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The association between malnutrition and childhood disability in low‐ and middle‐ income countries: systematic review and meta‐analysis of observational studies
Author(s) -
HumeNixon Maeve,
Kuper Hannah
Publication year - 2018
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.13139
Subject(s) - malnutrition , wasting , medicine , underweight , observational study , overnutrition , pediatrics , epidemiology , low and middle income countries , environmental health , developing country , body mass index , overweight , economics , economic growth
Objective The aim of this study was to evaluate the association between childhood disability and malnutrition in low‐ and middle‐ income countries ( LMIC s). Methods Articles were identified from 1990 to August 2017 by searching nine electronic databases. Epidemiological studies, undertaken in LMIC s that compared the prevalence of malnutrition in children with disabilities to children without disabilities were eligible for inclusion. Titles, abstracts, and full texts were screened by two reviewers, and data were extracted using a structured table for eligible papers. Meta‐analyses for the association between childhood disability and undernutrition were performed. Results The search generated 4678 results, from which 17 articles were eligible. Fifty‐three per cent of these studies showed a positive association between childhood disability and undernutrition. Results varied when disaggregated by type of disability, with positive associations identified for 44% of studies focussed on neurodevelopmental disability, 60% of general disability studies and 67% of studies on hearing impairment. Only four studies were identified that considered overnutrition outcomes, and these showed variable results. Eighteen per cent of eligible studies were considered at low risk of bias, 53% had a medium risk, and 29% had a high risk of bias. Pooled OR s showed that children with disabilities were almost three times more likely to be underweight ( OR 2.97, 95% CI 2.33, 3.79), and nearly twice as likely to experience stunting and wasting (Stunting: 1.82, 1.40, 2.36; Wasting: 1.90, 1.32–2.75), compared to controls. Conclusions Children with disabilities may be a vulnerable group for undernutrition in LMIC s, which should be reflected in disability and nutritional programming and policy‐making.