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The Prevalence of Stunting Among Children and Adolescents Living in the Middle East and North Africa Region (Mena): A Systematic Review and Meta-Analysis Publisher Pubmed



Joulaei H1 ; Keshani P2 ; Ashourpour M3, 4 ; Bemani P5 ; Amiri S6 ; Rahimi J7 ; Aliakbarpour M1 ; Salehiabargouei A8
Authors
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Authors Affiliations
  1. 1. Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
  2. 2. Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
  3. 3. Department of Nutrition Sciences, School of Health, Larestan University of Medical Sciences, Larestan, Iran
  4. 4. Emam Reza Teaching Hospital, Larestan University of Medical Sciences, Larestan, Iran
  5. 5. Department of Immunology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  6. 6. Department of Epidemiology, Health School, Shiraz University of Medical Sciences, Shiraz, Iran
  7. 7. Department of Epidemiology and Biostatistics, School of Public Health, North Khorasan University of Medical Sciences, Bojnurd, Iran
  8. 8. Nutrition and Food Security Research Center, Department of nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

Source: Journal of Global Health Published:2021


Abstract

Background Given the strategic importance of the MENA, the state of war and inequity in the region and its effect on malnutrition which leads to mortality and reduced economic development in this region, the current study purposed to examine the prevalence of stunting as an indicator of chronic malnutrition in the MENA region, with consideration given HDI, rural/urban area, and war-involved countries. Methods The electronic databases of PubMed, SCOPUS, Web of science, and Embase were systematically searched, and English-language articles published between January 1, 2009 and December 31, 2019 were included in this study. The POLIS (population, outcome, location, indicator, study design) criteria were used to perform the systematic review, and studies involving children 2 to 18 years of age were selected. Results Fifty-eight (n = 2 202 869) were included based on the study's inclusion criteria. The prevalence of stunting in children in the total MENA region was 22.0% (95% confidence interval (CI) = 20.4-23.6; I2 = 99.92%, P < 0.0001). The studies included in the meta-analysis were analyzed by subgroups. The pooled prevalence of stunting in children aged 2-5 years old and children aged 6 and older was 25.7% and 16.5%, respectively. The pooled prevalence of stunting was 34.1% in rural and 12.4% in urban areas. The pooled prevalence of stunting according to HDI was 30.1%, 28.5%, 13.1%, in low, medium, and high HDI countries, respectively. Furthermore, the pooled prevalence of stunting according to war status was 28.5% in war-involved countries vs 20.6% in others. Conclusions High prevalence of malnutrition was seen based on stunting indicator in the meta-analysis study in the MENA region, and this issue became more pronounced when the data was divided into subgroups based on age, residential area, and HDI. Inequality regarding social, economic, and political factors leads to significant malnutrition in the mentioned region. © 2021 The Author(s) ISoGH. All Rights Reserved.
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