Forecasting Seasonal Acute Malnutrition: Setting the Framework.

Abstract

Malnutrition is an umbrella term that refers to an impairment in nutrition indicative of subsequently compromised human well-being. The term covers the full spectrum of nutritional impairments from a small yet detectable departure from a "norm" to a terminal stage when severe malnutrition could result in death. This broad spectrum of nutritional departures from "the optimum" dictates the need for an ensemble of metrics to capture the complexity of involved mechanisms, risk factors, precipitating events, short-term, and long-term consequences. Ideally, these metrics should be universally applicable to vulnerable populations, settings, ages, and times when people are most susceptible to malnutrition. We should be able to characterize and intervene to minimize the risk of malnutrition, especially child acute malnutrition that could be assessed by anthropometric measurements. The main challenge in reaching such an ambitious goal is the complexity of measuring, characterizing, explaining, predicting, and preventing malnutrition at any dimension: temporal or spatial and at any scale: a person or a group. The expansive body of literature has been accumulated on many temporal aspects of malnutrition and seasonal changes in nutritional (anthropometric) status. The research community is now shifting their attention to predictive modeling of child malnutrition and its importance for clinical and public health interventions. This communication aims to provide an overview of challenges for understanding child malnutrition from a perspective of predictive modeling focusing on well-documented seasonal variations in nutritional outcomes and exploring "the systems approach" to tackle underlining conceptual and practical complexities to forecast seasonal malnutrition in an accurate and timely manner. This generalized approach to forecasting seasonal malnutrition is then applied specifically to child acute malnutrition.