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Reference Ranges for Head Circumference in Ethiopian Children 0-2 Years of Age

Ephrem Bililigne Amare1, Mari Idsøe2, Miriam Wiksnes3

  • 1Department of Pediatrics, University of Addis Ababa, Addis Ababa, Ethiopia; Centre for International Health, University of Bergen, Norway.

World Neurosurgery
|September 7, 2015
PubMed

Insights

New head circumference (HC) charts for Ethiopian children (birth to 24 months) show significant differences from WHO standards. These findings are crucial for early hydrocephalus detection in Ethiopia.

Area of Science:

  • Pediatrics
  • Public Health
  • Medical Diagnostics

Background:

  • Head circumference (HC) measurement is vital for detecting childhood hydrocephalus, particularly in low-income countries with limited population-specific data.
  • Hydrocephalus is more prevalent in low-income nations and often diagnosed late, leading to severe brain damage.
  • Ethiopia faces these challenges, and the applicability of World Health Organization (WHO) HC charts across diverse populations is questioned.

Purpose of the Study:

  • To establish normative head circumference (HC) reference ranges for healthy children in Ethiopia.
  • To assess the applicability of existing WHO HC charts in the Ethiopian context.

Main Methods:

  • A prospective, observational, cross-sectional study collected HC measurements from 4019 healthy Ethiopian children (birth to 24 months).
  • Data were gathered from health centers across five Ethiopian cities, encompassing diverse ethnicities.
  • Reference ranges were calculated using the LMS method and compared against WHO standards.

Main Results:

  • The study established distinct Ethiopian HC reference ranges for children aged 0-24 months.
  • A notable percentage of Ethiopian children fell outside WHO reference ranges: 6.7% of boys and 7.1% of girls above +2 SD; 2.8% of boys and 2.1% of girls below -2 SD.
  • Ethiopian +2 SD lines were higher than WHO standards, while median and -2 SD lines showed greater comparability.

Conclusions:

  • Significant differences exist between Ethiopian and WHO head circumference reference ranges for children aged 0-24 months.
  • Ethiopian-specific HC charts are recommended as the primary tool for hydrocephalus screening in this population.
  • Implementing localized charts can improve early diagnosis and prevent severe neurological damage in Ethiopian children.
Abstract

Keywords:
Developing countryEthiopiaHead circumferenceHydrocephalusNeurosurgeryOccipitofrontal circumferencePediatricsScreening

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