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Development of a screening tool to predict malnutrition among children under two years old in Zambia
Junko Hasegawa1, Yoichi M Ito2, Taro Yamauchi3
1a School of Rehabilitation Sciences , Health Sciences University of Hokkaido , Tobetsu , Japan.
Insights
A new screening tool can identify children at high risk of malnutrition in rural Zambia. This practical method aids community health workers in early intervention for undernutrition, improving child health outcomes.
Area of Science:
- Global Health
- Pediatrics
- Nutritional Science
Background:
- Maternal and child undernutrition is a critical issue in low- and middle-income countries, necessitating effective identification of at-risk children.
- Existing methods for identifying children at high risk of malnutrition are inadequate, highlighting the need for a practical assessment tool.
- Community health workers in sub-Saharan Africa require a simple nutrition assessment method for semi-professional use.
Purpose of the Study:
- To develop and validate a practical screening tool for predicting growth stunting in children under two years old.
- To create a community-based screening tool suitable for use in rural Zambia.
- To identify key risk factors for malnutrition in young children.
Main Methods:
- Field research conducted in Southern Province, Zambia, involving 264 mother-child pairs.
- Anthropometric measurements and maternal interviews were used to collect data.
- Least absolute shrinkage and selection operator analysis was employed to estimate risk factors, with ROC curve analysis to determine the cut-off value.
Main Results:
- A screening tool was developed incorporating age, weight-for-age Z-score, birth weight, feeding status, sibling death history, multiple birth, and maternal education.
- The tool's total score ranges from 0 to 22, with a determined cut-off value of eight.
- The screening tool achieved a sensitivity of 0.963 and a specificity of 0.697 in predicting malnutrition risk.
Conclusions:
- A validated screening tool for identifying children at high risk of malnutrition in Zambia has been developed.
- Further longitudinal studies are recommended to confirm the tool's predictive validity for future stunting.
- Investigating the effectiveness of malnutrition interventions based on this screening tool is crucial.
Background:
Maternal and child undernutrition is an important issue, particularly in low- and middle-income countries. Children at high risk of malnutrition should be prioritized to receive necessary interventions to minimize such risk. Several risk factors have been proposed; however, until now, there has been no appropriate evaluation method to identify these children. In sub-Saharan Africa, children commonly receive regular check-ups from community health workers. A simple and easy nutrition assessment method is therefore needed for use by semi-professional health workers.
Objectives:
The aim of this study was to develop and test a practical screening tool for community use in predicting growth stunting in children under two years in rural Zambia.
Methods:
Field research was conducted from July to August 2014 in Southern Province, Zambia. Two hundred and sixty-four mother-child pairs participated in the study. Anthropometric measurements were performed on all children and mothers, and all mothers were interviewed. Risk factors for the screening test were estimated by using least absolute shrinkage and selection operator analysis. After re-evaluating all participants using the new screening tool, a receiver operating characteristic curve was drawn to set the cut-off value. Sensitivity and specificity were also calculated.
Results:
The screening tool included age, weight-for-age Z-score status, birth weight, feeding status, history of sibling death, multiple birth, and maternal education level. The total score ranged from 0 to 22, and the cut-off value was eight. Sensitivity and specificity were 0.963 and 0.697 respectively.
Conclusions:
A screening tool was developed to predict children at high risk of malnutrition living in Zambia. Further longitudinal studies are needed to confirm the test's validity in detecting future stunting and to investigate the effectiveness of malnutrition treatment.
