biostudies-literature00560Local Burden of Disease Child Growth Failure CollaboratorsFIC NIH HHS231-234https://www.ebi.ac.uk/biostudies/studies/S-EPMC7015855biostudies-literatureUnknown577(7789)Childhood malnutrition is associated with high morbidity and mortality globally¹. Undernourished children are more likely to experience cognitive, physical, and metabolic developmental impairments that can lead to later cardiovascular disease, reduced intellectual ability and school attainment, and reduced economic productivity in adulthood². Child growth failure (CGF), expressed as stunting, wasting, and underweight in children under five years of age (0-59 months), is a specific subset of undernutrition characterized by insufficient height or weight against age-specific growth reference standards^3-5. The prevalence of stunting, wasting, or underweight in children under five is the proportion of children with a height-for-age, weight-for-height, or weight-for-age z-score, respectively, that is more than two standard deviations below the World Health Organization's median growth reference standards for a healthy population⁶. Subnational estimates of CGF report substantial heterogeneity within countries, but are available primarily at the first administrative level (for example, states or provinces)⁷; the uneven geographical distribution of CGF has motivated further calls for assessments that can match the local scale of many public health programmes⁸. Building from our previous work mapping CGF in Africa⁹, here we provide the first, to our knowledge, mapped high-spatial-resolution estimates of CGF indicators from 2000 to 2017 across 105 low- and middle-income countries (LMICs), where 99% of affected children live¹, aggregated to policy-relevant first and second (for example, districts or counties) administrative-level units and national levels. Despite remarkable declines over the study period, many LMICs remain far from the ambitious World Health Organization Global Nutrition Targets to reduce stunting by 40% and wasting to less than 5% by 2025. Large disparities in prevalence and progress exist across and within countries; our maps identify high-prevalence areas even within nations otherwise succeeding in reducing overall CGF prevalence. By highlighting where the highest-need populations reside, these geospatial estimates can support policy-makers in planning interventions that are adapted locally and in efficiently directing resources towards reducing CGF and its health implications.NatureMapping child growth failure across low- and middle-income countries.PMC7015855K43 TW010716Werdecker AMohammed SNyasulu PSBedi NPiwoz EGTadesse BTMalta DCAdamu AAOgbo FAMokdad AHSalimzadeh HMustafa GYounis MZKinyoki DKKhader YSYamada TKassebaum NJP A MKarami MXu GHenok AHall JBWang YPHu GAmini SSenbeta AMBhattacharjee NVMasaka ASalimi YIslam SMSDesta MMousavi SMSheikh AKimokoti RWAsadi-Aliabadi MRawat RSalam NKochhar SKoyanagi ATerkawi ASWangia ENAwasthi AChipeta MGOlusanya BONaghavi MPatil STHosseinzadeh MSepanlou SGThorne-Lyman ALChu DTBell MLKhan EADaoud FSchwebel DCLevy TSFukumoto TAbd El Razek MMMoodley YYu CSoofi MNaderi MUllah IMiazgowski TAl-Eyadhy AAl-Raddadi RMMoazen BShiadeh MNCollison MLDandona RFaro AEl-Khatib ZTemsah MHMurray CJLMajdan MDesalegn BBSudaryanto ARios-Gonzalez CWalson JLHole MKMirrakhimov EMSathian BKisa AOrtiz-Panozo ERostami AJha RPSalamati PRoever LSharafi KKanchan TShamsi MEffiong ASharma RAntonio CATRawaf DLTovani-Palone MRPana ASafdarian MNegoi IVu LGMohebi FLi SGupta RDDandona LLinn SFilip IHoang CLTessema ZTMoradi GPrado BHLeo DAremu OOtstavnov SSZaki MESRemuzzi GTran BXPandey AAvila MRawaf SSahebkar AGezae KENguyen SHHerteliu CPati SPirsaheb MAndrei CLBadawi AUthman OADinberu MTKahsay AZhang YLodha RQuintana HYousefifard MHerrero MGona PNGrada AMoradi-Lakeh MSafari YCastro FCar JGuo YWaheed YMalekzadeh RMensah GASamy AMPerico NLevine