Seasonality of underweight among infants 1–11 months old in Niger: an exploratory analysis of data from a cluster-randomised trial
Introduction Malnutrition is a risk factor for child mortality, with around 45% of deaths in children under 5 globally linked to malnutrition. Seasonality of malnutrition has important implications for the timing of child health programme activities, but evidence is mixed on the nature of such patte...
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BMJ Publishing Group
2025-03-01
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| Series: | BMJ Global Health |
| Online Access: | https://gh.bmj.com/content/10/3/e017643.full |
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| author | Catherine E Oldenburg Thomas M Lietman Jeremy David Keenan Elodie Lebas Amza Abdou Travis C Porco Kieran S O’Brien Ahmed Mamane Arzika Ramatou Maliki Alio Karamba Mankara Benjamin Arnold Brittany Peterson Bawa Aichatou Diallo Beidi Nasser Galo Nasser Harouna Sani Mahamadou Moustapha Abarchi Almou Ibrahim Ismael Sara |
| author_facet | Catherine E Oldenburg Thomas M Lietman Jeremy David Keenan Elodie Lebas Amza Abdou Travis C Porco Kieran S O’Brien Ahmed Mamane Arzika Ramatou Maliki Alio Karamba Mankara Benjamin Arnold Brittany Peterson Bawa Aichatou Diallo Beidi Nasser Galo Nasser Harouna Sani Mahamadou Moustapha Abarchi Almou Ibrahim Ismael Sara |
| author_sort | Catherine E Oldenburg |
| collection | DOAJ |
| description | Introduction Malnutrition is a risk factor for child mortality, with around 45% of deaths in children under 5 globally linked to malnutrition. Seasonality of malnutrition has important implications for the timing of child health programme activities, but evidence is mixed on the nature of such patterns. Moreover, the bulk of the existing evidence is focused on wasting and stunting in children 6–59 months, despite increasing evidence that younger children also face a high risk, and that underweight alone is an important predictor of mortality.Methods This study used data from the cluster-randomised AVENIR trial which compared the effect of biannual distribution of azithromycin vs placebo on mortality in children 1–59 months old in Niger. AVENIR included a biannual census conducted on a rolling basis over 2 years. A subset of 133 781 infants aged 1–11 months from 2904 communities were included in this study, and weight-for-age z-score (WAZ) was calculated at each census. The exposure for this analysis is the day of the year weight was captured. Harmonic regression was used to determine primary and secondary peaks and nadirs of WAZ over time.Results Overall, the primary peak of WAZ occurred in late February and the primary nadir occurred in mid-May, aligning with a seasonal temperature increase before the rainy season. A secondary peak in August and a secondary nadir in November were also seen, aligning with the postrainy season.Conclusion The seasonality of WAZ of infants 1–11 months in Niger may have implications for the timing of programmes aiming to decrease malnutrition. |
| format | Article |
| id | doaj-art-03e34c57a4b94c04afd904079875d60a |
| institution | OA Journals |
| issn | 2059-7908 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Global Health |
| spelling | doaj-art-03e34c57a4b94c04afd904079875d60a2025-08-20T02:10:50ZengBMJ Publishing GroupBMJ Global Health2059-79082025-03-0110310.1136/bmjgh-2024-017643Seasonality of underweight among infants 1–11 months old in Niger: an exploratory analysis of data from a cluster-randomised trialCatherine E Oldenburg0Thomas M Lietman1Jeremy David Keenan2Elodie Lebas3Amza Abdou4Travis C Porco5Kieran S O’Brien6Ahmed Mamane Arzika7Ramatou Maliki8Alio Karamba Mankara9Benjamin Arnold10Brittany Peterson11Bawa Aichatou12Diallo Beidi13Nasser Galo14Nasser Harouna15Sani Mahamadou16Moustapha Abarchi17Almou Ibrahim18Ismael Sara19Francis I. Proctor Foundation, University of California San Francisco, San Francisco, California, USAFrancis I. Proctor Foundation, University of California San Francisco, San Francisco, California, USAFrancis I. Proctor Foundation, University of California San Francisco, San Francisco, California, USAFrancis I. Proctor Foundation, University of California San Francisco, San Francisco, California, USAProgramme