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Background: Over the past three decades, double burden of malnutrition (DBM), a situation where high levels of undernutrition (stunting, thinness, or micronutrient deficiency) coexist with overnutrition (overweight and obesity), continues to rise in sub-Saharan Africa. Compared to other countries in the region, the evidence on DBM is limited in Nigeria.
Objective: This paper aimed to determine the comparative prevalence of population-level and individual-level DBM among adolescents in two emerging cities in northern and southern Nigeria.
Methods: This was a comparative cross-sectional study among apparently healthy secondary school adolescents aged 10-18 years in Gombe (northern Nigeria) and Uyo (southern Nigeria) between January 2015 and June 2017. A multistage random sampling technique was implemented to recruit adolescents from 24 secondary schools in both cities. Measures of general obesity (body mass index) and stature (height-for-age) were classified and Z-scores generated using the WHO software, which is based on the WHO 2006 growth reference. Population-level DBM was defined as the occurrence of thinness and overweight/obesity within the population. Individual-level DBM was defined as the proportion of individuals who were concurrently stunted and had truncal obesity or stunted and were overweight/obese.
Findings: Overall, at the population-level in both settings, 6.8% of adolescents had thinness, while 12.4% were overweight/obese signifying a high burden of population-level DBM. Comparatively, the population-level DBM was higher in Gombe compared to Uyo (thinness: 11.98% vs 5.3% and overweight/obesity: 16.08% vs 11.27% in Gombe vs Uyo respectively). Overall, at the individual level, 6.42% of stunted adolescents had coexisting truncal obesity, while 8.02% were stunted and had coexisting general overweight/obesity. Like the trend with population-level DBM, individual-level DBM was higher in Gombe (northern Nigeria) compared to Uyo (southern Nigeria).
Conclusion: High levels of population-level and individual-level DBM exist in Gombe and Uyo. However, the level of DBM (under- and over-nutrition) is higher in Gombe located in northern Nigeria compared to Uyo in southern Nigeria.
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http://dx.doi.org/10.5334/aogh.3093 | DOI Listing |
Nutr Diet
August 2025
National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia.
Aims: This study aims to evaluate the existing definitions of double burden of malnutrition and to synthesise and propose operational definitions at different levels, with the goal of improving consistency in measurement and policy development.
Methods: We conducted a narrative review that used structured search and narrative synthesis to review and summarise how double burden of malnutrition has been defined at different levels. We performed a structured search across PubMed, Web of Science and Scopus, focusing on peer-reviewed articles published between January 2010 and December 2024.
Lancet Glob Health
May 2025
UCL Respiratory Research Department, Division of Medicine, University College London, London, UK. Electronic address:
Background: Cryptococcal meningitis is a major driver of global HIV-related mortality, and validated approaches to stratify mortality risk could help to target effective treatment strategies. We aimed to develop and validate models to predict risk of all-cause mortality in people with HIV-associated cryptococcal meningitis in sub-Saharan African countries.
Methods: For this prediction modelling study, we pooled individual-level data from the ACTA (ISRCTN45035509) and AMBITION-cm (ISRCTN72509687) randomised controlled trials.
Sci Rep
April 2025
Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
There is limited evidence on the burden and drivers of the co-occurrence of overweight/obesity and undernutrition at the individual level in low- and middle-income countries. This gap hinders the design of double-duty actions (DDAs) that can effectively address all forms of malnutrition. This multi-country study aimed to determine the magnitude of double burden of malnutrition (DBM) among under five children and identify household and individual level determinants in Eastern and Southern Africa (ESA) countries.
View Article and Find Full Text PDFFront Public Health
May 2025
Division of Computer, Electrical and Mathematical Science and Engineering, King Abdullah University of Science and Technology, Makkah, Saudi Arabia.
Background: The double burden of malnutrition (DBM) in the same individual is a neglected public health concern, especially in low- and middle-income countries (LMICs). The DBM is associated with increased risks of non-communicable diseases, childbirth complications, and healthcare costs related to obesity in adulthood. However, evaluating low prevalence outcomes in relatively small populations is challenging using conventional frequentist statistics.
View Article and Find Full Text PDFJ Pediatr (Rio J)
February 2025
The University of Texas Health Science Center at Houston, School of Public Health in Austin, Department of Epidemiology, Michael & Susan Dell Center for Healthy Living, Texas Physical Activity Research Collaborative (Texas PARC), Austin, TX, USA. Electronic address:
Objective: This study aimed to assess the prevalence of the double burden of malnutrition (DBM) at the individual level in children and adolescents through a comprehensive literature review.
Sources: Electronic databases, including PubMed, Scopus, and Web of Science, were searched for articles published up until September 9, 2022. Studies reporting individual-level DBM in children and adolescents were included, and meta-regression models were used to investigate potential causes of heterogeneity across studies.