title: Drought, conflict and children's undernutrition in Ethiopia 2000-2013: a meta-analysis.
abstract: OBJECTIVE
  To estimate the prevalence of childhood wasting and to investigate the effects of drought and conflict on wasting in crisis-affected areas within Ethiopia.
  
  
  METHODS
  We searched the Complex Emergency Database for nutrition surveys carried out in Ethiopia over the period 2000-2013. We extracted data on the prevalence of wasting (weight-for-heightz-scores below -2) among children aged 6-59 months for areas of Ethiopia that had sufficient data available. Data on any conflict events (irrespective of magnitude or impact) and episodes of seasonal drought affecting the survey areas were extracted from publicly available data sources. Random-effects Bayesian meta-analysis was used to synthesize the evidence from 231 small-scale surveys.
  
  
  RESULTS
  From the total sample of 175 607 children analysed, the pooled number of children wasted was 21 709. The posterior median prevalence of wasting was 11.0% (95% credible interval, CrI: 10.3-11.7) over the 14-year period. Compared with areas unaffected by drought, the estimated prevalence of wasting was higher in areas affected by moderate levels of drought (posterior odds ratio, OR: 1.34; 95% CrI: 1.05-1.72) but similar in severe drought-affected areas (OR: 0.96; 95% CrI: 0.68-1.35). Although the pooled prevalence of wasting was higher in conflict-affected than unaffected areas, the difference was not plausible (OR: 1.02; 95% CrI: 0.82-1.26).
  
  
  CONCLUSIONS
  Despite an overall declining trend, a wasting problem persists among children in Ethiopia. Conflict events did not have a major impact on childhood wasting. Nutrition interventions should go beyond severe drought-prone areas to incorporate areas where moderate droughts occur.
authors.affiliation: Center for Research on the Epidemiology of Disasters, Institute of Health and Society, Université catholique de Louvain, Clos Chapelle-aux-Champs 30, 1200 Brussels, Belgium .
authors.forename: Tefera Darge
authors.initials: TD
authors.lastname: Delbiso
authors.affiliation: Center for Research on the Epidemiology of Disasters, Institute of Health and Society, Université catholique de Louvain, Clos Chapelle-aux-Champs 30, 1200 Brussels, Belgium .
authors.forename: Jose Manuel
authors.initials: JM
authors.lastname: Rodriguez-Llanes
authors.affiliation: Department of Public Health, University of Liège, Liège, Belgium .
authors.forename: Anne-Françoise
authors.initials: AF
authors.lastname: Donneau
authors.affiliation: Institute of Health and Society, Université catholique de Louvain, Clos Chapelle-aux-Champs, Brussels, Belgium .
authors.forename: Niko
authors.initials: N
authors.lastname: Speybroeck
authors.affiliation: Center for Research on the Epidemiology of Disasters, Institute of Health and Society, Université catholique de Louvain, Clos Chapelle-aux-Champs 30, 1200 Brussels, Belgium .
authors.forename: Debarati
authors.initials: D
authors.lastname: Guha-Sapir
mesh_terms: D000068337:Armed Conflicts / Q000706:statistics & numerical data*; D001499:Bayes Theorem; D015362:Child Nutrition Disorders / Q000453:epidemiology*; D002675:Child, Preschool; D055864:Droughts / Q000706:statistics & numerical data*; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D015995:Prevalence; D012044:Regression Analysis