Rally 4D

Wasting Analysis Clean-Up and Documentation

The Bill & Melinda Gates Foundation launched the Health Birth, Growth, and Development knowledge initiative (HBGDki) to collect study data from around the world and analyze the studies to answer key questions related to child growth and development. This knowledge integration will be used to define precise strategies to prevent preterm birth, growth faltering, wasting, and impaired neurocognitive development. The longitudinal analysis of wasting outlined in this document will address questions 2 and 4 of the HBGDki key questions, which ask: “What kind of recovery can we expect in infants born small for gestational age (SGA)?” and “Are there disproportionately large contributions to growth faltering from specific pathways, and can we rank-order risk factors?” The analyses in rallies 4A and 4B produced many questions about the context of the different studies that were being combined for the aggregate analysis that was performed. The first two rallies also included many complex analyses which need to be checked, verified, and fully documented. This rally sprint will ensure that the results of prior Rally 4 analyses are sound, as well as making sure future analyses will be productive. It is important to review the data and methods to ensure all assumptions are being met. It will also be used to create an analysis plan for the fully Rally 4 analysis, and create a project timeline.

Focus

In this rally, we will: 1. Clean up and document prior analyses. 2. Verify accuracy of incidence calculations against simulated data with a known incidence rate. 3. Combine prior analysis results with a more extensive literature review in order to make plans for further analyses. 4. Investigate context of all the studies that were combined in prior analyses and quality-assurance check each cohort's anthropometry measurements. 5. Draft an analysis plan formalizing all preliminary analyses completed in the rally and finalizing analyses to be completed and publications to be written as part of the project. 6. Draft a timeline for project completion

Background

Wasting (a weight-for-height Z-score < −2) and severe wasting (a weight-for-height Z-score < −3) are used to define moderate (MAM) and severe acute malnutrition (SAM). Wasting results from a loss of muscle and fat tissue due to acute malnutrition, infection, or the interaction between malnutrition and infection. Wasting is a serious condition as children with less fat stored are both at risk of starvation and have weakened immune systems and are vulnerable to disease. Severely wasted children are 11 times more likely to die than healthy children, and moderately wasted children also have an increased risk of mortality.4 Children who recover from wasting may have an increased risk of with poor long-term growth and neurocognitive development. Wasting affects at least 50 million children worldwide, and while treatment with fortified therapeutic foods has reduced the prevalence of severe wasting, prevalence of moderate wasting has not decreased over the last 30 years.

value

Not specified.