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Are the children considered heavier or overweight if Weight for Height Z is +5 even after taking out flagged ones.

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Anonymous 31980

Normal user

16 Apr 2019, 02:36

Hello,

World Health Organization Anthro survey analyzer already flags implausible z score. After not including the implausible z score, the maximum Weight for Height z score in my sample is around +4 or +5.56? Does that mean that they are heavier and overweight?

does that also imply that some older children could have been included in the sample especially when caregivers may not remember date of birth of their children?

I humbly seek for your expert opinions.

Mark Myatt

Frequent user

16 Apr 2019, 13:36

These are very high values for WHZ. Anything > +2 would be classed as overweight and anything > +3 would be classed as obese.

WHZ > +5 should have been flagged when using WHO flagging criteria (see page 41 in this WHO manual) as "biologically implausible". The child with WHZ = 5.56 should have been censored "after not including the implausible z score". Something did not work as expected. NCHS flagging criteria accept WHZ values up to +6,

Date-of-birth / age has no bearing on WHZ which is calculated using weight, height, and sex. I think that erroneous data (e.g. low height or high weight) might be to blame.

Note that flagging criteria usually apply to survey data. It is common to see (e.g.) a few true HAZ values more extreme than the lower WHO flagging criteria in clinical (CMAM/OTP) samples.

I hope this is of some use.

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