Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4 (62.3 (55.1�70.8) million) to 6.4 (58.3 (47.6�70.7) million), but is predicted to remain above the World Health Organization�s Global Nutrition Target of <5 in over half of LMICs by 2025. Prevalence of overweight increased from 5.2 (30 (22.8�38.5) million) in 2000 to 6.0 (55.5 (44.8�67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic. © 2020, The Author(s)

Author Correction: Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017 (Nature Medicine, (2020), 26, 5, (750-759), 10.1038/s41591-020-0807-6)

An amendment to this paper has been published and can be accessed via a link at the top of the paper. © 2020, The Author(s)

Author Correction: Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017 (Nature Medicine, (2020), 26, 5, (750-759), 10.1038/s41591-020-0807-6)

An amendment to this paper has been published and can be accessed via a link at the top of the paper. © 2020, The Author(s)

The Association of Maternal Social Factors and Antenatal Care with Cord Serum Zinc in Full – Term Neonates

Zinc is a crucial micronutrient in early childhood survival and the development of innate and acquired immunity. The objective is to determine the relationship between of maternal social class and antenatal care to serum zinc level in newborns in a tertiary and a rural hospital. It is prospective study using questionnaires on consecutive mothers with normal pregnancy(excluding sepsis and chronic illneses) and cord serum level of Zinc estimation in newborns using flame atomic absorption spectrophotometry. There were 106 mothers and neonates; were made up of 57 females and 49 males. The ages of the mother ranged between 21 years to 39 years, with a mean of 26 years; while the gestational age of the neonates ranged between 30 weeks and 45 weeks with a mean of 37.3. The range of the serum Zinc was 0.14μg/L – 0.92μg/L, with a mean of 0.64μg/L (SD=0.17) and median value of 0.63μg/L. The social classes of the mothers were low 66, middle 23 and high 17 with mean neonatal serum zinc of 0.62μg/L, 0.68μg/L and 0.72μg/L. The mean serum Zinc in 17/86 neonates of mothers with inadequate tetanus vaccination was 0.53μg/L, (below the median value) compared to 0.66μg/L in 89/106 neonates of mothers with complete vaccination. The serum zinc in the neonates of mothers <25 years of age was 0.68μg/L compared to 0.61μg/L in the neonates of mothers >25years. Fever in pregnancy was seen in 31/106; with mean neonatal serum Zinc of 0.63μg/L compared with those without fever 0.65μg/L. There were 94 neonates with normal weight (>2.5kg) and 12 low birth weight (<2.5kg) with mean serum Zinc of 0.69μg/L and 0.66μg/L respectively. Antenatal care was complete in 81 and incomplete in 25 with mean neonatal serum Zinc of 0.66μg/L and 0.56μg/L respectively. Univariate analysis revealed significant correlation between the mean serum Zinc and the socioeconomic class (P = 0.022), but there was no correlation with maternal age (P=0.327), sex (P=0.566), gestational age (P=0.100), birth weight (P=0.365), vaccination (P=0.954), malaria fever (P=0.875) and antenatal care (P=0.97), We concluded that low social status of the mothers and inadequate vaccination in pregnancy were major factors associated with low neonatal serum zinc. The control of these factors may impact on optimal neonatal nutrition

Author Correction: Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017 (Nature Medicine, (2020), 26, 5, (750-759), 10.1038/s41591-020-0807-6)

An amendment to this paper has been published and can be accessed via a link at the top of the paper. © 2020, The Author(s)

Global injury morbidity and mortality from 1990 to 2017: Results from the global burden of disease study 2017

Background Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries. methods We reviewed results for injuries from the GBD 2017 study. GBD 2017 measured injury-specific mortality and years of life lost (YLLs) using the Cause of Death Ensemble model. To measure non-fatal injuries, GBD 2017 modelled injury-specific incidence and converted this to prevalence and years lived with disability (YLDs). YLLs and YLDs were summed to calculate disability-adjusted life years (DALYs). Findings In 1990, there were 4 260 493 (4 085 700 to 4 396 138) injury deaths, which increased to 4 484 722 (4 332 010 to 4 585 554) deaths in 2017, while age-standardised mortality decreased from 1079 (1073 to 1086) to 738 (730 to 745) per 100 000. In 1990, there were 354 064 302 (95% uncertainty interval: 338 174 876 to 371 610 802) new cases of injury globally, which increased to 520 710 288 (493 430 247 to 547 988 635) new cases in 2017. During this time, age-standardised incidence decreased non-significantly from 6824 (6534 to 7147) to 6763 (6412 to 7118) per 100 000. Between 1990 and 2017, age-standardised DALYs decreased from 4947 (4655 to 5233) per 100 000 to 3267 (3058 to 3505). Interpretation Injuries are an important cause of health loss globally, though mortality has declined between 1990 and 2017. Future research in injury burden should focus on prevention in high-burden populations, improving data collection and ensuring access to medical care. © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