广东省4个月婴儿生长状况与喂养模式调查

在广东省的城乡对７７７名４个月的婴儿进行了生长状况与喂养模式的现况调查，与ＷＨＯ推荐的ＮＣＨＳ体格生长标准比较，城市婴儿４个月时其身长与体重的发育良好，而农村婴儿的身长和体重则低于参考标准，也低于同龄的城市婴儿。６４％城市婴儿和９９％的农村婴儿在４个月时仍喂哺母乳，７７％的城市婴儿和５９％的农村婴儿４个月前已经添加了辅助食品，辅助食品的种类有明显的城乡差别，农村辅食质量次于城市。母乳喂养有利于城乡４个月婴儿的体重生长，４个月前添加辅食影响农村婴儿体重生长。应继续在广东城乡提倡母乳喂养，不提倡过早添加辅食，应提高农村婴儿的断奶过渡食品的质量。     

6～24月龄中国婴幼儿喂养指数评价方法的建立

目的建立6～24月龄中国婴幼儿喂养指数,为综合评价婴幼儿喂养提供有效的工具。方法以2002年Ruel和Menon提出的喂养指数概念为基础,根据世界卫生组织(WHO)喂养建议和中国0～6岁儿童膳食指南,建立喂养指数确定各变量分类及分值,利用四川、河北、黑龙江三地区城乡6～24月龄共1738名婴幼儿年龄别体重(WAZ)、年龄别身长(HAZ)和身长别体重(WHZ),分析喂养指数与婴幼儿Z评分之间的相关性。结果喂养指数由持续母乳喂养、奶瓶使用、过去24小时膳食摄入种类和膳食摄入频率、过去一周辅食添加天数、配方奶首添时间、除配方奶外其他辅食首添时间7部分组成;城市婴幼儿喂养指数评分显著高于农村(P<0.05);城市6～8月龄组婴幼儿喂养指数得分低于9～24月龄组婴幼儿(P<0.05);城市婴幼儿喂养指数与WAZ、WHZ显著负相关(P<0.05),农村喂养指数与HAZ显著正相关(P<0.05),与WHZ显著负相关(P<0.05)。结论本研究建立的喂养指数可有效评价我国6～24月龄婴幼儿的喂养情况。     

广东省6～18月龄婴幼儿喂养指数分布及与体格发育的相关性研究

目的分析广东地区6—18月龄婴幼儿喂养指数（ICFI）及与体格发育指标之间的相关性,以探讨ICFI应用于定量评估和比较婴幼儿喂养习惯的有效性。方法整群抽取广东省广州市荔湾区（城市）、佛山市南海区（城镇）、江门市新会区（农村）所有已建立健康档案的6—18月龄婴幼儿,问卷凋查喂养现况及测查体格发育。以中国疾病预防控制中心营养与食品安全所提出的ICFI评分体系为依据,计算评价ICFI。使用WHO推荐的Anthro软件计算婴幼儿的年龄别身长z评分（HAZ）、年龄别体重z分（wAz）、身长别体重z分（WHZ）。分析ICFI与各类z评分的相关性。结果共调查6～18月龄婴幼儿1771人,其中男997人,女774人。全省ICFI为（7．05±2．47）,高于全国平均值（5．9±2．6）,其中城市（474人）、城镇（658人）ICFI分别为（7．29±2．25）和（7．39±2．53）,明显高于农村（639人）ICFI（6．52±2．49）（P〈0．05）。6—8月龄（606人）、9～11月龄（317人）、12—18月龄（848人）ICFl分别为（6．59±2．47）、（6．87±2．45）、（7．44±2．42）,ICFI随月龄增加而增加（P〈0．01）。ICFI总合格率49．2％（872／1771）,其中城市、城镇和农村分别为53．0％（251／474）、56．7％（373／658）和38．8％（248／639）,城市、城镇合格率高于农村（P〈0．01）,6—8、9～11、12～18月龄合格率分别为37．6％、46．7％和58．5％,随月龄增加,合格率明显提高（P〈0．01）。城市ICFI与HAZ、WHZ相关（r=0．108、0．117,均P〈0．05）,城镇ICFI与WHZ相关（r=0．104,P〈0．01）。12～18月龄组ICFI与WAZ和HAZ相关（,=0．110、0．136,均P〈0．01）。结论广东省6～18月龄婴幼儿ICFI高于全国平均值。ICFI可在一定程度上反映出婴幼儿群体的生长发育状况,并可用于婴幼儿喂养方法的综合评判,但其应用效度有待改善。     

