{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T15:08:17Z","timestamp":1782140897266,"version":"3.54.5"},"reference-count":34,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,3,25]],"date-time":"2020-03-25T00:00:00Z","timestamp":1585094400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Maternal &amp; Child Nutrition"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>We assessed prevalence of concurrently wasted and stunted (WaSt) and explored the overlaps between wasted, stunted, underweight and low mid\u2010upper arm circumference (MUAC) among children aged 6\u201359 months in Karamoja, Uganda. We also determined optimal weight\u2010for\u2010age (WAZ) and MUAC thresholds for detecting WaSt. We conducted secondary data analysis with 2015\u20132018 Food Security and Nutrition Assessment (FSNA) cross\u2010sectional survey datasets from Karamoja. Wasting, stunting and underweight were defined as &lt;\u22122.0 z\u2010scores using WHO growth standards. Low MUAC was defined as &lt;12.5 cm. We defined WaSt as concurrent wasting and stunting. Prevalence of WaSt was 4.96% (95% CI [4.64, 5.29]). WaSt was more prevalent in lean than harvest season (5.21% vs. 4.53%; <jats:italic>p<\/jats:italic> = .018). About half (53.92%) of WaSt children had low MUAC, and all were underweight. Younger children aged &lt;36 months had more WaSt, particularly males. Males with WaSt had higher median MUAC than females (12.50 vs. 12.10 cm; <jats:italic>p<\/jats:italic> &lt; .001). A WAZ &lt;\u22122.60 threshold detected WaSt with excellent sensitivity (99.02%) and high specificity (90.71%). MUAC threshold &lt;13.20 cm had good sensitivity (81.58%) and moderate specificity (76.15%) to detect WaSt. WaSt prevalence of 5% is a public health concern, given its high mortality risk. All children with WaSt were underweight and half had low MUAC. WAZ and MUAC could be useful tools for detecting WaSt. Prevalence monitoring and prospective studies on WAZ and MUAC cut\u2010offs for WaSt detection are recommended. Future consideration to integrate WAZ into therapeutic feeding programmes is recommended to detect and treat WaSt children.<\/jats:p>","DOI":"10.1111\/mcn.13000","type":"journal-article","created":{"date-parts":[[2020,3,25]],"date-time":"2020-03-25T07:09:49Z","timestamp":1585120189000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Concurrently wasted and stunted children 6\u201059 months in Karamoja, Uganda: prevalence and case detection"],"prefix":"10.1111","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5004-3701","authenticated-orcid":false,"given":"Gloria Adobea","family":"Odei Obeng\u2010Amoako","sequence":"first","affiliation":[{"name":"Clinical Epidemiology Unit, School of Medicine, College of Health Sciences Makerere University  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1119-1474","authenticated-orcid":false,"given":"Mark","family":"Myatt","sequence":"additional","affiliation":[{"name":"Brixton Health  Powys UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2603-5052","authenticated-orcid":false,"given":"Joel","family":"Conkle","sequence":"additional","affiliation":[{"name":"Health and Nutrition Section UNICEF  Windhoek Namibia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenda Kaijuka","family":"Muwaga","sequence":"additional","affiliation":[{"name":"Independent Consultant  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richmond","family":"Aryeetey","sequence":"additional","affiliation":[{"name":"School of Public Health University of Ghana  Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew Livex","family":"Okwi","sequence":"additional","affiliation":[{"name":"Department of Pathology, School of Biomedical Sciences, College of Health Sciences Makerere University  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaac","family":"Okullo","sequence":"additional","affiliation":[{"name":"Department of Dentistry, School of Health Sciences, College of Health Sciences Makerere University  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ezekiel","family":"Mupere","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Child Health, College of Health Sciences Makerere University  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry","family":"Wamani","sequence":"additional","affiliation":[{"name":"Department of Community Health and Behavioural Sciences, School of Public Health, College of Health Sciences Makerere University  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9390-8541","authenticated-orcid":false,"given":"Andr\u00e9","family":"Briend","sequence":"additional","affiliation":[{"name":"School of Medicine, Centre for Child Health Research University of Tampere  Tampere Finland"},{"name":"Department of Nutrition, Exercise and Sports University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles Amnon Sunday","family":"Karamagi","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Unit, School of Medicine, College of Health Sciences Makerere University  Kampala Uganda"},{"name":"Department of Paediatrics and Child Health, College of Health Sciences Makerere University  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan Nakayaga","family":"Kalyango","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Unit, School of Medicine, College of Health Sciences Makerere University  Kampala Uganda"},{"name":"Department of Pharmacy, College of Health Sciences Makerere University  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,3,25]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/nxy003"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1740-8709.2007.00125.x"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.3945\/an.111.001263"},{"key":"e_1_2_10_5_1","volume-title":"Basic epidemiology","author":"Bonita R.","year":"2006"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/1536867X1201200202"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1740-8709.2004.00004.x"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.12736"},{"key":"e_1_2_10_9_1","unstructured":"Golden M. Brennan M. Brennan R. Kaiser R. Mone C. Nathan R. \u2026Seaman J.