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Impact of anthropometry training and feasibility of 3D imaging on anthropometry data quality among children under
Priya M Gupta1, Kasthuri Sivalogan1, Richard Oliech2
1Nutrition and Health Sciences Program, Laney Graduate School, Emory University, Atlanta, Georgia, United States of America.
Insights
Postmortem anthropometry training improved data quality for child mortality surveillance. While 3D imaging shows promise, manual methods remain reliable, though technology adjustments are needed for 3D accuracy.
Area of Science:
- Public Health
- Biomedical Engineering
- Pediatric Mortality Research
Background:
- The Child Health and Mortality Prevention Surveillance Network (CHAMPS) aims to determine causes of death in children under five in high-mortality regions.
- Accurate postmortem nutritional assessment is crucial for understanding child mortality but faces significant challenges.
Purpose of the Study:
- To evaluate the effectiveness of anthropometry training on data quality for postmortem nutritional assessments.
- To assess the feasibility and accuracy of 3D imaging as an alternative to traditional methods within the CHAMPS Kenya site.
Main Methods:
- Training was provided on World Health Organization (WHO)-recommended manual anthropometry and novel 3D imaging techniques.
- Postmortem measurements were collected pre- and post-training, with data quality assessed using standard deviations, digit preference scores (DPS), and technical errors of measurement (TEMs).
- 3D imaging accuracy was compared to manual measurements, and qualitative feedback on user experience was gathered.
Main Results:
- Manual anthropometry data quality improved post-training, evidenced by reduced digit preference scores.
- Measurement reliability was high (relative technical errors of measurement <1.5%), though anthropometric indices sometimes exceeded WHO growth standard quality limits.
- 3D imaging showed high correlation with manual measurements but overestimated length and head circumference; staff preferred manual methods due to 3D imaging's technical requirements.
Conclusions:
- Manual anthropometry is a feasible and reliable postmortem method, even with rigor mortis.
- 3D imaging presents a potential accurate alternative, but requires technological refinement for improved usability and precision in postmortem assessments.
Background:
The Child Health and Mortality Prevention Surveillance Network (CHAMPS) identifies causes of under-5 mortality in high mortality countries.
Objective:
To address challenges in postmortem nutritional assessment, we evaluated the impact of anthropometry training and the feasibility of 3D imaging on data quality within the CHAMPS Kenya site.
Design:
Staff were trained using World Health Organization (WHO)-recommended manual anthropometry equipment and novel 3D imaging methods to collect postmortem measurements. Following training, 76 deceased children were measured in duplicate and were compared to measurements of 75 pre-training deceased children. Outcomes included measures of data quality (standard deviations of anthropometric indices and digit preference scores (DPS)), precision (absolute and relative technical errors of measurement, TEMs or rTEMs), and accuracy (Bland-Altman plots). WHO growth standards were used to produce anthropometric indices. Post-training surveys and in-depth interviews collected qualitative feedback on measurer experience with performing manual anthropometry and ease of using 3D imaging software.
Results:
Manual anthropometry data quality improved after training, as indicated by DPS. Standard deviations of anthropometric indices exceeded limits for high data quality when using the WHO growth standards. Reliability of measurements post-training was high as indicated by rTEMs below 1.5%. 3D imaging was highly correlated with manual measurements; however, on average 3D scans overestimated length and head circumference by 1.61 cm and 2.27 cm, respectively. Site staff preferred manual anthropometry to 3D imaging, as the imaging technology required adequate lighting and additional considerations when performing the measurements.
Conclusions:
Manual anthropometry was feasible and reliable postmortem in the presence of rigor mortis. 3D imaging may be an accurate alternative to manual anthropometry, but technology adjustments are needed to ensure accuracy and usability.
