Characterisation and Sociodemographic Determinants of Stunting Among Malaysian Children Aged 6-19 Years

December 6, 2017 updated by: Manjinder Sandhu
Child stunting remains an important global health issue, with 157 million children under five years of age estimated to be stunted in 2014. Until recently, stunting was thought to occur in the first 1000 days of life (between conception and 2 years of life), and was thought to be largely irreversible thereafter. However, emerging research suggests that children can transition between stunted and non stunted status up to 15 years of age, with studies also suggesting potential implications in terms of cognitive status. Despite this, there is little research on stunting and its potential determinants among children of older ages, with most current studies confined to those under five. This study aims to assess the prevalence of stunting and examine potential sociodemographic determinants of stunting (including individual, maternal and household level indices) among older children (aged 6-19 years) in a Malaysian population.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

This analysis is based on existing data collected by a health and demographic surveillance system operating in Segamat, Malaysia, and data for all individuals meeting the stated inclusion criteria are used in the study.

There is not a specific control treatment in this study. Rather, we calculate the risk of stunting associated with (1) a unit increase in each exposure, or (2) categories of exposure with respect to a referent category. Specifically, for the primary exposures as listed above:

  • Age: risk per year increase
  • Sex: risk in girls versus boys (referent)
  • Ethnicity: risk in (1) Indian, (2) Chinese, (3) Indigenous or (4) Other ethnicity, versus Malay (referent)
  • BMI-for-age status: risk in (1) underweight or (2) overweight, versus normal weight (referent)
  • Birth order: risk in children of second, third and fourth or higher birth order, versus first born (referent)
  • Maternal height: risk in children of mothers with height 155-159cm, 150-154cm, 145-149cm, and <145cm, versus those with height 160cm or higher (referent)
  • Maternal current underweight: risk in children of mothers with BMI <18.5 kg/m2, versus those with BMI >=18.5 kg/m2 (referent)
  • Rooms (bedrooms, bathrooms, living areas) per household member: risk per unit increase in room to person ratio for each room type
  • Type of toilet: risk among children in households with (1) Bore hole toilet, (2) Pour flush toilet, (3) Flush toilet with septic tank, (4) Flush toilet connected with sewerage system, versus those living in households with none, bucket or hanging latrine (referent)
  • Toilet shared with other household (yes/no): risk among children in households with a shared toilet, versus those living in households without one
  • Main source of drinking water: risk among children in households using water from (1) Public standpipe or other protected source, (2) Piped into yard, (3) Piped into house, versus those living in households using an unprotected source (referent)
  • Main method of garbage disposal: risk among children in households having their garbage (1) Collected and thrown for recycling, (2) Collected irregularly by local authority, (3) Collected regularly by local authority, versus in those in households where garbage is buried, burned or thrown (referent)

Methods for crude analysis and gaining an introductory sense of the data include examination of variable distributions and clustering of the outcome variable of interest (stunting or height-for-age). Exposure variables are assessed by stunting status; differences between stunted and non-stunted groups are assessed using Student's t test for continuous variables, and Pearson's chi squared test (Fisher's exact test for variables with cell counts <5) for categorical variables. Additionally, the classification and prevalence of stunting is assessed using two different references: the World Health 2007 reference and Centers for Disease Control and Prevention 2000 reference; agreement in classification between the two is calculated using Cohen's kappa.

The primary method of analysis is mixed effects Poisson regression, with stunting as the outcome of interest. Final models include all exposure variables of interest, in order to assess any independent associations between each exposure and stunting risk. All models are adjusted for clustering at the household level.

A number of secondary analyses are used in order to check the robustness and specificity of associations. These include:

  1. Adding maternal age as a covariate in models, examining associations of maternal age with stunting, and the effect of its addition on other associations
  2. Adding in maternal education, paternal education or head of household's education, and assessing subsequent effects as described in (1)
  3. Adding in paternal height, and assessing subsequent effects as described in (1)
  4. Adding in a number of theoretically uncorrelated variables to test the specificity of associations, and assessing subsequent effects as described in (1)
  5. Using mixed effects linear regression, with height-for-age z-score as the outcome of interest. Final models include all exposure variables of interest, in order to assess any independent associations between each exposure and stunting risk. All models are adjusted for clustering at the household level.

Both the primary and secondary analyses are run with stunting or height-for-age expressed according to (1) the Centers for Disease Control and Prevention 2000 reference and (2) the World Health Organization 2007 reference.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Observational

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
6759

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

6 years to 19 years (Child, Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

This study is based on existing observational data collected by the the South East Asia Community Observatory (SEACO), a health and demographic surveillance system (HDSS) covering approximately 45 000 individuals in Segamat, Malaysia. The HDSS regularly (annually) enumerates all consenting households and individuals within its catchment area, and has also conducted a health survey to date during which basic sociodemographic, lifestyle-related and anthropometric data were collected from individuals aged 6 years and above. Further information on the SEACO HDSS can be found at: https://academic.oup.com/ije/article/46/5/1370/4037470.This study uses cross-sectional data on children aged 6-19 years, collected between 2012-2014.

Description

Inclusion Criteria:

  1. Age >= 6 years and <= 19 years
  2. Whether or not the potential participant has information on all exposure and outcome variables of interest.

Exclusion Criteria None

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Observational Models: Other
  • Time Perspectives: Cross-Sectional

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Child stunting
Time Frame: This was a one-time measurement, taken during a survey.
Stunting was expressed using the Centers for Disease Control and Prevention 2000, and the World Health Organization 2007 references.
This was a one-time measurement, taken during a survey.

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Child height-for-age
Time Frame: This was a one-time measurement, taken during a survey (as above).
Height-for-age z-score was expressed using the Centers for Disease Control and Prevention 2000, and the World Health Organization 2007 references. (Same measure as above, but expressed as a continuous rather than categorical variable).
This was a one-time measurement, taken during a survey (as above).

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Manjinder Sandhu

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Daniel D Reidpath, PhD, Monash University Malaysia

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
April 12, 2012

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
September 23, 2014

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
September 23, 2014

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
November 30, 2017

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
November 30, 2017

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
December 6, 2017

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
December 8, 2017

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
December 6, 2017

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
December 1, 2017

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • U1111-1203-0963

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

Undecided

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

Clinical Trials on Stunting

Clinical Trials on No intervention

Search Similar Trials

Sponsors and Collaborators

Medical Conditions

Drug Interventions

Conditions

Rare Diseases

Drug Interventions

Dietary Supplements

Sponsor/Collaborators

Locations

Cookie Settings

We use cookies to ensure that we give you the best experience on our website. For more details carefully read our Privacy and Cookies Policy. ...>>>You can change your preferences or withdraw your consent at any time by deleting the cookies from your website or computer as described in the policy. Please accept it and choose your preferences by ticking the corresponding boxes in the "Manage Settings" section below. Please carefully read our Terms of Service before you proceed with using any part of this website.
«Manage Settings