(2006).Measuring mortality nutritional status and food security in crisis situations: SMART methodology version 1 SMART Project"},{"key":"e_1_2_10_10_1","volume-title":"Designing Clinical Research: An epidemiological approach","author":"Hulley S. B.","year":"2001"},{"key":"e_1_2_10_11_1","unstructured":"Khara T. &Dolan C.(2014).The relationship between wasting and stunting: Policy programming and research implications. Technical briefing paper. Retrieved fromhttps:\/\/www.ennonline.net\/waststuntreview2014"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.12516"},{"key":"e_1_2_10_13_1","unstructured":"Leroy J.(2011).ZSCORE06: Stata module to calculate anthropometric z\u2010scores using the 2006 WHO child growth standards. Retrieved fromhttp:\/\/www.ifpri.org\/staffprofile\/jef-leroy"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.112.047639"},{"key":"e_1_2_10_15_1","unstructured":"MoH Uganda & UNICEF. (2016).Guidelines for integrated management of acute malnutrition in UgandaRetrieved fromhttp:\/\/www.health.go.ug\/docs\/IMAM.pdf"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/15648265060273s302"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1017\/S136898001800318X"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13690-018-0277-1"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0230480"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.3349\/ymj.2011.52.6.948"},{"key":"e_1_2_10_21_1","unstructured":"Powell J. (2010).Karamoja: A literature review. Retrieved fromhttps:\/\/www.saferworld.org.uk\/downloads\/pubdocs\/Karamoja%20A%20literature%20review.pdf"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/4654920"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/nqy326"},{"key":"e_1_2_10_24_1","volume-title":"Uganda Demographic and Health Survey 2016 Kampala, Uganda and Rockville","author":"UBOS, & ICF","year":"2018"},{"key":"e_1_2_10_25_1","unstructured":"Uganda IPC Technical Working Group. (2019).Report of the integrated food security phase classification analysis for Uganda.Retrieved fromhttps:\/\/reliefweb.int\/sites\/reliefweb.int\/files\/resources\/1_IPC_AFI_Uganda_2018OctDec2019JanMarch.pdf"},{"key":"e_1_2_10_26_1","volume-title":"Guidelines for selective feeding: The management of malnutrition in emergencies. Collaboration with the United Nations Standing Committee on Nutrition and the World Health Organization","author":"UNHCR, & WFP","year":"2011"},{"key":"e_1_2_10_27_1","unstructured":"UNICEF DFID WFP FAO & IBFAN. (2018).Food security and nutrition assessment in Karamoja sub\u2010region January 2018Retrieved fromhttps:\/\/karamojaresilience.org\/publications\/item\/food-security-and-nutrition-assessment-for-karamoja-sub-region-2"},{"key":"e_1_2_10_28_1","unstructured":"UNICEF WHO & World Bank Group. (2018).Joint child malnutrition estimates 2018 edition.Retrieved fromhttps:\/\/www.who.int\/nutgrowthdb\/2018-jme-brochure.pdf"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1080\/14786448008626877"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.4.5936.88"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-4642(19)30244-5"},{"key":"e_1_2_10_32_1","unstructured":"WHO. (2006).Multicentre growth reference study group: WHO Child Growth Standards: Length\/height\u2010for\u2010age weight\u2010for\u2010age weight\u2010for\u2010length weight\u2010for\u2010height and body mass index\u2010for\u2010age: Methods and development."},{"key":"e_1_2_10_33_1","volume-title":"WHO AnthroPlus for personal computers manual: Software for assessing growth of the world's children and adolescents","author":"WHO","year":"2009"},{"key":"e_1_2_10_34_1","volume-title":"Guideline: Updates on the management of severe acute malnutrition in infants and children","author":"WHO","year":"2013"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(1950)3:1<32::AID-CNCR2820030106>3.0.CO;2-3"}],"container-title":["Maternal &amp; Child Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fmcn.13000","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/mcn.13000","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/mcn.13000","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/mcn.13000","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,31]],"date-time":"2023-10-31T10:31:00Z","timestamp":1698748260000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/mcn.13000"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3,25]]},"references-count":34,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2020,10]]}},"alternative-id":["10.1111\/mcn.13000"],"URL":"https:\/\/doi.org\/10.1111\/mcn.13000","archive":["Portico"],"relation":{},"ISSN":["1740-8695","1740-8709"],"issn-type":[{"value":"1740-8695","type":"print"},{"value":"1740-8709","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,3,25]]},"assertion":[{"value":"2019-10-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-03-12","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-03-25","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e13000"}}