Prognostic value of different anthropometric indices over different measurement intervals to predict mortality in 6–59-month-old children
Author: André Briend, Mark Myatt, James A Berkley, Robert E Black, Erin Boyd, Michel Garenne, Natasha Lelijveld, Sheila Isanaka, Christine M McDonald, Martha Mwangwome, Kieran S O’Brien et al
Year: 2023
Resource type: Article
Abstract
Objective:
To compare the prognostic value of mid-upper arm circumference (MUAC), weight-for-height Z-score (WHZ) and weight-for-age Z-score (WAZ) for predicting death over periods of 1, 3 and 6 months follow-up in children.
Design:
Pooled analysis of twelve prospective studies examining survival after anthropometric assessment. Sensitivity and false-positive ratios to predict death within 1, 3 and 6 months were compared for three individual anthropometric indices and their combinations.
Setting:
Community-based, prospective studies from twelve countries in Africa and Asia.
Participants:
Children aged 6–59 months living in the study areas.
Results:
For all anthropometric indices, the receiver operating characteristic curves were higher for shorter than for longer durations of follow-up. Sensitivity was higher for death with 1-month follow-up compared with 6 months by 49 % (95 % CI (30, 69)) for MUAC < 115 mm (P < 0·001), 48 % (95 % CI (9·4, 87)) for WHZ < -3 (P < 0·01) and 28 % (95 % CI (7·6, 42)) for WAZ < -3 (P < 0·005). This was accompanied by an increase in false positives of only 3 % or less. For all durations of follow-up, WAZ < -3 identified more children who died and were not identified by WHZ < -3 or by MUAC < 115 mm, 120 mm or 125 mm, but the use of WAZ < -3 led to an increased false-positive ratio up to 16·4 % (95 % CI (12·0, 20·9)) compared with 3·5 % (95 % CI (0·4, 6·5)) for MUAC < 115 mm alone.
Conclusions:
Frequent anthropometric measurements significantly improve the identification of malnourished children with a high risk of death without markedly increasing false positives. Combining two indices increases sensitivity but also increases false positives among children meeting case definitions.
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Reference this page
André Briend, Mark Myatt, James A Berkley, Robert E Black, Erin Boyd, Michel Garenne, Natasha Lelijveld, Sheila Isanaka, Christine M McDonald, Martha Mwangwome, Kieran S O’Brien et al (2023). Prognostic value of different anthropometric indices over different measurement intervals to predict mortality in 6–59-month-old children. www.ennonline.net/prognostic-value-anthropometric-indices-predict-mortality
(ENN_7566)