{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T05:21:18Z","timestamp":1763529678353,"version":"3.45.0"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T00:00:00Z","timestamp":1763510400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study investigated the relationship between multidimensional poverty and the co-occurrence of undernutrition and intestinal parasitic infections among children under five in Ecuador.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>Using the 2021 national outpatient Ecuadorian registry, we assessed the co-occurrence of undernutrition and intestinal parasitic infection incidences at the municipal-level through spatial analysis. We applied spatial autocorrelation to identify geographic co-occurrence clusters of high-high and low-low incidence rates. Subsequently, we compared the proportions of multidimensional poverty between the high-high and low-low co-occurrence clusters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A spatial correlation was observed between the incidence of undernutrition (14.57 per 1,000 child-years) and intestinal parasitic infections (34.07 per 1,000 child-years) (Bivariate Moran\u2019s Index\u202f=\u202f0.19,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.001). High-high incidence clusters for both conditions were concentrated in the Amazon region. The median multidimensional poverty in these high-high incidence clusters was 72.62% (IQR: 62.08\u201382.44%), which was nearly twice as high as in low-low incidence clusters (38.15%; IQR: 38.15\u201338.93%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our findings suggest that undernutrition and intestinal parasitic infections in children under 5\u202fyears of age tend to co-cluster, and their joint occurrence serves as an indicator of social inequity. High-high incidence clusters were concentrated in the nation\u2019s poorest regions, particularly the Amazon. To overcome this double burden, public-health measures must go beyond biomedical interventions and address its underlying social and structural determinants.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2025.1668303","type":"journal-article","created":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T05:18:16Z","timestamp":1763529496000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Multidimensional poverty and the co-occurrence of undernutrition and intestinal parasitic infections in Ecuadorian infants: a geospatial analysis"],"prefix":"10.3389","volume":"13","author":[{"given":"Pamela","family":"Vinueza-Veloz","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andr\u00e9s Fernando","family":"Vinueza-Veloz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Estephany","family":"Tapia-Veloz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriela","family":"Tapia-Veloz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tannia Valeria","family":"Carpio-Arias","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Fernanda","family":"Vinueza-Veloz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,19]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2543","DOI":"10.1016\/S0140-6736(24)01821-X","article-title":"Global, regional, and national progress towards the 2030 global nutrition targets and forecasts to 2050: a 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