MEASURING MALNUTRITION-THE ROLE OF Z-SCORES AND THE COMPOSITE INDEX OF

ANTHROPOMETRIC FAILURE

Seetharaman N, chacko TV, shankar SLR, Mathew AC

Indian Journal of community medicine vol.32 (1):Jan 2007;35-39

Moderator: Presenter:Dr.Abhishek Raut Rohan R Patil

Introduction: India

-highest % of undernourished children

-problem accentuated in slum

Classifications:-Gomez-Waterlow

?

Further Answers: WHO

-NCHS-Z Score

Composite index of anthropometric Failure (CIAF)

objective To learn to understand use of different

anthropometric measurement among children

To learn Z-score computation

Objective of study:

To estimate the magnitude of undernutrition among under five children in slums by using

Z score system and CIAF

Material and Methods: Study type: Cross sectional study

Study area: Urban Health Centre of PSG Institute of Medical Sciences & Research

Study Participant: 0-5 yrs children

Sample size: 405 study subjects

Material and Methods: Data collection: -Age of child -nutritional assessment

Analysis:-Epi info-Chi square test

Clinical examination Anthropometry

Results:

Indicators Frequencies(%)

Majority of Study population (Hindus) 93.6%

Nuclear Families 70%

Open air defecation 65.2%

Overcrowding dwellings 74.8%

Per capita income less than 750 Rs 86.4%

Results:

45.70%54.30% malefemale

Sex wise distribution among 0-59 months children

Age groupmonths

Male % Female % Total %

0-11 19.5 14.6 16.8

12-23 23.2 16.8 19.8

24-35 20.5 22.3 21.5

36-47 21.1 20 20.5

48-59 15.7 26.4 21.5

Age wise distribution among children

ResultsClassification of children with anthropometric failureGroup Anthropometric status No. of children

A No failure 127(31.4%)

B Wasting only 11(2.2%)

C Wasting + Underweight 48(11.9%)

D Wasting + stunting+ underweight 23(5.7%)

E Stunting + underweight 100(24.7%)

F Stunting only 78(19.3%)

Y Underweight only 18(4.4%)

Total 405(100%)

Results

Z ScoreIAP

Normal Undernutrition Severeundernutrition

Total

Normal 197 00 00 197(48.6%)

Mild(I) 19 93 00 112(27.7%)

Moderate(II) 00 19 64 83(20.5%)

Severe(III & IV)

00 00 13 13(3.2%)

total 216(53.3%)

112(27.7%)

77(19%)

405(100%)

Comparison of the IAP and the Z-score system

Discussion

IAP system identifies 4.8% more children with undernutrition

Z score system identifies significantly more children with severe undernutrition

Conclusion

As this system enables estimation of all three indices

More widespread use of z score system classification especially in community based trial is recommended

Comment Objectives are not clearly defined

Duration of study ???

Discussion is not properly written

If clinical assessment was done then why not morbidity data assessed?

Study is slum based why not study participants selected from rural and

urban setting?

Thank you

r