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

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dc.contributor.authorAndré Briend
dc.contributor.authorMark Myatt
dc.contributor.authorJames A Berkley
dc.contributor.authorRobert E Black
dc.contributor.authorErin Boyd
dc.contributor.authorMichel Garenne
dc.contributor.authorNatasha Lelijveld
dc.contributor.authorSheila Isanaka
dc.contributor.authorChristine M McDonald
dc.contributor.authorMartha Mwangwome
dc.contributor.authorKieran S O’Brien
dc.contributor.authorCatherine Schwinger
dc.contributor.authorHeather Stobaugh
dc.contributor.authorSunita Taneja
dc.contributor.authorKeith P West
dc.contributor.authorTanya Khara
dc.date.accessioned2023-10-19T10:30:56Z
dc.date.available2023-10-19T10:30:56Z
dc.date.issued2023-06
dc.description.abstractObjective: 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.
dc.description.librarianPM2023
dc.facultyFaculty of Health Sciences
dc.identifier.urihttps://hdl.handle.net/10539/36823
dc.language.isoen
dc.schoolPublic Health
dc.subjectWasting, Stunting, Underweight, Mid-upper arm circumference, Anthropometry, Mortality
dc.titlePrognostic value of different anthropometric indices over different measurement intervals to predict mortality in 6–59-month-old children
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