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Disparities with global standards about growth references of mid-upper arm circumference-for-age for Pakistani

Natasha Akbar1, Muhammad Aslam1, Jørgen Holm Petersen2

  • 1Department of Statistics, Bahauddin Zakariya University, Multan, Pakistan.

Acta Paediatrica (Oslo, Norway : 1992)
|April 10, 2024
PubMed

Insights

Pakistan

Area of Science:

  • Pediatric Nutrition
  • Anthropometry
  • Public Health

Background:

  • Mid-upper arm circumference (MUAC) is crucial for assessing child nutrition.
  • Pakistan lacks established MUAC growth references and charts for children.
  • Accurate growth references are essential for early detection of malnutrition.

Purpose of the Study:

  • To develop age- and sex-specific MUAC-for-age growth references for Pakistani children aged 6-60 months.
  • To compare these newly developed Pakistani MUAC references with international standards (e.g., WHO).
  • To identify potential regional, age, and gender variations in MUAC growth patterns within Pakistan.

Main Methods:

  • Utilized data from the 2018 National Nutrition Survey of Pakistan (n=57,285 children).
  • Employed generalized additive models for location, scale, and shape (GAMLSS) with a Box-Cox power exponential distribution.
  • Generated percentile values and growth charts for MUAC-for-age.

Main Results:

  • Mean MUAC was 14.21 cm (boys) and 14.13 cm (girls).
  • Median MUAC percentiles for Pakistani children were lower than WHO 2007 and international references.
  • Slightly higher P3 and P97 percentiles observed for girls than boys at 60 months.

Conclusions:

  • Significant disparities exist between Pakistani MUAC-for-age references and global standards.
  • Variations highlight the need for context-specific growth references in Pakistan.
  • Developing national growth references is crucial for effective child nutrition programs.
Abstract

Keywords:
box–cox power exponential distributiongrowth reference chartlambda‐mu‐sigma methodsmoothed percentiles

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