Nutrition Assessment of Under-Five Children in Sudan: Tracking the Achievement of the Global Nutrition Targets
Abstract
1. Introduction
2. Materials and Methods
2.1. Methods of S3M Surveys
2.2. Tracking Tools of the Global Nutrition Targets
2.3. The Sample
2.4. Data Collection
2.5. Definitions of Nutrition Indicators
- 1—Wasting is acute malnutrition reflected by weight-for-height Z-score (WHZ) or MUAC. Global Acute Malnutrition GAM includes Severe Acute malnutrition (SAM) and Moderate Acute Malnutrition (MAM).
- ➢
- Wasting global (WHZ) is the percentage of children 6–59 months < −2 Z-scores weight for height and/or oedema.
- Wasting severe (WHZ) is the percentage of children 6–59 months < −3 Z-scores weight for height and/or oedema.
- Wasting Moderate (WHZ) is the percentage of children 6–59 months between < −2 Z-scores and −3 z-scores weight for height.
- ➢
- Wasting global (MUAC) is the percentage of children 6–59 months with an MUAC < 125 mm and or oedema.
- Wasting severe (MUAC) is the percentage of children 6–59 months with a MUAC < 115.
- Wasting Moderate (MUAC) is the percentage of children 6–59 months with a MUAC between <1 25 mm and > 115 mm.
- 2—Stunting is chronic malnutrition reflected by height-for-age Z-score (HAZ).
- ➢
- Stunting global (HAZ) is the percentage of children 6–59 months < −2 Z-scores height for age.
- Stunting severe (HAZ) is the percentage of children 6–59 months < −3 Z-scores height for age.
- Stunting Moderate (HAZ) is the percentage of children 6–59 months between < −2 Z-scores and −3 z-scores height for age.
- 3—Underweight is the percentage of children who have low weight for age Z-score (WAZ),
- ➢
- Underweight global (WAZ) is the percentage of children 6–59 months < −2 Z-scores weight for age.
- Underweight severe (WAZ) is the percentage of children 6–59 months < −3 Z-scores weight for age.
- Underweight Moderate (WAZ) is the percentage of children 6–59 months between < −2 Z-scores and −3 z-scores weight for age.
- 4—Overweight/Obesity is the percentage of children 6–59 months >2 Z-scores weight for height/age.
- 5—Nutritional oedema was assessed clinically using the bilateral pitting oedema test.
- 6—Exclusive breastfeeding is the percentage of children 0–6 months taking breast milk only.
- 7—Continuing Breast-feeding is the percentage of children 6–24 months currently breastfeeding.
- 8—Meal frequency is the percentage of children receiving meals the appropriate number of times for their age during the 24 h before the survey.
- 9—Dietary diversity is the percentage of children consuming the appropriate number of food groups for their age during the 24 h before the survey.
