Journal article
Prognostic value of different anthropometric indices over different measurement intervals to predict mortality in 6–59-month-old children
- Abstract:
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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 1-month follow-up compared with 6 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 with 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.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, pdf, 740.0KB, Terms of use)
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- Publisher copy:
- 10.1017/S1368980023000149
Authors
- Publisher:
- Cambridge University Press
- Journal:
- Public Health Nutrition More from this journal
- Volume:
- 26
- Issue:
- 6
- Pages:
- 1210–1221
- Place of publication:
- England
- Publication date:
- 2023-02-01
- Acceptance date:
- 2022-12-26
- DOI:
- EISSN:
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1475-2727
- ISSN:
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1368-9800
- Pmid:
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36722310
- Language:
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English
- Keywords:
- Pubs id:
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1327586
- Local pid:
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pubs:1327586
- Deposit date:
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2023-06-23
- ARK identifier:
Terms of use
- Copyright holder:
- Briend et al.
- Copyright date:
- 2023
- Rights statement:
- © The Author(s), 2023. Published by Cambridge University Press on behalf of The Nutrition Society. This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike licence, which permits non-commercial re-use, distribution, and reproduction in any medium, provided the same Creative Commons licence is used to distribute the re-used or adapted article and the original article is properly cited. The written permission of Cambridge University Press must be obtained prior to any commercial use.
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