Drought exposure as a risk factor for child undernutrition in low- and middle-income countries: A systematic review and assessment of empirical evidence

Background: Droughts affect around 52 million people globally each year, a figure that is likely to increase under climate change. Objectives: To assess the strength of empirical evidence on drought exposure as a risk factor for undernutrition in children <5 years of age in low- and middle-in...

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Main Authors: Kristine Belesova, Caroline Noel Agabiirwe, Margaret Zou, Revati Phalkey, Paul Wilkinson
Format: Article
Language:English
Published: Elsevier 2019-10-01
Series:Environment International
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Online Access:http://www.sciencedirect.com/science/article/pii/S0160412019306075
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author Kristine Belesova
Caroline Noel Agabiirwe
Margaret Zou
Revati Phalkey
Paul Wilkinson
author_facet Kristine Belesova
Caroline Noel Agabiirwe
Margaret Zou
Revati Phalkey
Paul Wilkinson
author_sort Kristine Belesova
collection DOAJ
description Background: Droughts affect around 52 million people globally each year, a figure that is likely to increase under climate change. Objectives: To assess the strength of empirical evidence on drought exposure as a risk factor for undernutrition in children <5 years of age in low- and middle-income countries (LMICs). Methods: Systematic review of observational studies published between 1990 and 2018 in English and reporting undernutrition outcomes in children <5 years of age in relation to droughts in LMICs. The search was performed in the Global Health, Medline, Embase, and Scopus databases. We assessed the strength of evidence following the Navigation Guide. Results: 27 studies met our inclusion criteria. 12 reported prevalence estimates in drought-affected conditions without comparison to unaffected conditions. These showed high prevalence of chronic and mixed undernutrition and poor to critical levels of acute undernutrition. Only two studies were judged to have low risk of bias. Overall, the strength of evidence of drought as a risk factor was found to be limited, but the two studies with low risk of bias suggested positive associations of drought exposure with children being underweight and having anaemia. Conclusion: Published evidence suggests high levels of all types of child undernutrition in drought-affected populations in low-income settings, but the extent to which these levels are attributable to drought has not been clearly quantified and may be context specific. This review offers suggestions for enhancing the quality of future studies to strengthen evidence on the potential magnitude, timing, and modifying factors of drought impacts.
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spelling doaj-art-678cf1c672c4423fa3c19171588b53622025-08-20T03:36:42ZengElsevierEnvironment International0160-41202019-10-01131Drought exposure as a risk factor for child undernutrition in low- and middle-income countries: A systematic review and assessment of empirical evidenceKristine Belesova0Caroline Noel Agabiirwe1Margaret Zou2Revati Phalkey3Paul Wilkinson4Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK; Corresponding author at: Department of Public Health, Environments, and Society, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK.Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UKDepartment of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UKDivision of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK; Institute of Public Health, University of Heidelberg, Im Neuenheimer Feld 324, Heidelberg 69120, GermanyDepartment of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UKBackground: Droughts affect around 52 million people globally each year, a figure that is likely to increase under climate change. Objectives: To assess the strength of empirical evidence on drought exposure as a risk factor for undernutrition in children <5 years of age in low- and middle-income countries (LMICs). Methods: Systematic review of observational studies published between 1990 and 2018 in English and reporting undernutrition outcomes in children <5 years of age in relation to droughts in LMICs. The search was performed in the Global Health, Medline, Embase, and Scopus databases. We assessed the strength of evidence following the Navigation Guide. Results: 27 studies met our inclusion criteria. 12 reported prevalence estimates in drought-affected conditions without comparison to unaffected conditions. These showed high prevalence of chronic and mixed undernutrition and poor to critical levels of acute undernutrition. Only two studies were judged to have low risk of bias. Overall, the strength of evidence of drought as a risk factor was found to be limited, but the two studies with low risk of bias suggested positive associations of drought exposure with children being underweight and having anaemia. Conclusion: Published evidence suggests high levels of all types of child undernutrition in drought-affected populations in low-income settings, but the extent to which these levels are attributable to drought has not been clearly quantified and may be context specific. This review offers suggestions for enhancing the quality of future studies to strengthen evidence on the potential magnitude, timing, and modifying factors of drought impacts. http://www.sciencedirect.com/science/article/pii/S0160412019306075climate changedisasterdroughtundernutritionnutritionevidence assessment
spellingShingle Kristine Belesova
Caroline Noel Agabiirwe
Margaret Zou
Revati Phalkey
Paul Wilkinson
Drought exposure as a risk factor for child undernutrition in low- and middle-income countries: A systematic review and assessment of empirical evidence
Environment International
climate change
disaster
drought
undernutrition
nutrition
evidence assessment
title Drought exposure as a risk factor for child undernutrition in low- and middle-income countries: A systematic review and assessment of empirical evidence
title_full Drought exposure as a risk factor for child undernutrition in low- and middle-income countries: A systematic review and assessment of empirical evidence
title_fullStr Drought exposure as a risk factor for child undernutrition in low- and middle-income countries: A systematic review and assessment of empirical evidence
title_full_unstemmed Drought exposure as a risk factor for child undernutrition in low- and middle-income countries: A systematic review and assessment of empirical evidence
title_short Drought exposure as a risk factor for child undernutrition in low- and middle-income countries: A systematic review and assessment of empirical evidence
title_sort drought exposure as a risk factor for child undernutrition in low and middle income countries a systematic review and assessment of empirical evidence
topic climate change
disaster
drought
undernutrition
nutrition
evidence assessment
url http://www.sciencedirect.com/science/article/pii/S0160412019306075
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AT margaretzou droughtexposureasariskfactorforchildundernutritioninlowandmiddleincomecountriesasystematicreviewandassessmentofempiricalevidence
AT revatiphalkey droughtexposureasariskfactorforchildundernutritioninlowandmiddleincomecountriesasystematicreviewandassessmentofempiricalevidence
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