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Labels | Wasting WHZ% | Overweight WAZ% | Stunting HAZ% |
---|---|---|---|
Very Low | <2.5 | <2.5 | <2.5 |
Low | 2.5 < 5 | 2.5 < 5 | 2.5 < 5 |
Medium | 5 < 10 | 5 < 10 | 5 < 10 |
High | 10 < 15 | 10 < 15 | 10 < 15 |
Very High | >15 | >15 | >30 |
WHZ: weight-for-height Z-score, WAZ: weight-for-age Z-score, HAZ: Height-for-Age Z-score |
State | Mean HAZ | HAZ < −2% | HAZ −3 to −2% | HAZ < −3% | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Estimation | 95% LCL | 95% UCL | Estimation | 95% LCL | 95% UCL | Estimation | 95% LCL | 95% UCL | Estimation | 95% LCL | 95% UCL | |
Al Gedaref | −1.76 | −1.98 | −1.54 | 45.16 | 39.03 | 51.28 | 23.14 | 14.73 | 31.54 | 21.95 | 16.37 | 27.54 |
Al-Gezira | −1.46 | −1.65 | −1.26 | 35.04 | 29.56 | 40.52 | 22.51 | 15.53 | 29.49 | 12.42 | 7.66 | 17.19 |
Blue Nile | −1.50 | −1.72 | −1.29 | 37.23 | 31.26 | 43.20 | 21.13 | 13.46 | 28.79 | 16.08 | 10.90 | 21.27 |
Central Darfur | −1.65 | −1.94 | −1.36 | 41.95 | 32.56 | 51.34 | 20.96 | 9.20 | 32.71 | 20.93 | 12.62 | 29.24 |
East Darfur | −1.54 | −1.79 | −1.28 | 39.55 | 33.92 | 45.19 | 21.00 | 13.03 | 28.98 | 18.57 | 13.06 | 24.07 |
Kassala | −1.89 | −2.06 | −1.71 | 47.72 | 41.41 | 54.03 | 24.95 | 16.48 | 33.42 | 22.81 | 17.62 | 28.01 |
Khartoum | −1.07 | −1.30 | −0.85 | 25.19 | 18.03 | 32.34 | 16.59 | 8.35 | 24.82 | 8.52 | 4.42 | 12.61 |
North Darfur | −1.83 | −2.07 | −1.59 | 45.80 | 37.41 | 54.19 | 25.07 | 14.21 | 35.94 | 20.66 | 14.14 | 27.18 |
North Kordofan | −1.67 | −1.83 | −1.50 | 40.11 | 35.28 | 44.94 | 24.41 | 17.78 | 31.03 | 15.77 | 11.43 | 20.12 |
Northern | −1.20 | −1.43 | −0.96 | 30.17 | 22.77 | 37.56 | 19.40 | 10.89 | 27.92 | 10.86 | 5.56 | 16.15 |
Red Sea | −1.90 | −2.18 | −1.62 | 48.38 | 40.11 | 56.65 | 23.58 | 12.04 | 35.11 | 24.83 | 17.04 | 32.61 |
River Nile | −1.56 | −1.76 | −1.36 | 39.02 | 31.64 | 46.39 | 22.25 | 14.06 | 30.44 | 16.61 | 11.05 | 22.17 |
Sennar | −1.48 | −1.69 | −1.28 | 35.13 | 29.26 | 41.00 | 21.57 | 13.88 | 29.26 | 13.63 | 9.01 | 18.26 |
South Darfur | −1.16 | −1.35 | −0.96 | 23.68 | 16.17 | 31.19 | 16.81 | 8.19 | 25.42 | 6.78 | 2.56 | 10.99 |
South Kordofan | −1.67 | −1.90 | −1.44 | 40.77 | 31.75 | 49.79 | 22.80 | 12.21 | 33.39 | 17.81 | 11.28 | 24.35 |
West Darfur | −1.57 | −1.78 | −1.36 | 41.45 | 35.95 | 46.95 | 21.86 | 14.31 | 29.41 | 19.62 | 14.79 | 24.45 |
West Kordofan | −1.54 | −1.73 | −1.36 | 36.83 | 31.20 | 42.46 | 21.88 | 15.11 | 28.65 | 15.02 | 10.89 | 19.16 |
White Nile | −1.60 | −1.81 | −1.39 | 39.95 | 33.50 | 46.40 | 22.68 | 15.30 | 30.06 | 17.29 | 12.51 | 22.08 |
Sudan | −1.49 | −1.71 | −1.28 | 36.35 | 29.56 | 43.14 | 21.25 | 12.81 | 29.70 | 15.06 | 9.87 | 20.25 |