Nationale de Santé Oculaire, Niamey, NigerFrancis I. Proctor Foundation, University of California San Francisco, San Francisco, California, USAFrancis I. Proctor Foundation, University of California San Francisco, San Francisco, California, USACentre de Recherche et Interventions en Sante Publique, Niamey, NigerCarter Center, Niamey, NigerCentre de Recherche et Interventions en Sante Publique, Niamey, NigerFrancis I. Proctor Foundation, University of California San Francisco, San Francisco, California, USAFrancis I. Proctor Foundation, University of California San Francisco, San Francisco, California, USACentre de Recherche et Interventions en Sante Publique, Niamey, NigerCentre de Recherche et Interventions en Sante Publique, Niamey, NigerCentre de Recherche et Interventions en Santé Publique, Birni N’Gaoure, NigerCentre de Recherche et Interventions en Sante Publique, Niamey, NigerCentre de Recherche et Interventions en Sante Publique, Niamey, NigerCentre de Recherche et Interventions en Sante Publique, Niamey, NigerProgramme Nationale de Santé Oculaire, Niamey, NigerCentre de Recherche et Interventions en Sante Publique, Niamey, NigerIntroduction Malnutrition is a risk factor for child mortality, with around 45% of deaths in children under 5 globally linked to malnutrition. Seasonality of malnutrition has important implications for the timing of child health programme activities, but evidence is mixed on the nature of such patterns. Moreover, the bulk of the existing evidence is focused on wasting and stunting in children 6–59 months, despite increasing evidence that younger children also face a high risk, and that underweight alone is an important predictor of mortality.Methods This study used data from the cluster-randomised AVENIR trial which compared the effect of biannual distribution of azithromycin vs placebo on mortality in children 1–59 months old in Niger. AVENIR included a biannual census conducted on a rolling basis over 2 years. A subset of 133 781 infants aged 1–11 months from 2904 communities were included in this study, and weight-for-age z-score (WAZ) was calculated at each census. The exposure for this analysis is the day of the year weight was captured. Harmonic regression was used to determine primary and secondary peaks and nadirs of WAZ over time.Results Overall, the primary peak of WAZ occurred in late February and the primary nadir occurred in mid-May, aligning with a seasonal temperature increase before the rainy season. A secondary peak in August and a secondary nadir in November were also seen, aligning with the postrainy season.Conclusion The seasonality of WAZ of infants 1–11 months in Niger may have implications for the timing of programmes aiming to decrease malnutrition.https://gh.bmj.com/content/10/3/e017643.full |
| spellingShingle | Catherine E Oldenburg Thomas M Lietman Jeremy David Keenan Elodie Lebas Amza Abdou Travis C Porco Kieran S O’Brien Ahmed Mamane Arzika Ramatou Maliki Alio Karamba Mankara Benjamin Arnold Brittany Peterson Bawa Aichatou Diallo Beidi Nasser Galo Nasser Harouna Sani Mahamadou Moustapha Abarchi Almou Ibrahim Ismael Sara Seasonality of underweight among infants 1–11 months old in Niger: an exploratory analysis of data from a cluster-randomised trial BMJ Global Health |
| title | Seasonality of underweight among infants 1–11 months old in Niger: an exploratory analysis of data from a cluster-randomised trial |
| title_full | Seasonality of underweight among infants 1–11 months old in Niger: an exploratory analysis of data from a cluster-randomised trial |
| title_fullStr | Seasonality of underweight among infants 1–11 months old in Niger: an exploratory analysis of data from a cluster-randomised trial |
| title_full_unstemmed | Seasonality of underweight among infants 1–11 months old in Niger: an exploratory analysis of data from a cluster-randomised trial |
| title_short | Seasonality of underweight among infants 1–11 months old in Niger: an exploratory analysis of data from a cluster-randomised trial |
| title_sort | seasonality of underweight among infants 1 11 months old in niger an exploratory analysis of data from a cluster randomised trial |
| url | https://gh.bmj.com/content/10/3/e017643.full |
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