Measuring the burden of wasting & stunting |
1. |
How to estimate incidence of wasting over time in different contexts? |
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What is the global burden of children experiencing wasting and stunting concurrently? |
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What are the implications of the global burden of concurrent wasting and stunting on the global burden of mortality? |
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What is the global burden of severe stunting? |
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What are the implications of the global burden of severe stunting on mortality burden? |
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How do wasting and stunting develop and interplay in individuals over time? |
Understanding risk factors for wasting & stunting |
2. |
What is the role of pre-pregnancy nutritional status in determining risk of being born stunted and/or wasted? |
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Does foetal growth (in terms of timing of deficits in ponderal and/or linear growth) predict wasting and stunting? |
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Does anthropometric status at birth (in terms of ponderal and/or linear growth) predict wasting and stunting in childhood? |
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Does the process of stunting (slowing of linear growth) or wasting (loss of weight) carry greater risks for a child compared to the end point of being stunted or wasted in relation to the growth reference? |
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What role does gut health/inflammation play in wasting? |
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What are the long-term implications of wasting and stunting (separately and combined) in early life on adult health. |
Evaluating existing interventions |
3. |
What are the implications of rapid weight gain (as during wasting treatment) on body composition and function in childhood? |
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What are the implications of rapid weight gain (as during wasting treatment) on body composition and function in adulthood? |
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Does treatment of wasting support catch-up in linear growth? |
Basic research to develop or improve interventions |
4. |
What are the physiological/functional changes which occur during wasting and stunting and when both are underway concurrently? |
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How does body proportion and composition change during wasting and stunting, in particular muscle and fat mass? |
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At what level of wasting does linear growth slow down or speed up? |
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Does mid-upper arm circumference (MUAC) preferentially identify children for treatment who have lower weight-for-height and height-for-age in different contexts? |
Clinical research to develop or improve interventions |
5. |
What is the optimal formulation of RUTF to promote optimal ponderal growth and also support linear growth during and after SAM recovery? |
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Can nutrition convalescent support (e.g. provision of nutritional supplements & support triggered by a drop in weight-for-height or weight-for-age after acute illness), prevent both wasting and stunting? |
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What existing interventions work for treating severe stunting in order to prevent associated mortality? |
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What new interventions work in trial conditions for treating severe stunting in order to prevent associated mortality? |
Public Health research to develop or improve interventions |
6. |
Can interventions outside of the 1000 days, e.g. pre-school, school age and adolescence, lead to catch-up in height and in other developmental markers? |
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What existing interventions work for stunting reduction? |
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What new interventions work in trial conditions for stunting reduction? |
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What timely interventions work to mitigate seasonal peaks in undernutrition (both wasting and stunting)? |
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What are effective packages of interventions for both maternal nutrition and new-born outcomes? |
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How can pre-pregnancy nutrition support for adolescent girls be effectively and appropriately delivered? |
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What practical linkages between interventions to treat and prevent wasting and stunting will have the highest impact? (e.g. referral systems between programmes, carrying out mid-upper arm circumference (MUAC) checks at routine points of contact, etc.) |