State | Mean WAZ | WAZ < −2% | WAZ −3 to −2% | WAZ < −3% | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Estimation | 95% LCL | 95% UCL | Estimation | 95% LCL | 95% UCL | Estimation | 95% LCL | 95% UCL | Estimation | 95% LCL | 95% UCL | |
Al Gedaref | −1.42 | −1.60 | −1.24 | 29.98 | 23.87 | 36.08 | 21.64 | 13.98 | 29.30 | 8.26 | 3.81 | 12.72 |
Al-Gezira | −1.27 | −1.42 | −1.12 | 23.68 | 16.57 | 30.79 | 18.64 | 10.88 | 26.40 | 4.88 | 1.63 | 8.12 |
Blue Nile | −1.19 | −1.33 | −1.04 | 21.30 | 15.67 | 26.94 | 16.93 | 10.56 | 23.30 | 4.34 | 1.59 | 7.10 |
Central Darfur | −1.56 | −1.80 | −1.32 | 33.64 | 26.40 | 40.89 | 22.57 | 12.62 | 32.52 | 10.84 | 4.85 | 16.82 |
East Darfur | −1.60 | −1.80 | −1.39 | 35.97 | 29.47 | 42.47 | 23.73 | 15.51 | 31.96 | 12.10 | 7.03 | 17.17 |
Kassala | −1.51 | −1.67 | −1.35 | 32.71 | 25.82 | 39.60 | 23.80 | 15.74 | 31.86 | 8.86 | 4.44 | 13.27 |
Khartoum | −1.19 | −1.37 | −1.01 | 23.48 | 16.59 | 30.37 | 17.70 | 10.07 | 25.33 | 5.75 | 2.00 | 9.50 |
North Darfur | −1.85 | −2.05 | −1.64 | 44.01 | 33.47 | 54.56 | 29.54 | 17.30 | 41.79 | 14.44 | 7.25 | 21.64 |
North Kordofan | −1.55 | −1.68 | −1.43 | 32.55 | 27.30 | 37.81 | 24.71 | 18.55 | 30.86 | 7.84 | 4.84 | 10.85 |
Northern | −1.36 | −1.54 | −1.17 | 26.82 | 18.88 | 34.76 | 20.73 | 12.12 | 29.34 | 5.73 | 2.10 | 9.36 |
Red Sea | −2.02 | −2.22 | −1.81 | 49.77 | 40.16 | 59.38 | 26.19 | 13.37 | 39.01 | 23.33 | 14.31 | 32.35 |
River Nile | −1.54 | −1.76 | −1.33 | 33.20 | 25.91 | 40.48 | 22.89 | 13.94 | 31.85 | 10.19 | 5.06 | 15.31 |
Sennar | −1.32 | −1.48 | −1.17 | 25.78 | 19.33 | 32.23 | 19.92 | 12.98 | 26.86 | 5.67 | 2.50 | 8.83 |
South Darfur | −1.29 | −1.45 | −1.13 | 22.27 | 16.14 | 28.39 | 18.22 | 11.38 | 25.06 | 3.97 | 0.71 | 7.22 |
South Kordofan | −1.32 | −1.50 | −1.14 | 26.07 | 19.12 | 32.93 | 20.15 | 12.25 | 28.05 | 5.88 | 2.41 | 9.35 |
West Darfur | −1.34 | −1.52 | −1.16 | 26.71 | 19.72 | 33.70 | 20.12 | 12.39 | 27.85 | 6.32 | 2.86 | 9.79 |
West Kordofan | −1.47 | −1.62 | −1.31 | 30.74 | 24.46 | 37.02 | 22.50 | 14.73 | 30.26 | 8.32 | 3.98 | 12.67 |
White Nile | −1.31 | −1.48 | −1.15 | 26.49 | 20.28 | 32.70 | 19.89 | 12.50 | 27.28 | 6.46 | 2.93 | 10.00 |
Sudan | −1.41 | −1.59 | −1.24 | 29.16 | 22.05 | 36.27 | 21.14 | 12.82 | 29.45 | 7.93 | 3.43 | 12.42 |
State | Mean WHZ | WHZ < 2% | WHZ −3 to −2% | WHZ < −3% | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Estimation | 95% LCL | 95% UCL | Estimation | 95% LCL | 95% UCL | Estimation | 95% LCL | 95% UCL | Estimation | 95% LCL | 95% UCL | |
Al Gedaref | −0.50 | −0.72 | −0.28 | 10.98 | 5.33 | 16.62 | 8.38 | 2.12 | 14.64 | 2.35 | 0.01 | 5.04 |
