Prognostic value of different anthropometric indices over different measurement intervals to predict mortality in 6-59-month-old children

André Briend*, Mark Myatt, James A Berkley, Robert E Black, Erin Boyd, Michel Garenne, Natasha Lelijveld, Sheila Isanaka, Christine M McDonald, Martha Mwangwome, Kieran S O'Brien, Catherine Schwinger, Heather Stobaugh, Sunita Taneja, Keith P West, Tanya Khara

*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

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Abstract

Objective: To compare the prognostic value of mid-upper arm circumference (MUAC), weight-for-height Z-score (WHZ) and weight-for-age Z-score (WAZ) for predicting death over periods of 1, 3 and 6 months follow-up in children.

Design: Pooled analysis of twelve prospective studies examining survival after anthropometric assessment. Sensitivity and false-positive ratios to predict death within 1, 3 and 6 months were compared for three individual anthropometric indices and their combinations.

Setting: Community-based, prospective studies from twelve countries in Africa and Asia.

Participants: Children aged 6-59 months living in the study areas.

Results: For all anthropometric indices, the receiver operating characteristic curves were higher for shorter than for longer durations of follow-up. Sensitivity was higher for death with one month follow-up compared to six months by 49% (95% CI (30-69)) for MUAC <115 mm (P<0.001), 48% (95% CI (9.4-87)) for WHZ <-3 (P<0.01) and 28% (95% CI (7.6-42)) for WAZ <-3 (P<0.005). This was accompanied by an increase in false positives of only 3% or less. For all durations of follow-up, WAZ <-3 identified more children who died and were not identified by WHZ <-3 or by MUAC <115 mm, 120 mm or 125 mm, but the use of WAZ <-3 led to an increased false-positive ratio up to 16.4% (95% CI (12.0-20.9)) compared to 3.5% (95% CI (0.4-6.5)) for MUAC <115 mm alone.

Conclusions: Frequent anthropometric measurements significantly improve the identification of malnourished children with a high risk of death without markedly increasing false-positives. Combining two indices increases sensitivity but also increases false positives among children meeting case definitions.

OriginalsprogEngelsk
TidsskriftPublic Health Nutrition
Vol/bind26
Udgave nummer6
Sider (fra-til)1210-1221
Antal sider12
ISSN1368-9800
DOI
StatusUdgivet - 2023

Bibliografisk note

CURIS 2023 NEXS 047

Emneord

  • Det Natur- og Biovidenskabelige Fakultet

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