TY - JOUR
A1 - Seetharaman, N
A1 - Chacko, T
A1 - Shankar, SLR
A1 - Mathew, A
T1 - Measuring malnutrition -The role of Z scores and the composite index of anthropometric failure (CIAF)
Y1 - 2007/1/1
JF - Indian Journal of Community Medicine
JO - Indian J Community Med
SP - 35
EP - 39
VL - 32
IS - 1
UR - http://www.ijcm.org.in/article.asp?issn=0970-0218;year=2007;volume=32;issue=1;spage=35;epage=39;aulast=Seetharaman
DO - 10.4103/0970-0218.53392
N2 - **Background : ** The current WHO recommendation is to use the Z-Score or SD system to grade undernutrition which allows us to measure all the three indices and express the results in terms of Z scores or standard deviation units from the median of the international reference population.
** Objectives : ** To estimate the prevalence of undernutrition among under-five children in Coimbatore slums, using the Z-Score system of classification and the recently constructed Composite Index of Anthropometric Failure (CIAF). 2. To compare the Z-Score system with the Indian Academy of Pediatrics (IAP) classification of undernutrition.
** Methods : ** Nutritional assessment was done using anthropometry and clinical examination. Children were weighed and measured as per the WHO guidelines on Anthropometry. Epi-Info 2002 software package was used to calculate the Z scores and for statistical analysis.
** Results : ** Only 31.4% of the children studied were normal; 68.6% were in a state of "Anthropometric Failure". As per the Z score system, 49.6% were underweight (21.7% severely); 48.4% were stunted (20.3% severely) and 20.2% were wasted (6.9% severely). Whereas, as per IAP criteria, 51.4% were undernourished and 3.2% were severely undernourished. Using Underweight (low weight-for-age) as the only criterion for identifying undernourished children (as done in the Integrated Child Development Services currently) may underestimate the true prevalence of undernutrition, by as much as 21.9%.
** Conclusions : ** More widespread use of the Z-Score system is recommended for identifying all the facets of undernutrition. Estimates of the true prevalence of undernutrition must incorporate a composite index of anthropometric failure.
ER -