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Calculation of weight gain in CMAM

This question was posted the Prevention and treatment of severe acute malnutrition forum area and has 8 replies. You can also reply via email – be sure to leave the subject unchanged.

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Charulatha Banerjee

Terre des hommes Foundation

Normal user

17 Jul 2014, 05:48

SAM child - oedema free- but comes with diarrhoea to the facility. After 2-3 days of diarrhoea child loses weight - hence weight on 3rd /4th day is lower than admission weight. i.e. this is the lowest weight of the child. When weight gain is being calculated should it be done against admission weight or lowest weight of the child on 3rd/4th day?

This situation is not frequent but we do encounter such cases.

Answers from the forum will be appreciated.

Regine Kopplow

Sen. Advisor Food& Nutrition Security

Normal user

17 Jul 2014, 10:01

Weight gain is calculated using the lowest weight during the treatment period and not the weight on admission day

Lovely Amin

Nutrition Adviser

Normal user

17 Jul 2014, 13:14

Dear Dr. Charulata,

Hope you are well. I’m now in Sahel for SQUEAC! In CMAM programme, any cases (oedematous and /or acute illness), weight gain always to be calculated from the lowest point of weight.

Best regards,

Charulatha Banerjee

Terre des hommes Foundation

Normal user

21 Jul 2014, 04:22

Thank you Regina and Lovely Apa. Wish you both a good week ahead.

Anonymous 2550

Nutrition specialist for World vision Ethiopia

Normal user

21 Jul 2014, 10:19

Greetings,
Whenever we want to calculate Wt gain, we need to use minimum wt rather than Admissin; but incase when we don't have min Wt, we can use Admission wt

If we take Oedematous cases, Wt lose in subsequent follow ups doesnt mean that the condition is deteriorating; it could be sign for improvement.

I dont want to go further as others reponded in a more clear way!

Thanks!

Alice Burrell

MSc student, LSHTM

Normal user

21 Jul 2014, 10:48

Hello,

A slightly different direction to this quetion - but does anyone know how I can calculate weight gain in either excel or STATA given that I need to use the lowest weight over the time series for each patient to calculate this?

Thank-you

Moses Cowan

Nutrition Officer

Normal user

18 Sep 2014, 13:25

It is best advisable to calculate weight gain during discharge (cure) for a clear picture of how the child progresses. Calculating weight gain between days can give very small evolution taking into account the feed per day. But in general calculating weight gain requires using the minimum weight attained by the child in respective of the days been the (3rd or 4th). What I want to know is to what context in the CMAM programme does the child belongs to (OTP/IPF)? Because in the IPF it is normally very small weight gain whilst in the OTP it is difficult to determine the minimum weight within days.
Hope to get response on facility of the CMAM programme. Thanks

Mark Myatt

Consultant Epideomiologist

Frequent user

18 Sep 2014, 14:49

Alice,

Sorry to get to this so late. I am not a STATA or EXCEL user but the procedure would be the same in any environment. Suppose you have columns of days and weights such as:

  day      weight
    1       10.9
    7        9.7
   14       10.1
   21       10.9
   28       11.4
   35       11.8
   42       12.1
   49       12.5

Then your wight gain would be:

  last weight - minimum weight

Using R this would be something like:

  weight[length(weight)] - min(weight)

This should be easy to do do in STATA (not sure about EXCEL).

Moses,

I agree that weight between days will be small and gains may be lost in the noise of measurement errors and other sources of variation (e.g. hydration). Gains should be large enough between visits (weekly or fortnightly) to be detectable. In this case we would not want to see a zero or negative weight gain between visits (the exception is that we'd want to see negative weight gain as oedema is lost in kwashiorkor cases).

I assume "IPF" means inpatient stabilisation (SC). Weight gains will usually be small or negative (in the case of loss of oedema). It is common to transfer from SC to OTP after a few days based on clinical criteria (infections treated, oedema lost, appetite returned) rather than weight loss. Whether you use data from the start of the SC phase or from the start of the OTP episode is a matter of choice. If the SC is run by a separate agency then and you do not have easy access to patients' SC records then it is common to use data from the OTP episode alone. This should not make much difference as their should be << 5% of patients entering SC after the first few weeks of operation.

I hope this is of some use.

Anonymous 3445

M&E officer

Normal user

6 Sep 2016, 18:11

Hi Alice,
"Average weight gain = Sum of individual weight gains (gram/kg/day) / Total number of beneficiaries".
STATA code for a variable set:
var1 var2 var3 ...... var12
x11 x12 x13 ...... x112
x21 x22 x23 ...... x212

1. generate a variable with minimum weight
. egen minweight = rowmin (var1 - var12)
2. generate a variable with maximum weight
. egen maxweight = rowmax (var1 - var12)
3. generate a variable with gained weights
. gen weight_gained = maxweight - minweight
4. calculate the average of gained weights
. mean weight_gained

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