Abstract
Conventional indicators – weight-for-age, height-for-age, weight-for-height and mid-upper arm circumference (MUAC) reflect different facets of the nutritional status. Weight-for-age is the most commonly used indicator. When used individually or in combination, conventional indices fail to depict the overall magnitude of undernutrition in the population. Composite Index of Anthropometric Failure (CIAF) is an alternative classification system which attempts to fill this lacuna. Thus, we undertook this study with the objective to compare the prevalence of undernutrition using CIAF and the conventional indices. We included 634 children aged between 2 to 4 years from anganwadis located in three areas of Mumbai. Weight, height and MUAC measurements were taken. Z scores were computed for weight-for-age (WAZ), height-for-age (HAZ) and weight-for-height (WHZ) using WHO Anthro software. Children were classified as per the conventional indices and CIAF. The prevalence of underweight, stunting and wasting was 35.7 %, 33.8 % and 18.5 % respectively. None of the children had MUAC < 11.5 cm. About 1 % of the children were moderately wasted according to MUAC. As per CIAF, 47.8 % children were undernourished. According to CIAF, one-third of the undernourished children had single anthropometric failure while half of them had dual failure and 17.1 % had multiple failures. When compared with the conventional indices, CIAF could recognize 12.1 %, 14.0 %, 29.3 % and 46.7 % more undernourished children than WAZ, HAZ, WHZ and MUAC respectively. In conclusion, CIAF is seen to have many advantages over the conventional indices. CIAF is useful in assessing the overall magnitude of undernutrition and identifying children with multiple anthropometric failures. It also recognizes more undernourished children than all the conventional indices. Therefore, CIAF should be used more widely as a tool for nutritional assessment particularly in developing countries where the burden of undernutrition is high.
Highlights
Undernutrition among children under five years is traditionally assessed using anthropometric indices such as – weight-for-age, height-for-age, weight-for-height and mid-upper arm circumference (MUAC)
Nandy and Miranda have used the national data from seven developing countries to calculate the Composite Index of Anthropometric Failure (CIAF) and compare it with prevalence of underweight in the same areas [8]
Children with weight-for-age Z scores (WAZ), height-for-age Z scores (HAZ) and weight-for-height Z scores (WHZ) scores between – 3.0 to – 2.0 SD were classified as moderately underweight, stunted and wasted respectively
Summary
Undernutrition among children under five years is traditionally assessed using anthropometric indices such as – weight-for-age, height-for-age, weight-for-height and mid-upper arm circumference (MUAC). Savanur and Ghugre Journal of Health, Population and Nutrition (2015) 33:3 the nutritional status This may be because underweight indicates both acute and chronic undernutrition. We might tend to miss out on children who are stunted and wasted if underweight is used as a sole indicator of nutritional status. Nandy and Miranda have used the national data from seven developing countries to calculate the CIAF and compare it with prevalence of underweight in the same areas [8]. In Maharashtra state, the prevalence of underweight, stunting and wasting in under-five children in rural and urban areas was 37 %, 46 % and 17 % respectively. We conducted the present study with an objective to compare the prevalence of undernutrition by using CIAF and the conventional indices
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