Al-Gezira | −0.61 | −0.77 | −0.44 | 10.44 | 6.18 | 14.70 | 8.90 | 4.46 | 13.35 | 1.45 | 0.10 | 2.80 |
Blue Nile | −0.44 | −0.61 | 0.27 | 7.02 | 3.25 | 10.79 | 6.01 | 2.10 | 9.92 | 0.92 | 0.01 | 2.12 |
Central Darfur | −0.82 | −1.04 | −0.60 | 16.46 | 9.03 | 23.89 | 12.65 | 4.64 | 20.66 | 3.65 | 0.16 | 7.14 |
East Darfur | −0.94 | −1.12 | −0.75 | 18.93 | 13.18 | 24.68 | 13.90 | 7.18 | 20.63 | 4.91 | 1.87 | 7.95 |
Kassala | −0.60 | −0.76 | −0.45 | 9.40 | 4.52 | 14.29 | 7.72 | 2.54 | 12.89 | 1.63 | 0.01 | 3.48 |
Khartoum | −0.81 | −1.00 | −0.61 | 14.61 | 9.98 | 19.25 | 11.92 | 6.79 | 17.04 | 2.56 | 0.75 | 4.37 |
North Darfur | −1.09 | −1.39 | −0.80 | 19.11 | 10.89 | 27.34 | 15.44 | 5.81 | 25.07 | 3.41 | 0.01 | 8.15 |
North Kordofan | −0.83 | −0.97 | −0.70 | 11.75 | 8.11 | 15.39 | 10.26 | 6.47 | 14.04 | 1.41 | 0.33 | 2.50 |
Northern | −0.88 | −1.08 | −0.68 | 16.46 | 11.19 | 21.72 | 12.82 | 7.12 | 18.53 | 3.47 | 0.92 | 6.02 |
Red Sea | −1.12 | −1.40 | −0.83 | 24.88 | 16.02 | 33.75 | 14.05 | 3.02 | 25.08 | 10.95 | 2.99 | 18.91 |
River Nile | −0.89 | −1.08 | −0.69 | 19.59 | 14.34 | 24.84 | 13.99 | 7.34 | 20.63 | 5.53 | 1.74 | 9.31 |
Sennar | −0.67 | −0.82 | −0.52 | 10.40 | 5.85 | 14.12 | 8.90 | 4.12 | 13.68 | 1.44 | 0.01 | 2.88 |
South Darfur | −0.92 | −1.12 | −0.71 | 15.03 | 8.50 | 21.56 | 12.38 | 5.41 | 19.36 | 2.59 | 0.01 | 5.33 |
South Kordofan | −0.51 | −0.70 | −0.33 | 7.83 | 3.26 | 12.39 | 6.78 | 2.29 | 11.27 | 0.94 | 0.01 | 2.20 |
West Darfur | −0.59 | −0.79 | −0.40 | 10.86 | 6.26 | 15.47 | 8.88 | 3.97 | 13.79 | 1.97 | 0.30 | 3.64 |
West Kordofan | −0.80 | −0.95 | −0.65 | 12.20 | 7.34 | 17.06 | 10.22 | 5.16 | 15.28 | 1.90 | 0.01 | 3.82 |
White Nile | −0.51 | −0.66 | −0.37 | 9.56 | 6.20 | 12.92 | 7.90 | 4.21 | 11.59 | 1.59 | 0.28 | 2.89 |
Sudan | −0.76 | −0.96 | −0.57 | 13.60 | 8.16 | 19.04 | 10.78 | 4.69 | 16.87 | 2.72 | 0.01 | 5.58 |
State | Mean MUAC (mm) | MUAC < 125 mm
GAM% | MAUC 115 mm–125 mm MAM% | MUAC < 115 mm
SAM% | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Estimation | 95% LCL | 95% UCL | Estimation | 95% LCL | 95% UCL | Estimation | 95% LCL | 95% UCL | Estimation | 95% LCL | 95% UCL | |
Al Gedaref | 143.59 | 141.82 | 145.36 | 6.62 | 2.99 | 10.25 | 5.61 | 2.03 | 9.19 | 0.97 | 0.01 | 1.96 |
Al-Gezira | 142.56 | 140.85 | 144.28 | 6.46 | 2.40 | 10.52 | 5.48 | 1.30 | 9.67 | 0.86 | 0.01 | 1.79 |
Blue Nile | 142.02 | 140.36 | 143.69 | 8.63 | 5.21 | 12.04 | 7.08 | 3.40 | 10.75 | 1.51 | 0.24 | 2.78 |
Central Darfur | 139.52 | 137.69 | 141.35 | 10.53 | 5.99 | 15.08 | 8.72 | 3.90 | 13.53 | 1.72 | 0.13 | 3.31 |
East Darfur | 138.49 | 136.74 | 140.24 | 13.02 | 7.26 | 18.79 | 10.51 | 4.10 | 16.92 | 2.40 | 0.26 | 4.55 |
