Mapping child growth failure across low- and middle-income countries

Childhood malnutrition is associated with high morbidity and mortality globally1. Undernourished children are more likely to experience cognitive, physical, and metabolic developmental impairments that can lead to later cardiovascular disease, reduced intellectual ability and school attainment, and reduced economic productivity in adulthood2. Child growth failure (CGF), expressed as stunting, wasting, and underweight in children under five years of age (0�59 months), is a specific subset of undernutrition characterized by insufficient height or weight against age-specific growth reference standards3�5. The prevalence of stunting, wasting, or underweight in children under five is the proportion of children with a height-for-age, weight-for-height, or weight-for-age z-score, respectively, that is more than two standard deviations below the World Health Organization�s median growth reference standards for a healthy population6. Subnational estimates of CGF report substantial heterogeneity within countries, but are available primarily at the first administrative level (for example, states or provinces)7; the uneven geographical distribution of CGF has motivated further calls for assessments that can match the local scale of many public health programmes8. Building from our previous work mapping CGF in Africa9, here we provide the first, to our knowledge, mapped high-spatial-resolution estimates of CGF indicators from 2000 to 2017 across 105 low- and middle-income countries (LMICs), where 99 of affected children live1, aggregated to policy-relevant first and second (for example, districts or counties) administrative-level units and national levels. Despite remarkable declines over the study period, many LMICs remain far from the ambitious World Health Organization Global Nutrition Targets to reduce stunting by 40 and wasting to less than 5 by 2025. Large disparities in prevalence and progress exist across and within countries; our maps identify high-prevalence areas even within nations otherwise succeeding in reducing overall CGF prevalence. By highlighting where the highest-need populations reside, these geospatial estimates can support policy-makers in planning interventions that are adapted locally and in efficiently directing resources towards reducing CGF and its health implications. © 2020, The Author(s)

Mapping child growth failure across low- and middle-income countries

Childhood malnutrition is associated with high morbidity and mortality globally. Undernourished children are more likely to experience cognitive, physical, and metabolic developmental impairments that can lead to later cardiovascular disease, reduced intellectual ability and school attainment, and reduced economic productivity in adulthood. Child growth failure (CGF), expressed as stunting, wasting, and underweight in children under five years of age (0–59 months), is a specific subset of undernutrition characterized by insufficient height or weight against age-specific growth reference standards, The prevalence of stunting, wasting, or underweight in children under five is the proportion of children with a height-for-age, weight-for-height, or weight-for-age z-score, respectively, that is more than two standard deviations below the World Health Organization’s median growth reference standards for a healthy population. Subnational estimates of CGF report substantial heterogeneity within countries, but are available primarily at the first administrative level (for example, states or provinces; the uneven geographical distribution of CGF has motivated further calls for assessments that can match the local scale of many public health programmes. Building from our previous work mapping CGF in Africa, here we provide the first, to our knowledge, mapped high-spatial-resolution estimates of CGF indicators from 2000 to 2017 across 105 low- and middle-income countries (LMICs), where 99% of affected children live, aggregated to policy-relevant first and second (for example, districts or counties) administrative-level units and national levels. Despite remarkable declines over the study period, many LMICs remain far from the ambitious World Health Organization Global Nutrition Targets to reduce stunting by 40% and wasting to less than 5% by 2025. Large disparities in prevalence and progress exist across and within countries; our maps identify high-prevalence areas even within nations otherwise succeeding in reducing overall CGF prevalence. By highlighting where the highest-need populations reside, these geospatial estimates can support policy-makers in planning interventions that are adapted locally and in efficiently directing resources towards reducing CGF and its health implications.Bill & Melinda Gates FoundationpublishedVersio

