Authors

I Gabain¹; J Webster¹; TR Rosenstock²; BY Yet³;  ¹ Royal Veterinary College, UK;  ² Alliance Bioversity International and CIAT, France;  ³ Middle East Technical University, Turkey

Discussion

Childhood stunting is defined by the World Health Organization as falling more than -2 standard deviations below the height-for-age Child Growth Standards median and affects approximately 149.2 million children under five years globally. Soil-transmitted helminths (STH) and schistosomes are considered potentially causative in the mechanistic pathway to stunting.
Our research aims to identify potential causal associations between maternal helminthic infection during pregnancy and low birthweight (LBW) babies, and child helminthic infection and physical stunting. Identification of risk factors for stunting mainly relies on logistic regression models, which often assume independence between variables and cannot demonstrate causality. Directed Acyclic Graphs (DAGs) are visual tools for representing probabilistic relationships between variables (exposures, outcomes, and confounders) explicitly. Here, we built a DAG using the systematic Evidence synthesis for constructing directed acyclic graphs (ESC-DAGs) method. Bayesian Network Analysis (BNA) is a method used to infer causal relationships via specification of conditional probability distributions for variables in a DAG based on observed data. We are using BNA to explore the potential aforementioned associations using open-access Demographic Health Survey (DHS) data from selected countries within Africa and Asia. Our analysis involves pooling data across multiple years within individual countries, and collectively across sub-Saharan countries. Further, we are conducting analyses to determine potential improvements in outcomes (LBW and stunting) before and after the conception of mass drug administration programmes during the 2000s.
Results to date are discussed in terms of their theoretical and applied implications, primarily in terms of potential actionable insights regarding future deworming recommendations.