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The reliability of weight-for-length/height Z scores in children

Martha K Mwangome1, James A Berkley

  • 1KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya.

Maternal & Child Nutrition
|May 3, 2014
PubMed

Insights

The World Health Organisation

Area of Science:

  • Pediatric Nutrition
  • Public Health
  • Anthropometry

Background:

  • The World Health Organisation (WHO) recommends weight-for-length/height (WFL/H) Z scores for diagnosing acute malnutrition in children under five.
  • While individual measurements are reliable, the consistency of WFL/H Z scores across diverse settings is not well-established.

Purpose of the Study:

  • To systematically review and meta-analyze the reliability of WFL/H Z scores in children aged 0-60 months.
  • To assess the reliability of WFL/H Z scores in different age groups (under 24 months and above 24 months) and settings.

Main Methods:

  • Systematic literature search on PubMed and Google Scholar for studies on WFL/H Z score reliability.
  • Inclusion criteria: studies reporting reliability scores for WFL/H Z scores in children under five.
  • Meta-analysis to determine pooled intra-class correlation coefficient (ICC) estimates.

Main Results:

  • Only three community-based studies reported WFL/H Z score reliability.
  • Overall pooled ICC for WFL/H Z score was 0.81 (95% CI 0.64 to 0.99).
  • Reliability was lower in children under 24 months (ICC=0.72) compared to older children (ICC=0.97).

Conclusions:

  • Information on WFL/H Z score reliability in all settings is limited.
  • In community settings, WFL/H Z score reliability is lower than individual measurements, particularly for younger children.
  • Further evaluation of WFL/H Z score reliability is needed, especially in real-world field conditions.

Keywords:
childrenreliabilityweight-for-heightweight-for-length

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