Mapping child growth failure across low- and middle-income countries

Child growth failure (CGF), manifested as stunting, wasting, and underweight, is associated with high 5 mortality and increased risks of cognitive, physical, and metabolic impairments. Children in low- and middle-income countries (LMICs) face the highest levels of CGF globally. Here we illustrate national and subnational variation of under-5 CGF indicators across LMICs, providing 2000–2017 annual estimates mapped at a high spatial resolution and aggregated to policy-relevant administrative units and national levels. Despite remarkable declines over the study period, many LMICs remain far from the World Health 10 Organization’s ambitious Global Nutrition Targets to reduce stunting by 40% and wasting to less than 5% by 2025. Large disparities in prevalence and rates of progress exist across regions, countries, and within countries; our maps identify areas where high prevalence persists even within nations otherwise succeeding in reducing overall CGF prevalence. By highlighting where subnational disparities exist and the highest-need populations reside, these geospatial estimates can support policy-makers in planning locally 15 tailored interventions and efficient directing of resources to accelerate progress in reducing CGF and its health implications

Design and Implementation of an Agent-Based Model of Pertussis with Performance Considerations

Pertussis, also known as Whooping Cough, is an airborne communicable disease caused by the Bordetella pertussis bacterium. Symptoms include fever, runny nose, and a cough that typically progresses to the point where it interferes with breathing, producing the characteristic whoop from which the common name is derived. Complications, which disproportionately affect infants, include bacterial pneumonia which can lead to death. Pertussis is vaccine-preventable and vaccination programs exist in most countries yet a recent resurgence has been observed in jurisdictions with high vaccine coverage, including Alberta and Canada. Simulation modeling has a long history in the study of epidemiology, including that of pertussis, but most of such work has employed compartmental models. Agent-based models (ABMs) allow differentiation down to the individual level, which cannot be done in aggregate compartmental models, as well as simpler specification of heterogeneity and interaction patterns which can be tedious to implement in aggregate compartmental models. These benefits come at the cost of increased computational burden. This thesis seeks to design and implement an ABM representing the epidemiology of pertussis in Alberta, Canada, and apply that model to evaluate vaccination during pregnancy as a potential intervention strategy to reduce pertussis incidence in infants. In support of this objective, data structures will be explored to improve performance for large ABMs developed using AnyLogic software

Antecedents and consequences of female consumer's attitude and lifestyle in facial care market

Evaluation of ethical marketing practices of businesses from a consumer perspective has often been prescribed as an international research direction, more particularly for the developing economies. In accordance with the above, this consumer study based in Malaysia investigated the antecedents and consequences of consumer attitude towards ethical marketing practices of firms depicted by product fairness, price fairness, and fairness aspects of marketing communications and channels of distribution in the facial care sector. Moderating influences of consumer lifestyle and demography were also taken into consideration in order to describe the scenario with enhanced precision and possibilities. The model under study was developed using the proven predictive power of the theory of planned behavior supported with the consumer decision process model. Relying on a survey research design, and following a rigorous multi stage sampling method, 483 female consumers falling within 15 years and above age range were surveyed from different parts of Malaysia. Descriptive analysis was done using SPSS, and inferential analysis using SmartPLS software, a variance based structural equations modeling tool. The findings revealed that product fairness, marketing communications, price fairness, and channels of distribution possess significant positive relationship with consumer attitude which further significantly predicts behavioral intention. Social factors and perceived behavioral control too were seen to predict behavioral intention which was further seen to influence the actual behavior of consumers. Consumer lifestyle as a whole, reflected through self-confidence, health consciousness, family orientation, religiosity, and women role and perception was found to have no moderation effect on the consumer attitude and behavioral intention relationship. The results of multi group analysis revealed that income of consumers exerts no moderation effect whereas education moderates the relationship of marketing communications, price fairness, and channels of distribution taken with consumer attitude. As Malaysian consumers exhibit serious concern towards ethical marketing practices of firms, it is recommended to the managers that they ensure fairness in their offerings, pricing, marketing communications and the way they make the products available to the consumers. Also, the policy makers are suggested to focus on creating awareness regarding the growing significance of ethical aspects, in addition to instituting desirable regulation