title: Child Wasting in Emergency Pockets: A Meta-Analysis of Small-Scale Surveys from Ethiopia.
abstract: Child undernutrition is a major public health concern in Ethiopia (stunting national prevalence: 44%; wasting: 10%), despite the overall improvement in child health status during the last decade. Hundreds of small-scale surveys are conducted in Ethiopia's emergency pockets under ENCU's supervision. We reviewed the evidence from small-scale surveys conducted between 2008 and 2013 with two objectives: to provide a summary estimate of wasting prevalence from emergency pockets and to examine reasons for variation in prevalence estimates. We created a dataset by combining data from the Complex Emergency Database, the Famine Early Warning System Network and the Armed Conflict Location Event Data. We conducted a meta-analysis of small-scale surveys using a random effects model with known within-study heterogeneity. The influence of survey covariates on estimated prevalence was investigated with meta-regression techniques. We included 158 surveys in the analysis. A high degree of heterogeneity among surveys was observed. The overall estimate of wasting prevalence was 10.6% (95% CI 9.8-11.4), with differences among regions and between residents and refugees. Meta-regression results showed that vaccination coverage, child mortality, diarrhea prevalence and food insecurity are significantly associated with wasting prevalence. Child care and displacement status were not. Aggregated analysis of small-scale surveys provides insights into the prevalence of wasting and factors explaining its variation. It can also guide survey planning towards areas with limited data availability.
authors.affiliation: Centre for Research on the Epidemiology of Disasters, Institute of Health and Society, Université catholique de Louvain, Clos Chapelle-aux-Champs, 30.94, 1200 Brussels, Belgium. chiara.altare@uclouvain.be.
authors.forename: Chiara
authors.initials: C
authors.lastname: Altare
authors.affiliation: Centre for Research on the Epidemiology of Disasters, Institute of Health and Society, Université catholique de Louvain, Clos Chapelle-aux-Champs, 30.94, 1200 Brussels, Belgium. tefera.delbiso@uclouvain.be.
authors.forename: Tefera Darge
authors.initials: TD
authors.lastname: Delbiso
authors.affiliation: Centre for Research on the Epidemiology of Disasters, Institute of Health and Society, Université catholique de Louvain, Clos Chapelle-aux-Champs, 30.94, 1200 Brussels, Belgium. debarati.guha@uclouvain.be.
authors.forename: Debarati
authors.initials: D
authors.lastname: Guha-Sapir
mesh_terms: D002648:Child; D005002:Ethiopia / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D044342:Malnutrition / Q000453:epidemiology* / Q000209:etiology; D015233:Models, Statistical; D015995:Prevalence; D012307:Risk Factors; D019282:Wasting Syndrome / Q000453:epidemiology* / Q000209:etiology
keywords: Ethiopia; meta-analysis; small-scale surveys; wasting
references.citation: BMC Pediatr. 2014 Apr 04;14:91
references.pmid: 24708711
references.citation: Bull World Health Organ. 2000;78(10):1207-21
references.pmid: 11100616
references.citation: BMC Public Health. 2013 Sep 18;13:864
references.pmid: 24047474
references.citation: J Nutr. 2013 Dec;143(12):2015-21
references.pmid: 24089419
references.citation: Lancet. 2013 Aug 3;382(9890):427-451
references.pmid: 23746772
references.citation: Food Nutr Bull. 2010 Sep;31(3 Suppl):S234-47
references.pmid: 21049844
references.citation: Nutr Res Pract. 2013 Apr;7(2):122-31
references.pmid: 23610605
references.citation: Annu Rev Public Health. 1997;18:283-312
references.pmid: 9143721
references.citation: East Afr Med J. 2010 Jun;87(6):248-54
references.pmid: 23057267
references.citation: BMC Pediatr. 2015 Aug 22;15:96
references.pmid: 26297004
references.citation: Breastfeed Med. 2011 Aug;6(4):171-6
references.pmid: 21770732
references.citation: Ethiop Med J. 1998 Jul;36(3):153-66
references.pmid: 10214456
references.citation: Indian J Pediatr. 1991 Jan-Feb;58(1):13-24
references.pmid: 1937618
references.citation: Int J Epidemiol. 2011 Aug;40(4):971-84
references.pmid: 21296853
references.citation: Int Stat Rev. 2010 Apr;78(1):40-64
references.pmid: 21743766
references.citation: PLoS One. 2014 Oct 21;9(10):e109022
references.pmid: 25333954
references.citation: Am J Public Health. 1993 Aug;83(8):1130-3
references.pmid: 8342721
references.citation: BMC Pediatr. 2008 May 05;8:19
references.pmid: 18457590
references.citation: Br J Math Stat Psychol. 2011 Feb;64(Pt 1):1-19
references.pmid: 21506942
references.citation: Matern Child Nutr. 2014 Jan;10(1):1-17
references.pmid: 23945347
references.citation: Public Health Nutr. 2014 Jun;17(6):1318-27
references.pmid: 23642497
references.citation: Matern Child Nutr. 2009 Jul;5(3):260-75
references.pmid: 20572929
references.citation: East Afr Med J. 2005 Dec;82(12):625-30
references.pmid: 16619706
references.citation: PLoS One. 2010 May 21;5(5):e10775
references.pmid: 20505829
references.citation: Food Nutr Bull. 2010 Sep;31(3 Suppl):S219-33
references.pmid: 21049843
references.citation: J Nutr. 2010 Feb;140(2):348-54
references.pmid: 20007336
references.citation: Am J Epidemiol. 2013 Oct 1;178(7):1129-38
references.pmid: 23966558
references.citation: Lancet. 2004 Nov 13-19;364(9447):1801-13
references.pmid: 15541455