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Identifying the malnourished within Peru: regional variation in the performance of a nutrition indicator
M E Leon1, M Serdula, D F Williamson
1Emory University, Atlanta, GA 30322.
Insights
Identifying stunting in older siblings can help detect malnutrition risk in younger siblings. This early identification allows for timely interventions to prevent severe health issues in children.
Area of Science:
- Public Health
- Pediatrics
- Nutritional Science
Background:
- Malnourished children often have siblings facing similar health risks.
- Early identification of at-risk siblings is crucial for timely intervention.
- Sibling stunting can serve as an indicator for a child's malnutrition status.
Purpose of the Study:
- To evaluate the effectiveness of older sibling stunting as an indicator for malnutrition in younger siblings.
- To assess the performance of this screening indicator across different regions in Peru.
Main Methods:
- A nationwide survey in Peru in 1984 involved 3284 sibling pairs.
- Stunting was defined as height/age less than or equal to 3.00 SD of NCHS/CDC reference median.
- Prevalence ratios and screening indices were calculated for different regions.
Main Results:
- Target siblings with stunted older siblings showed significantly higher stunting prevalence.
- Prevalence ratios varied by region: 8.5 in Lima, 4.7 in urban areas, and 2.5 in rural areas.
- Screening indices (sensitivity, specificity, positive predictive value) also varied regionally.
Conclusions:
- Older sibling stunting is a potential indicator for younger sibling malnutrition.
- The performance of this indicator varies significantly across different geographic and socioeconomic regions.
- Screening tools must be evaluated within the specific populations where they will be applied due to the multifactorial nature of malnutrition.
Abstract:
Malnourished children may also have siblings at increased risk of poor health. Early identification of siblings at risk could lead to timely intervention to prevent the development of malnutrition or other potentially life-threatening events. In a nationwide survey conducted in Peru in 1984, stunting in an older sibling (defined as height/age less than or equal to 3.00 SD of the NCHS/CDC reference median) was evaluated as an indicator for stunting in a target sibling (next youngest) sibling) (n = 3284). The prevalence of stunting was much higher in target siblings who had an older sibling with stunting compared to those whose older sibling was not stunted, with prevalence ratios of 8.5 in Lima, 4.7 in urban areas, and 2.5 in rural areas. Screening indices (sensitivity, specificity, and predictive value positive) also showed marked variation across regions. The variation in this indicator's performance across regions demonstrates the importance of evaluating screening tools within the populations where they will be applied. Regional variations in the performance of malnutrition indicators should be anticipated because malnutrition is the result of a complex, multifactorial process.