广东4月龄婴儿生长影响因素的多元回归分析

目的：对广东省７７７名城乡４月龄健康婴儿的生长与２８个环境和遗传因素的关系进行调查。方法：以ＷＨＯ推荐的儿童身高和体重标准作参考，采用美国疾病控制中心的Ａｎｔｈｒｏ软件计算年龄别身高Ｚ分（ＨＡＺ），年龄别体重Ｚ分（ＷＡＺ）和身高别体重Ｚ分（ＷＨＺ），进行多元回归分析。结果：城乡地区、婴儿出生体重、父亲年龄、父母亲身高和学历显著影响婴儿的ＨＡＺ（Ｐ＜０．０１）。婴儿出生体重、城乡地区、母亲身高、父亲籍贯、曾患过病显著影响婴儿的ＷＡＺ（Ｐ＜０．０１）。城乡地区、婴儿出生身长和体重、家庭收入、因病住过医院显著影响婴儿的ＷＨＺ（Ｐ＜０．０１）。结论：环境和遗传因素综合影响广东婴儿的生长。提高家长的文化水平，普及营养知识，加强教育是改善婴儿生长的重要措施，尤其是在农村地区更具实际意义     

Impact of intestinal permeability, inflammation status and parasitic infections on infant growth faltering in rural Bangladesh

A longitudinal study of 298 rural Bangladeshi infants found evidence of growth faltering starting at 3 months of age. Anthropometric status declined substantially in the first 2 years of life, with weight-for-height (WHZ) falling from - 0.49 to - 1.75, weight-for-age (WAZ) from - 1.18 to - 2.87 and height-for-age (HAZ) from - 1.00 to - 1.88. Higher concentrations of the acute-phase protein alpha-1-acid glycoprotein (AGP) and higher gut mucosal damage (as signified by raised lactulose:mannitol (L:M) ratios) were both associated with chronic malnutrition as indicated by poorer HAZ and WAZ scores (P = 0.011 and 0.005 for AGP and 0.039 and 0.019 for L:M ratio, respectively). Higher Hb levels were related to improved z-scores, while elevation of Giardia-specific IgM titre (GSIgM) was associated with poor WAZ and WHZ (P = 0.015 and 0.039, respectively). IgG did not show any significant association with z-scores and the L:M ratio did not correlate with any of the inflammation markers or Giardia infection. The prevalence of geohelminth infections was low (only 4 % in the total study period). However, the level of GSIgM indicated high endemicity of Giardia infection from early in life, although very few cysts were detected from stool samples. These findings suggest that rural Bangladeshi infants are being exposed to high levels of infection with concomitant gut damage and growth faltering.     