Kassala | 139.54 | 138.05 | 141.02 | 12.45 | 8.46 | 16.44 | 9.79 | 5.03 | 14.55 | 2.73 | 0.88 | 4.58 |
Khartoum | 146.16 | 144.24 | 148.08 | 5.24 | 2.04 | 8.44 | 4.33 | 1.04 | 7.62 | 0.83 | 0.01 | 1.76 |
North Darfur | 136.79 | 134.94 | 138.64 | 15.86 | 9.59 | 22.13 | 12.43 | 5.60 | 19.26 | 3.22 | 0.75 | 5.69 |
North Kordofan | 141.88 | 140.37 | 143.40 | 6.79 | 3.29 | 10.29 | 5.81 | 1.99 | 9.63 | 0.89 | 0.01 | 1.98 |
Northern | 142.51 | 140.79 | 144.23 | 5.70 | 1.57 | 9.84 | 5.04 | 0.69 | 9.40 | 0.69 | 0.01 | 1.54 |
Red Sea | 132.20 | 129.99 | 134.42 | 29.60 | 21.84 | 37.36 | 20.95 | 11.81 | 30.09 | 8.50 | 3.27 | 13.72 |
River Nile | 140.95 | 138.97 | 142.93 | 10.65 | 4.63 | 16.66 | 8.38 | 2.21 | 14.55 | 1.98 | 0.01 | 4.55 |
Sennar | 144.24 | 142.54 | 145.94 | 6.47 | 2.85 | 10.09 | 5.29 | 1.68 | 8.89 | 1.03 | 0.01 | 2.16 |
South Darfur | 140.62 | 138.96 | 142.27 | 8.87 | 4.75 | 13.00 | 7.35 | 2.91 | 11.80 | 1.52 | 0.01 | 3.42 |
South Kordofan | 140.39 | 138.26 | 142.52 | 9.78 | 5.08 | 14.49 | 7.88 | 2.81 | 12.95 | 1.86 | 0.09 | 3.63 |
West Darfur | 140.06 | 138.63 | 141.49 | 9.02 | 4.90 | 13.14 | 7.58 | 3.66 | 11.50 | 1.34 | 0.19 | 2.50 |
West Kordofan | 138.76 | 137.01 | 140.51 | 11.99 | 6.42 | 17.57 | 9.94 | 4.09 | 15.78 | 1.91 | 0.14 | 3.67 |
White Nile | 141.99 | 140.40 | 143.58 | 7.97 | 2.71 | 13.22 | 6.34 | 1.05 | 11.64 | 1.19 | 0.01 | 2.75 |
Sudan | 141.44 | 139.66 | 143.21 | 9.50 | 4.90 | 14.09 | 7.63 | 2.69 | 12.56 | 1.76 | 0.01 | 3.62 |
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Abu-Manga, M.; Al-Jawaldeh, A.; Qureshi, A.B.; Ali, A.M.E.; Pizzol, D.; Dureab, F. Nutrition Assessment of Under-Five Children in Sudan: Tracking the Achievement of the Global Nutrition Targets. Children 2021, 8, 363. https://doi.org/10.3390/children8050363
Abu-Manga M, Al-Jawaldeh A, Qureshi AB, Ali AME, Pizzol D, Dureab F. Nutrition Assessment of Under-Five Children in Sudan: Tracking the Achievement of the Global Nutrition Targets. Children. 2021; 8(5):363. https://doi.org/10.3390/children8050363
Chicago/Turabian StyleAbu-Manga, Mohamed, Ayoub Al-Jawaldeh, Abdul Baseer Qureshi, Amira M. Elmunier Ali, Damiano Pizzol, and Fekri Dureab. 2021. "Nutrition Assessment of Under-Five Children in Sudan: Tracking the Achievement of the Global Nutrition Targets" Children 8, no. 5: 363. https://doi.org/10.3390/children8050363
APA StyleAbu-Manga, M., Al-Jawaldeh, A., Qureshi, A. B., Ali, A. M. E., Pizzol, D., & Dureab, F. (2021). Nutrition Assessment of Under-Five Children in Sudan: Tracking the Achievement of the Global Nutrition Targets. Children, 8(5), 363. https://doi.org/10.3390/children8050363