Assessing the impact of the introduction of the World Health Organization growth standards and weight-for-height z-score criterion on the response to treatment of severe acute malnutrition in children: Secondary data analysis

Hdl Handle:
http://hdl.handle.net/10144/47873
Title:
Assessing the impact of the introduction of the World Health Organization growth standards and weight-for-height z-score criterion on the response to treatment of severe acute malnutrition in children: Secondary data analysis
Authors:
Isanaka, S; Villamor, E; Shepherd, S; Grais, R
Journal:
Pediatrics
Abstract:
OBJECTIVE: The objective of our study was to assess the impact of adopting the World Health Organization growth standards and weight-for-height z-score criterion on the response to treatment of severe acute malnutrition in children compared with the use of the National Center for Health Statistics growth reference. METHODS: We used data from children aged 6 to 59 months with acute malnutrition who were admitted to the Médecins sans Frontières nutrition program in Maradi, Niger, during 2006 (N = 56214). Differences in weight gain, duration of treatment, recovery from malnutrition, mortality, loss to follow-up, and need for inpatient care were compared for severely malnourished children identified according to the National Center for Health Statistics reference and weight-for-height <70% of the median criterion versus the World Health Organization standards and the weight-for-height less than -3 z-score criterion. RESULTS: A total of 8 times more children (n = 25754) were classified as severely malnourished according to the World Health Organization standards compared with the National Center for Health Statistics reference (n = 2989). Children included according to the World Health Organization standards had shorter durations of treatment, greater rates of recovery, fewer deaths, and less loss to follow-up or need for inpatient care. CONCLUSIONS: The introduction of the World Health Organization standards with the z-score criterion to identify children for admission into severe acute malnutrition treatment programs would imply the inclusion of children who are younger but have relatively higher weight for height on admission compared with the National Center for Health Statistics reference. These children have fewer medical complications requiring inpatient care and are more likely to experience shorter durations of treatment and lower mortality rates. The World Health Organization standards with the z-score criterion might become a useful tool for the early detection of acute malnutrition in children, although additional research on the resource implications of this transition is required.
Affiliation:
Departments of Epidemiology and Nutrition, Harvard School of Public Health, Boston, MA; Harvard Humanitarian Initiative, Harvard University, Cambridge, MA; Médecins Sans Frontières, Paris, France; Epicentre, Paris, France
Publisher:
Published by the American Academy of Pediatrics
Issue Date:
1-Jan-2009
URI:
http://hdl.handle.net/10144/47873
DOI:
10.1542/peds.2008-1375
PubMed ID:
19117847
Additional Links:
http://pediatrics.aappublications.org/cgi/content/abstract/123/1/e54
Submitted date:
2009-01-05
Type:
Article
Language:
en
ISSN:
1098-4275
Sponsors:
Research support was provided by Medecins sans Frontieres and the United Nations System Standing Committee on Nutrition. Ms Isanaka was supported in part by National Cancer Institute grant R25-CA098566. The funding sources had no role in the authors’ work.
Appears in Collections:
Nutrition

Full metadata record

DC FieldValue Language
dc.contributor.authorIsanaka, S-
dc.contributor.authorVillamor, E-
dc.contributor.authorShepherd, S-
dc.contributor.authorGrais, R-
dc.date.accessioned2009-01-22T09:14:35Z-
dc.date.available2009-01-22T09:14:35Z-
dc.date.issued2009-01-01-
dc.date.submitted2009-01-05-
dc.identifier.citationPediatrics 2009;123(1):e54-9en
dc.identifier.issn1098-4275-
dc.identifier.pmid19117847-
dc.identifier.doi10.1542/peds.2008-1375-
dc.identifier.urihttp://hdl.handle.net/10144/47873-
dc.description.abstractOBJECTIVE: The objective of our study was to assess the impact of adopting the World Health Organization growth standards and weight-for-height z-score criterion on the response to treatment of severe acute malnutrition in children compared with the use of the National Center for Health Statistics growth reference. METHODS: We used data from children aged 6 to 59 months with acute malnutrition who were admitted to the Médecins sans Frontières nutrition program in Maradi, Niger, during 2006 (N = 56214). Differences in weight gain, duration of treatment, recovery from malnutrition, mortality, loss to follow-up, and need for inpatient care were compared for severely malnourished children identified according to the National Center for Health Statistics reference and weight-for-height <70% of the median criterion versus the World Health Organization standards and the weight-for-height less than -3 z-score criterion. RESULTS: A total of 8 times more children (n = 25754) were classified as severely malnourished according to the World Health Organization standards compared with the National Center for Health Statistics reference (n = 2989). Children included according to the World Health Organization standards had shorter durations of treatment, greater rates of recovery, fewer deaths, and less loss to follow-up or need for inpatient care. CONCLUSIONS: The introduction of the World Health Organization standards with the z-score criterion to identify children for admission into severe acute malnutrition treatment programs would imply the inclusion of children who are younger but have relatively higher weight for height on admission compared with the National Center for Health Statistics reference. These children have fewer medical complications requiring inpatient care and are more likely to experience shorter durations of treatment and lower mortality rates. The World Health Organization standards with the z-score criterion might become a useful tool for the early detection of acute malnutrition in children, although additional research on the resource implications of this transition is required.en
dc.description.sponsorshipResearch support was provided by Medecins sans Frontieres and the United Nations System Standing Committee on Nutrition. Ms Isanaka was supported in part by National Cancer Institute grant R25-CA098566. The funding sources had no role in the authors’ work.en
dc.language.isoenen
dc.publisherPublished by the American Academy of Pediatricsen
dc.relation.urlhttp://pediatrics.aappublications.org/cgi/content/abstract/123/1/e54en
dc.rightsPublished by the American Academy of Pediatrics - Reproduced on this site with kind permission from Pediatrics, copyright 2009 by the American Academy of Pediatricsen
dc.subjectWHO growth standardsen
dc.subjectChild malnutritionen
dc.subjectWastingen
dc.subjectSelective feedingen
dc.subjectTherapeutic feedingen
dc.subjectNigeren
dc.titleAssessing the impact of the introduction of the World Health Organization growth standards and weight-for-height z-score criterion on the response to treatment of severe acute malnutrition in children: Secondary data analysisen
dc.typeArticleen
dc.contributor.departmentDepartments of Epidemiology and Nutrition, Harvard School of Public Health, Boston, MA; Harvard Humanitarian Initiative, Harvard University, Cambridge, MA; Médecins Sans Frontières, Paris, France; Epicentre, Paris, Franceen
dc.identifier.journalPediatricsen
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