汶川大地震后3个月四川省北川和理县6～23月龄婴幼儿的营养状况

目的 调查分析四川省北川、理县两个地震重灾区6～23月龄婴幼儿的营养状况.方法 测量了北川县擂鼓镇、曲山镇和理县杂谷脑镇、薛城镇和朴头乡478名6～23月龄婴幼儿的身长、体重和血红蛋白(Hb)水平,6～11、12～17、18～23月龄段婴幼儿分别为190、144、144名;分别计算年龄别体重(WAZ)、年龄别身长(HAZ)、身长别体重(WHZ);分析低体重率、生长迟缓率、消瘦率、贫血率情况.结果 6～23月龄男童和女童WAZ平均值分别为-0.97～-0.13、-0.67～-0.23,HAZ平均值分别为-1.23～-0.31、-1.25～-0.38;北川18～23月龄婴幼儿的WAZ(-0.89±1.16)和HAZ(-1.20±1.60)与6～11和12～17月龄婴幼儿差异具有统计学意义(WAZ分别为-0.32±0.92、-0.47±1.00,HAZ分别为-0.58±0.98、-0.68±1.34;F值分别为7.161、4.584,P值均＜0.05);理县18～23月龄婴幼儿的WAZ(-0.65±1.03)和HAZ(-1. 11±1.15)与6～11和12～17月龄的婴幼儿的差异具有统计学意义(WAZ分别为-0.23±0.93、-0.58±0.52,HAZ分别为-0.51±1.55、-0.80±1.19;F值分别为3.156、4.345,P值均＜0.05).北川和理县18～23月龄婴幼儿低体重率分别为15.6%(12/77)和9.1%(6/66);生长迟缓率分别为26%(20/77)和24.2%(16/66).北川18～23月龄婴幼儿的消瘦率达到了9.1%(7/77).北川、理县婴幼儿贫血率分别高达49.6%(123/248)和78.8%(178/226).中度贫血率达到7.7%(19/248)和19.9%(45/226).结论 震后北川、理县6～23月龄婴幼儿生长发育状况不佳;贫血率较高.18～23月龄婴幼儿的营养不良更为严重,应采用有针对性的营养干预.     

7岁以下农村儿童体格发育调查

目的:了解江西省农村儿童体格发育水平及营养不良的患病率。方法:通过整群抽样调查江西省农村9238例儿童,所有儿童均由统一培训人员测量身高、体重,以WHO/NCHS标准为参数评价儿童体格发育水平,计算年龄别身高Z值(HAZ)、年龄别体重Z值(WAZ)和身高别体重Z值(WHZ)。分别计算儿童生长迟缓、低体重、消瘦的患病率。结果:我省农村儿童体格发育水平6月以内可达甚至超过WHO标准,6月龄后开始滞后。6月龄内儿童Z值主要分布在0～1和-1～0两个区间;6月龄后逐渐向左移,Z值主要分布于-1～0和-1～-2两个区间。儿童HAZ和WAZ主要分布在-1～0和-1～-2两个区间;而WHZ则以0～1和-1～0两个区间为主。生长迟缓、低体重和消瘦的患病率分别是13.2%、13.0%和2.9%,出生后6月内营养不良检出率最低,以后随年龄增长检出率逐渐增加,生长迟缓率在18～24月龄时达高峰。结论:我省农村儿童体格发育水平与WHO标准仍有一定差距,提示应进一步提高农村卫生水平和加强健康教育,有效改善农村儿童营养状况。     

婴幼儿生长发育与辅食添加的关系

应用1998年6岁以下儿童营养监测现场调查资料分析4至24个月以内婴儿辅助食品添加对婴幼儿生长发育的影响,以便为农村特别是贫困农村合理添加辅助食品提供参考。统计分析采用了描述性,相关回归分析及Logistic回归分析。结果表明贫困农村婴幼儿各类辅助食品添加率低于一般农村和城市。贫困农村婴幼儿在24个月以内平均添加动物性食物只占42％、乳类30．5％、淀粉类57．8％、蔬菜水果类48．6％,相当于城市添加比例的一半。通过相关分析表明,在4至6个月,6至12个月,12至18个月,18至24月几个年龄段的按年龄身高和体重与动物性食物和蔬菜水果类食物的添加率呈显著的正相关关系,但淀粉类食物在各个年龄段相关都不显著。通过回归分析,估算了如果每个营养监测点动物性食物添加率提高10％时,18至24个月的婴幼儿生长迟缓率可下降2．6个百分点,低体重下降1．2个百分点。Logistic回归分析表明,没有添加动物生长迟缓率可下降2．6个百分点,低体重下降1．2个百分点。Logistic回归分析表明,没有添加动物性食物时,发生生长迟缓的危险度（OR＝2．21（4－6个月）、1．73（6－12个月）、2．81（12－18个月）和2．58（12－24个月）。未添加蔬菜水果类食物发生生长迟缓的危险度与动物性食物类似。     

