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[Classification of Colombian children with malnutrition according to NCHS reference or WHO standard]

Claudia Velásquez1, Juliana Bermúdez, Claudia Echeverri

  • 1Grupo Investigación Alimentación y Nutrición Humana, Universidad de Antioquia. Universidad de Antioquia, Medellín, Colombia.

Archivos Latinoamericanos De Nutricion
|October 26, 2012
PubMed

Insights

The World Health Organization (WHO) Child Growth Standards identify more malnourished children, including severe cases, than the National Center for Health Statistics (NCHS) reference. This highlights the need for updated malnutrition classification in pediatric nutrition programs.

Area of Science:

  • Pediatric Nutrition
  • Public Health
  • Growth Monitoring

Background:

  • The National Center for Health Statistics (NCHS) reference is commonly used for classifying childhood malnutrition.
  • The World Health Organization (WHO) Child Growth Standards offer an alternative framework for assessing child growth.
  • Evaluating concordance between these standards is crucial for accurate malnutrition assessment in clinical settings.

Purpose of the Study:

  • To assess the concordance between the NCHS reference and WHO Child Growth Standards for classifying malnutrition in Colombian children.
  • To compare the identification of acute and severe malnutrition using both NCHS and WHO standards.
  • To evaluate the impact of using WHO standards on hospitalization and length of stay criteria.

Main Methods:

  • A descriptive study analyzed data from children aged 6-59 months admitted to a nutrition program in Colombia.
  • Height-for-age and weight-for-height indicators were assessed at admission and discharge.
  • Statistical methods including T-student, Intraclass Correlation Coefficient (CCI), Kappa index, and McNemar test were employed.

Main Results:

  • WHO standards classified 10.4% of children as stunted who were considered normal by NCHS.
  • Acute malnutrition identification increased from 64% (NCHS) to a higher prevalence when using WHO standards.
  • Severe emaciation identification significantly increased from 36.0% to 63.3% with WHO standards.
  • An estimated 5% of children leaving the hospital might require extended stays if evaluated by WHO standards.

Conclusions:

  • WHO Child Growth Standards are more sensitive in identifying malnourished children and more severe states of malnutrition compared to NCHS.
  • Implementing WHO standards could lead to increased hospital admissions and longer stays for malnourished children.
  • Accurate growth monitoring using appropriate standards is vital for effective pediatric nutrition interventions.

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