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Malnutrition among children 6-24months

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Anonymous 422

Normal user

18 Oct 2010, 18:13

Is there a global estimate of the prevalence of malnutrition of children 6-24months compared to prevalence of malnutrition among chidren greater than 24 and less 60months. Some analysis of 2010 survey data for an arid district in Kenya showed me that GAM among 6-24months was twice GAM among children above 24 months. The same applied to MAM but some was about the same.Is this typical?

Mark Myatt

Consultant Epideomiologist

Frequent user

19 Oct 2010, 09:47

I am not sure if there are any global data on the ratio of prevalences between these two age-groups. It is, however, recognised that wasting tends to be most prevalent in younger children at around the time of weaning. This is consistent with your findings.

The ratio that you find will change depending on the indicator used (i.e. WHZ or MUAC):

(1) A fixed MUAC threshold will tend to select more younger children than MUAC adjusted for height or age or WHZ. This is a good thing because the selected children tend to have the same (elevated) mortality risk. The typical ratio for MUAC will be about 4:1 or 5:1 in favour of younger children.

(2) WHZ will tend to select fewer younger children and more older children compared to MUAC. The typical ratio for WHZ will be about 2:1 in favour of younger children. This is complicated by body shape. In pastoralists living in hot and arid environments with milk in the diet, older children tend to have long legs. This depresses WHZ in older children (note that they are not wasted just long-legged). In Somali and Afar populations (e.g) the effect can be so marked as to reverse the ratio (i.e. it can become 2:1 or 3:1 in favour of older children).

I have a database of 560 nutritional anthropometry surveys. I looked at the ratio of prevalences in these age groups for both MUAC (MUAC < 125 or oedema) and WHZ (WHZ < -2 or oedema) in the 560 datasets. I got the following results:

For MUAC:

Min = 1.2
P25 = 3.1
Median = 4.5
Mean = 5.6
P75 = 6.4
Max = 68.8

For WHZ:

Min = 0.4
P25 = 1.4
Median = 2.0
Mean = 2.3
P75 = 2.9
Max = 11.7

The ratios presented here are for younger:older for GAM.

Doing the same for MAM (115 <= MUAC < 125 without oedema / -3 <= WHZ < -2 without oedema):

For MUAC:

Min = 1
P25 = 2.8
Median = 4.1
Mean = 5.3
P75 = 6.2
Max = 65.1

For WHZ:

Min = 0.5
P25 = 1.2
Median = 1.8
Mean = 2.3
P75 = 2.8
Max = 13.9

These are, I think, consistent with your findings.

I hope this helps.

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