AJGopalani SVMarczak LBBritton GSingh JASartorius BAusloos MMansournia MAYonemoto NCerin EBassat QVaezi ADarwesh AMAlipour VNdwandwe DEAhmadi KWeaver NDNajafi FZaman SBZamani MMiller TRVaezghasemi MVlassov VBaye KFolayan MOAlahdab FPourshams ACuevas-Nasu LFischer FVu GTOsgood-Zimmerman AESchaeffer LEPatton GCBekele BBBhattarai SMassenburg BBNguyen HLTFareed MDubey MOlusanya JOSinha DNLocal Burden of Disease Child Growth Failure CollaboratorsMueller UOFoigt NAJakovljevic MTabares-Seisdedos RKumar GALami FHDeribe KMejia-Rodriguez FBiadgo BBurstein RDeshpande APigott DMRai RKAbebe ZRadfar AMartins-Melo FRNangia VRoss JMRafiei AMelku MValdez PRVeisani YGhajar ANoubiap JJPostma MJCromwell EAHaj-Mirzaian ALazzar-Atwood AAjumobi OMini GKMosser JFKumar MBhutta ZAMendoza WSadat NDoku DTLad SDPickering BVWang YHay SIHossain NDuraes ARAdekanmbi VButt ZADefo BKCastaneda-Orjuela CABarnighausen TWHenry NJRenzaho AMNDiaz DAlijanzadeh MNgunjiri JWSchipp MFLee PHYisma EMayala BKArabloo JBriko ANKrishan KNeve JWGill PSBhattacharyya KTran KBKasaeian AAltirkawi KSufiyan MBPrakash SEshrati BDwyer-Lindgren LKim YJEl Razek HMASilva DASMorrison SDShaikh MANguyen LHRahimi-Movaghar VAzari SOlagunju ATQuintanilla BPAGebrehiwot TTAtique STantawi MEMoraga PEarl LNie JHamidi SKosen SRajati FNnaji CABikbov BCork MAVanderheide JMamun AAShil AFereshtehnejad SMJonas JBMajeed AKhater MMViolante FSJozwiak JJ56falseMapping child growth failure across low- and middle-income countries.Childhood malnutrition is associated with high morbidity and mortality globally¹. Undernourished children are more likely to experience cognitive, physical, and metabolic developmental impairments that can lead to later cardiovascular disease, reduced intellectual ability and school attainment, and reduced economic productivity in adulthood². Child growth failure (CGF), expressed as stunting, wasting, and underweight in children under five years of age (0-59 months), is a specific subset of undernutrition characterized by insufficient height or weight against age-specific growth reference standards^3-5. The prevalence of stunting, wasting, or underweight in children under five is the proportion of children with a height-for-age, weight-for-height, or weight-for-age z-score, respectively, that is more than two standard deviations below the World Health Organization's median growth reference standards for a healthy population⁶. Subnational estimates of CGF report substantial heterogeneity within countries, but are available primarily at the first administrative level (for example, states or provinces)⁷; the uneven geographical distribution of CGF has motivated further calls for assessments that can match the local scale of many public health programmes⁸. Building from our previous work mapping CGF in Africa⁹, here we provide the first, to our knowledge, mapped high-spatial-resolution estimates of CGF indicators from 2000 to 2017 across 105 low- and middle-income countries (LMICs), where 99% of affected children live¹, aggregated to policy-relevant first and second (for example, districts or counties) administrative-level units and national levels. Despite remarkable declines over the study period, many LMICs remain far from the ambitious World Health Organization Global Nutrition Targets to reduce stunting by 40% and wasting to less than 5% by 2025. Large disparities in prevalence and progress exist across and within countries; our maps identify high-prevalence areas even within nations otherwise succeeding in reducing overall CGF prevalence. By highlighting where the highest-need populations reside, these geospatial estimates can support policy-makers in planning interventions that are adapted locally and in efficiently directing resources towards reducing CGF and its health implications.2020-01-01T00:00:00Z2020 Jan2021-02-21T04:13:24Z2020-05-22T12:00:06ZS-EPMC70158553191539310.1038/s41586-019-1878-8