地震灾区宁强县6~24月龄婴幼儿营养干预周期研究

【目的】 探讨宁强县6~24月龄婴幼儿营养干预效果与干预周期的关系。 【方法】 按照干预措施实施的时限将婴幼儿分组,分别比较不同时限干预组与未干预组婴幼儿的年龄别体重Z评分(Weight-for-age Z-score,WAZ)、年龄别身长Z评分(Height-for-age Z-score,HAZ)、身高别体重Z评分(Weight-for -Height Z-score,WHZ)以及血红蛋白的差异。 【结果】 干预0~2.9月组、3~5.9月组和6~8.9月组的WAZ分别为0.37±1.25、0.07±0.97、0.07±1.02,与未干预组相比差异存在统计学意义(P<0.01);干预0~2.9月组、3~5.9月组和6~8.9月组的WHZ分别为0.55±1.11、0.43±1.00、0.32±1.26,较未干预组有显著增加(P<0.01);干预0~2.9月组(P<0.01)、6~8.9月组(P<0.05)的HAZ较未干预组显著增加。 【结论】 通过营养干预可以显著改善宁强县6~24月龄婴幼儿营养状况,本研究存在“0~9个月”的敏感干预周期。     

河北省5岁以下儿童生长发育Z评分及营养状况评价

【目的】 应用Z评分法对河北省5岁以下儿童生长发育及营养状况进行评价和分析,为做好儿童保健工作提供科学依据。 【方法】 采用分层随机整群抽样法,抽取河北省24个县、3个城市5岁以下儿童15 930人为研究对象,对其进行身高、体重测量,采用WHO Anthroplus 2007软件计算Z评分值。 【结果】 生长发育迟缓(HAZ<2)患病率11.41％(1 818/15 930)、低体重(WAZ<2)患病率7.06%(1 125/15 930)、消瘦(WHZ<2)患病率2.58%(411/15 930),且城乡差异显著,尤其是生长发育迟缓农村患病率12.35%,约是城市的3.2倍;儿童年龄别身高Z评分(HAZ)、年龄别体重Z评分(WAZ)以及身高别体重Z评分(WHZ)均值分别为0.96±1.08、0.51±1.32和0.08±1.68。其中城市分别为0.18±1.37、0.19±1.12和0.52±1.11,农村分别为1.23±1.40、0.63±1.21和0.12±1.24。仅城市WAZ和WHZ为正值,其余均为负值,且平均Z评分随年龄增长呈下降趋势。 【结论】 河北省儿童生长发育水平与WHO推荐的参考标准有一定差距,且城乡差异显著,农村儿童营养状况欠佳。     

辅食添加时间对婴儿生长发育和营养状况的影响

为了解城市婴儿辅食添加的种类、质量及其对生长发育和营养状况的影响，对合肥市４２３名１２月龄婴儿各类辅食添加的时间进行了调查，并测量了他们的身高、体重、胸围和Ｈｂ含量。结果表明，在０～４月龄添加蛋类、水果类和乳类的婴儿较多，而在５～８月龄添加肉类、蔬菜类、豆类和粮谷类的较多。虽然各类辅食添加的顺序较合理，但开始添加的时间较早，在０～４月龄添加蛋类、乳类、蔬菜、水果、谷类的婴儿均占被调查婴儿的３０％以     

北京市顺义区4～12月龄婴儿膳食中铁摄入量调查

目的了解顺义区4～12个月婴儿膳食营养素铁摄入情况,为合理喂养提供依据。方法采用随机整群抽样方法抽取顺义区农村和城镇地区4～12月龄婴儿266名,对婴儿喂养人进行连续3天(72h)膳食问卷调查。结果 4～5月龄婴儿膳食铁摄入量达到DRIs摄入标准,且城乡婴儿膳食铁摄入量差异无显著性(P>0.05)。6～12月龄农村地区婴儿膳食铁摄入量达到适宜摄入量(AI)人数的比例仅为19.8%,城镇地区达到适宜摄入量人数的比例为36.9%,城镇地区婴儿膳食铁摄入量高于农村地区(P<0.01)。不同组之间的婴儿母乳喂养率无统计学差异(P>0.05)。婴儿膳食铁摄入的主要食物来源为谷类、水果类、蛋类、蔬菜类和肉类。结论无论城镇还是农村,顺义区6～12月龄婴儿膳食营养素铁摄入量明显不足,在鼓励完全母乳喂养至6月龄的同时,应根据婴儿的实际情况适时添加富含铁的辅食。     

