and financing levels despite similar risk factors, overlapping burdens and multiplicative risk of death when the conditions are concurrent. The aim of this study was to elucidate shared risk factors and the temporal relationship between wasting and stunting among children under 2 years of age in rural Niger. From August 2014 to December 2019, anthropometric data were collected every 4 weeks from 6 to 8 weeks to 24 months of age for 6567 children comprising 139,529 visits in Madarounfa, Niger. Children were defined as wasted if they had a weight-for-length Z-score < − 2 and stunted if they had a length-for-age Z-score < − 2 using the 2006 World Health Organization child growth standards. Parental, child, and socioeconomic risk factors for wasting and stunting at 6 and 24 months of age and the relationship between episodes of wasting, stunting and concurrent wasting-stunting were assessed using general estimating equations. Half of children (50%) were female, and 8.3% were born low birthweight (< 2500 g). Overall, at 24 months of age, 14% of children were wasted, 80% were stunted and 12% were concurrently wasted-stunted. We found that maternal short stature, male sex, and low birthweight were risk factors for wasting and stunting at 6 and 24 months, whereas higher maternal body mass index and household wealth were protective factors. Wasting at 6 and 24 months was predicted by a prior episodes of wasting, stunting, and concurrent wasting-stunting. Stunting at 6 and 24 months was similarly predicted by prior episodes of stunting and concurrent wasting-stunting at any prior age but only by prior episodes of wasting after 6 months of age. These data support a complex and dynamic bi-directional relationship between wasting and stunting in young children in rural Niger and an important burden of concurrent wasting-stunting in this setting. Further research to better understand the inter-relationships and mechanisms between these two conditions is needed in order to develop and target interventions to promote child growth. ClinicalTrials.gov Identifier: NCT02145000 .

中文翻译：

---

探索尼日尔两岁以下儿童的消瘦和发育迟缓之间的关系

消瘦和发育迟缓是儿童营养不良的身体发育表现，历来被单独考虑，并在计划、政策和融资层面采取不同的干预措施，尽管风险因素相似，负担重叠，并且在条件同时发生时死亡的风险增加。本研究的目的是阐明尼日尔农村地区 2 岁以下儿童的共同风险因素以及消瘦和发育迟缓之间的时间关系。从 2014 年 8 月到 2019 年 12 月，从 6 到 8 周到 24 个月大的每 4 周收集了 6567 名儿童的人体测量数据，其中包括 139,529 次访问尼日尔 Madarounfa。如果儿童的身高别体重 Z 分数 < - 2，则被定义为消瘦，如果年龄别身长 Z 分数 < - 2，则儿童被定义为发育迟缓 − 2 使用 2006 年世界卫生组织儿童生长标准。6 个月和 24 个月时出现消瘦和发育迟缓的父母、儿童和社会经济风险因素，以及消瘦、发育迟缓和同时发生的消瘦-发育迟缓发作之间的关系使用一般估计方程进行评估。一半的儿童 (50%) 是女性，8.3% 出生时体重低 (< 2500 g)。总体而言，在 24 个月大时，14% 的儿童消瘦，80% 发育迟缓，12% 同时消瘦-发育迟缓。我们发现，母亲身材矮小、男性和低出生体重是 6 个月和 24 个月时消瘦和发育迟缓的危险因素，而较高的母亲体重指数和家庭财富是保护因素。6 个月和 24 个月的消瘦是通过先前的消瘦、发育迟缓和同时发生的消瘦-发育迟缓来预测的。6 个月和 24 个月时的发育迟缓类似地通过先前任何年龄的发育迟缓发作和同时发生的消瘦-发育迟缓进行预测，但仅通过 6 个月大之后发生的消瘦发生类似。这些数据支持尼日尔农村幼儿消瘦和发育迟缓之间复杂而动态的双向关系，以及在这种情况下并发消瘦发育的重要负担。需要进一步研究以更好地了解这两种情况之间的相互关系和机制，以便制定和针对促进儿童成长的干预措施。ClinicalTrials.gov 标识符：NCT02145000。这些数据支持尼日尔农村幼儿消瘦和发育迟缓之间复杂而动态的双向关系，以及在这种情况下并发消瘦发育的重要负担。需要进一步研究以更好地了解这两种情况之间的相互关系和机制，以便制定和针对促进儿童成长的干预措施。ClinicalTrials.gov 标识符：NCT02145000。这些数据支持尼日尔农村幼儿消瘦和发育迟缓之间复杂而动态的双向关系，以及在这种情况下并发消瘦发育的重要负担。需要进一步研究以更好地了解这两种情况之间的相互关系和机制，以便制定和针对促进儿童成长的干预措施。ClinicalTrials.gov 标识符：NCT02145000。