Incidence correction factors for moderate and severe acute child malnutrition from two longitudinal cohorts in Mali and Burkina Faso

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Oxford University Press
Johns Hopkins Bloomberg School of Public Health

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Child acute malnutrition (AM) is an important cause of child mortality. Accurately estimating its burden requires cumulative incidence data from longitudinal studies which are rarely available in low-income settings. In the absence of such data, the AM burden is approximated using prevalence estimates from cross-sectional surveys and the incidence correction factor K⁠, obtained from the few available cohorts that measured AM. We estimated K factors for severe acute malnutrition (SAM) and moderate acute malnutrition (MAM) from AM incidence and prevalence using representative cross-sectional baseline and longitudinal data from two cluster-randomized controlled trials (Innovative Approaches for the Prevention of Childhood Malnutrition—PROMIS) conducted between 2014 and 2017 in Burkina Faso and Mali. We compared K estimates using a complete (weight-for-length z score, mid-upper arm circumference (MUAC), edema) and partial (MUAC, edema) definition of SAM and MAM. K estimates ranged from 9.4 and 5.7 for SAM, and from 4.7 and 5.1 for MAM in Burkina Faso and Mali, respectively. The MUAC and edema-based definition of AM did not lead to different K estimates. Our results suggest that K can be reliably estimated when only MUAC and edema-based data are available. Additional studies, however, are required to confirm this finding in different settings.

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child nutrition, malnutrition, children, cohort studies, longitudinal studies

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