(外)祖父母对婴幼儿喂养模式和生长发育的影响

为了解家长对婴幼儿喂养模式和生长发育的影响.方法1992年对广东省城乡777名4个月大的婴儿以及城市375名8个月大的婴儿进行了喂养模式与生长发育的现况调查.根据决定婴儿喂养方式的家长因素将对象分为3组.结果 在城区,由父母决定喂养方式者,4个月大的婴儿的体重和体重年龄Z分(WAZ)显著高于由(外)祖父母决定喂养方式者(P<0.05);其母乳喂养率在2,3,4个月时也显著高于后者;但在农村以及城市8个月的婴儿3组间的差异不明显.结论 在城市地区,父母亲决定婴儿喂养方式有利于促进母乳喂养,有利于婴儿的生长发育.     

1998年中国4个月以内婴儿纯母乳喂养与生长发育

重点分析了中国城市与农村4个月以内婴儿纯母乳喂养情况及其与婴儿生长发育及疾病的关系。资料来源于1998年全国40个食物与营养监测点现场调查,通过分析表明中国4个月以内婴儿纯母乳喂养率城市为53．7％,一般农村为76．6％,较贫困农村为64．6％。生长迟缓婴儿的纯母乳喂养率为57．7％,显著低于身长正常的儿童73．04％。4个月以内采用纯母乳喂养的婴儿比非纯母乳喂养的婴儿体重平均重0．36kg,身长平均高1．2cm,WAZ值高0．4,HAZ高0．53,相差显著。同时,纯母乳喂养的婴儿腹泻患病率显著低于非纯母乳喂养的婴儿,两者相差15．9个百分点。通过Logistic回归分析显示,非纯母乳喂养的婴儿发生生长迟缓的危险度为纯母乳喂养的婴儿的2．19倍（OR＝2．19）,发生腹泻的危险度为2．74倍（OR＝2．74）。     

地震灾区宁强县6~24月龄婴幼儿营养干预效果研究

【目的】 评价发放辅食营养包和开展健康教育对地震灾区宁强县婴幼儿营养状况的改善效果。 【方法】 对宁强县所有6~24月龄婴幼儿添加辅食营养包、对婴幼儿看护人开展婴幼儿喂养健康教育,在干预措施实施18个月前后,分别抽取327名和300名6~24月龄婴幼儿进行调查,对比干预前后婴幼儿的身高、体重、血红蛋白、WAZ(Weight-for-age Z-score)、HAZ (Height-for-age Z-score)、WHZ (Weight-for -Height Z-score)、低体重率、生长迟缓率、消瘦率以及贫血检出率的差异。 【结果】 6~24月龄婴幼儿干预后平均体重较干预前增加0.90 kg(t=-9.94,P<0.01),平均身长增加3.40 cm(t=-7.74,P<0.01),差异有统计学意义;干预后的WAZ(-0.48 vs 0.09,t=-6.95,P<0.01)、HAZ (-0.73 vs -0.25,t=-4.63,P<0.01))、WHZ(-0.15 vs 0.30,t=-4.90,P<0.01)均有显著提高;干预后婴幼儿血红蛋白平均浓度由10.94 g/dL提高到11.70 g/dL(t=-7.97,P<0.01),贫血检出率由49.5%降至23.9%( χ²=43.72,P<0.01)。 【结论】 通过18个月的营养干预可以显著改善宁强县6~24月龄婴幼儿营养状况。     

