TY - JOUR
T1 - Not water, sanitation and hygiene practice, but timing of stunting is associated with recovery from stunting at 24 months
T2 - Results from a multi-country birth cohort study
AU - Das, Subhasish
AU - Fahim, Shah Mohammad
AU - Alam, Md Ashraful
AU - Mahfuz, Mustafa
AU - Bessong, Pascal
AU - Mduma, Esto
AU - Kosek, Margaret
AU - Shrestha, Sanjaya K.
AU - Ahmed, Tahmeed
N1 - Funding Information:
Acknowledgements: The authors would like to thank all the participants and their parents for sharing their time and providing consent and the information necessary for a successful completion of the study. The authors express their gratitude to MAL-ED study site lead investigators – Tahmeed Ahmed, Pascal Bessong, Zulfiqar A. Bhutta, Rashidul Haque, Sushil John, Gagandeep Kang, Margaret N. Kosek, Aldo A. M. Lima, Estomih R. Mduma, Reinaldo Oria´, Sanjaya Kumar Shrestha, Prakash Sundar Shrestha, Erling Svensen and Anita K. M. Zaidi. The authors also acknowledge the contribution of icddr,b’s core donors, including the Government of the People’s Republic of Bangladesh; Global Affairs Canada; Swedish International Development Cooperation Agency; and the Department for International Development, UKAid, for their continuous support and commitment to icddr,b’s research efforts. Financial support: The MAL-ED birth cohort study was funded by the Foundation of National Institute of Health, Fogarty International Centre with overall support from the Bill & Melinda Gates Foundation, grant no. GR-681. Conflict of interest: None of the authors had any conflict of interest to declare. Authorship: S.D. developed the research concept presented here. S.D. and T.A. contributed to the study design. T.A. led the Bangladesh MAL-ED study. S.D. and M.A.A. participated in the data analysis. S.D. and S.M.F wrote the first draft. S.D. had the primary responsibility for the final content. S.D., S.M.F., M.A.A., M.M., P.B., E.M., M.K., S.K.S. and T.A. critically reviewed the drafts. All authors have read and approved the final draft of the manuscript. Ethics of human subject participation: The protocol received approval from the ethical review board of respective site’s institutional review board. Informed consent was obtained from the parents or legal guardians of the enrolled children after notifying them about the purpose of the study.
Publisher Copyright:
© Authors 2020.
PY - 2021/4
Y1 - 2021/4
N2 - Objectives: To measure the role of water, sanitation and hygiene (WASH) practices on recovery from stunting and assess the role of timing of stunting on the reversal of this phenomenon Design: Data from the MAL-ED multi-country birth cohort study was used for the current analysis. Generalised linear mixed-effects models were used to estimate the probability of reversal of stunting with WASH practice and timing of stunting as the exposures of interest. Setting: Seven different countries across three continents. Participants: A total of 612 children <2 years of age. Results: We found that not WASH practice but timing of stunting had statistically significant association with recovery from stunting. In comparison with the children who were stunted at 6 months, children who were stunted at 12 months had 1.9 times (β = 0.63, P = 0.03) more chance of recovery at 24 months of age. And, children who were stunted at 18 months of age even had higher odds (adjusted OR = 3.01, β = 1.10, P < 0.001) of recovery than children who were stunted at 6 months. Additionally, mother's height (β = 0.59, P = 0.04) and household income (β = 0.02, P < 0.05) showed statistically significant associations with the outcome. Conclusions: The study provided evidence for the role of timing of stunting on the recovery from the phenomenon. This novel finding indicates that the programmes to promote linear growth should be directed at the earliest possible timepoints in the course of life.
AB - Objectives: To measure the role of water, sanitation and hygiene (WASH) practices on recovery from stunting and assess the role of timing of stunting on the reversal of this phenomenon Design: Data from the MAL-ED multi-country birth cohort study was used for the current analysis. Generalised linear mixed-effects models were used to estimate the probability of reversal of stunting with WASH practice and timing of stunting as the exposures of interest. Setting: Seven different countries across three continents. Participants: A total of 612 children <2 years of age. Results: We found that not WASH practice but timing of stunting had statistically significant association with recovery from stunting. In comparison with the children who were stunted at 6 months, children who were stunted at 12 months had 1.9 times (β = 0.63, P = 0.03) more chance of recovery at 24 months of age. And, children who were stunted at 18 months of age even had higher odds (adjusted OR = 3.01, β = 1.10, P < 0.001) of recovery than children who were stunted at 6 months. Additionally, mother's height (β = 0.59, P = 0.04) and household income (β = 0.02, P < 0.05) showed statistically significant associations with the outcome. Conclusions: The study provided evidence for the role of timing of stunting on the recovery from the phenomenon. This novel finding indicates that the programmes to promote linear growth should be directed at the earliest possible timepoints in the course of life.
KW - Generalised linear mixed-effects models
KW - Multi-country birth cohort study
KW - Recovery from stunting
KW - Timing of stunting
KW - Water, sanitation and hygiene
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U2 - 10.1017/S136898002000004X
DO - 10.1017/S136898002000004X
M3 - Article
C2 - 32404220
AN - SCOPUS:85085292884
SN - 1368-9800
VL - 24
SP - 1428
EP - 1437
JO - Public health nutrition
JF - Public health nutrition
IS - 6
ER -