河南省0～2岁婴幼儿碘营养状况和喂养方式与生长发育的关系

目的 探讨0～2岁婴幼儿的喂养方式和碘营养状况对其生长发育的影响。方法 采用整群抽样的方法,在河南省的18个省辖市各随机抽取2个县,每个县调查100名0～2岁婴幼儿的尿碘水平、喂养方式、生长指标。利用WHO Anthro软件计算年龄别体重评分（weight for age Z score,WAZ）和年龄别身高评分（height for age Z score,HAZ）。分别采用单因素方差分析和多元线性回归探讨碘营养水平和喂养方式对婴幼儿身高和体重的影响。结果 不同碘营养水平之间,13～18月龄组婴幼儿WAZ差异有统计学意义（F = 2.494,P = 0.043）;不同喂养方式之间,13～18月龄组WAZ差异有显著性（F = 3.040,P = 0.049）,19～24月龄组HAZ差异有统计学意义（F = 3.428,P = 0.034）。在校正了父母亲身高和体重、母亲年龄和文化程度、家庭收入等变量后,多元线性回归分析结果显示:13～18月龄的婴幼儿尿碘水平在50 μg/L以下的婴幼儿体重显著低于尿碘水平在50 μg/L以上的婴幼儿,未发现碘营养水平和身长的相关关系有统计学意义;在13～18月龄组,人工喂养的婴儿比母乳喂养的婴儿体重偏低（t = - 2.381,P = 0.018）;但在19～24月龄组,人工喂养的婴儿比母乳喂养的婴儿身长偏高（t = 2.639,P = 0.009）。结论 碘营养水平对婴儿的生长发育有一定影响,应保持婴儿适宜的碘营养水平。母乳喂养和人工喂养的婴儿生长方式存在一定的差异,但都在正常范围之内。     

Poor nutritional status of younger Tibetan children living at high altitudes

BACKGROUND: The growth, development and nutrition of children in Tibet with high-altitude and unique traditional culture have recently gained attention. However, few researches are available on the nutritional status of younger children of Tibet. OBJECTIVE: The objective of the study was to evaluate the nutritional status of children below 36 months old in Tibet by means of anthropometry. DESIGN: The cross-sectional survey was conducted between August and September in 1999 and a sample of 1655 children below 36 months old was obtained using a stratified multistage cluster random sampling method from a total of seven districts of Tibet. Height, weight and hemoglobin concentration were measured and at the same time related sociodemographic and environmental information were collected. NCHS/CDC/WHO reference data were used to evaluate the nutritional status of the entire study children population and estimate the prevalence of stunting, underweight and wasting. RESULTS: Compared with the reference of NCHS/CDC/WHO, the distributions of HAZ and WAZ shifted to the left significantly and the means of HAZ and WAZ were -1.53 and -1.05, respectively, which were significantly lower than the reference value. The distribution of WHZ, however, was close to that of the reference. The reduction of Z-scores for height and weight occurred very early in life and was greatest in the second year after birth. The prevalence of malnutrition of children was 39.0% for stunting, 23.7% for underweight and 5.6% for wasting, respectively. Rural children had prevalence of stunting of 41.4% and underweight of 24.7%, as compared with prevalence of stunting of 25.3% and underweight of 18.1% for urban children. Stunting and underweight were associated with altitudes. The mean of hemoglobin (Hb) of children was 120.4 g/l and rural children had a significantly lower Hb concentration (119.9 g/l) than urban children (123.3 g/l). The prevalence of anemia seemed higher when using different altitude corrections for Hb to estimate the prevalence, but the consequences were uneven. CONCLUSIONS: For Tibetan young children, the nutritional status of the entire population is poor and the prevalence of malnutrition is higher, especially for stunting. Malnutrition is related to high altitudes. Although the Hb concentration is higher induced by high altitude, there must be quite a lot of anemic children at high altitudes. The relationship between altitude and Hb for children on the Tibetan plateau requires further study in order to determine correctly the magnitude of anemia of children.     

安徽省界首市农村婴儿喂养现况及其与生长发育的关系

目的:了解安徽省界首市农村地区婴儿的营养状况,进一步探讨不同喂养方式与婴儿生长发育的关系。方法:以安徽省界首市农村地区所有婴儿作为研究对象进行普查。制定统一调查表,现场调查由乡村或社区医生承担,由课题负责人对调查员进行统一培训。调查员对婴儿的身高与体重进行测量,并对婴儿的监护人进行询问,了解婴儿一般情况、母乳喂养情况以及监护人自身的情况,逐一填写调查表。结果:有效调查1490人,男921人,女569人。其中母乳喂养532人,占35.7%;混合喂养748人,占50.2%;人工喂养210人,占14.1%。不同性别间的喂养方式差别无显著性,男婴的WAZ值为0.9786±0.0425,HAZ值为0.3316±0.04962,Kaup指数为18.4856±0.09425;女婴的WAZ值为1.1515±0.05293,HAZ值为0.4968±0.06044,Kaup指数为17.9830±0.1219,不同性别间这3个指数的差别有显著性。母乳喂养和混合喂养组婴儿的WAZ、HAZ值高于人工喂养组。结论:界首市农村地区的母乳喂养率较低,母乳喂养与混合喂养组婴儿的生长发育好于人工喂养组。     

Sensitivity and Specificity of Visual Clinical Assessment as Compared to WHO 2006 Standard and NCHS 1977 Reference in Measuring the Growth Status of Malaysian Infants

Objective: To study the validity of the visual clinical assessment of weight relative to length and length relative to age as compared to the World Health Organization (WHO) 2006 standard and National Center for Health Statistics (NCHS) 1977 reference in asssessing the physical growth of children younger than 1 year.

Materials and Methods: A prospective cohort study was carried out among 684 infants attending goverment health clinics in 2 states in Malaysia. Body weight, length, and clinical assessment were measured on the same day for 9 visits, scheduled every month until 6 months of age and every 2 months until 12 months of age. All of the 3 z-scores for weight for age (WAZ), length for age (HAZ), and weight for length (WHZ) were calculated using WHO Anthro for Personal Computers software.

Results: The average sensitivity and specificity for the visual clinical assessment for the detection of thinness were higher using the WHO 2006 standard as compared with using NCHS 1977. However, the overall sensitivity of the visual clinical assessment for the detection of thin and lean children was lower from 1 month of age until a year as compared with the WHO 2006 standard and NCHS 1977 reference. The positive predictive value (PPV) for the visual clinical assessment versus the WHO 2006 standard was almost doubled as compared with the PPV of visual clinical assessment versus the NCHS 1977 reference. The overall average sensitivity, specificity, PPV, and negative predictive value for the detection of stunting was higher for visual clinical assessment versus the WHO 2006 standard as compared with visual clinical assessment versus the NCHS 1977 reference.

Conclusion: The sensitivity and specificity of visual clinical assessment for the detection of wasting and stunting among infants are better for the WHO 2006 standard than the NCHS 1977 reference.     

Standard deviation of anthropometric Z-scores as a data quality assessment tool using the 2006 WHO growth standards: a cross country analysis

OBJECTIVE: Height- and weight-based anthropometric indicators are used worldwide to characterize the nutritional status of populations. Based on the 1978 WHO/National Center for Health Statistics (NCHS) growth reference, the World Health Organization has previously indicated that the standard deviation (SD) of Z-scores of these indicators is relatively constant across populations, irrespective of nutritional status. As such, the SD of Z-scores can be used as quality indicators for anthropometric data. In 2006, WHO published new growth standards. Here, we aim to assess whether the SD of height- and weight-based Z-score indicators from the 2006 WHO growth standards can still be used to assess data quality. METHODS: We examined data on children aged 0-59 months from 51 Demographic and Health Surveys (DHS) in 34 developing countries. We used 2006 growth standards to assign height-for-age Z-scores (HAZ), weight-for-age Z-scores (WAZ), weight-for-height Z-scores (WHZ) and body-mass-index-for-age Z-scores (BMIZ). We also did a stratified analysis by age group. FINDINGS: The SD for all four indicators were independent of their respective mean Z-scores across countries. Overall, the 5th and 95th percentiles of the SD were 1.35 and 1.95 for HAZ, 1.17 and 1.46 for WAZ, 1.08 and 1.50 for WHZ and 1.08 and 1.55 for BMIZ. CONCLUSION: Our results concur with the WHO assertion that SD is in a relatively small range for each indicator irrespective of where the Z-score mean lies, and support the use of SD as a quality indicator for anthropometric data. However, the ranges of SDs for all four indicators analysed were consistently wider than those published previously by WHO.