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App or programme to calculate weight gain (g/kg/day) at each OTP visit

This question was posted the Management of wasting/acute malnutrition forum area and has 6 replies.

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Kirrily de Polnay

Nutrition Adviser

Frequent user

21 Sep 2020, 08:31

Dear All,

Does anyone know of an app or programme that an OTP staff member could plug in the weight from last visit and the weight at this visit and get the g/kg/day weight gain from one visit to the next (adapted if these are weekly or bi-weekly visits)?

We often say when weight gain is poor, <5g/kg/day, that further action is needed (e.g. home visit, health promotion session, etc), but I think this is rarely calculated in day to day practice and although the calculation is not hard, it is long and time consuming for a busy OTP staff member.

Thanks,

Kirrily

Mark Myatt

Consultant Epidemiologist

Frequent user

21 Sep 2020, 10:56

I do not have or know of such an app but ... creating an app is not too hard to do. Javascript is a useful language that is built into just about all web-browsers. You can make a form in HTML and do the calculations with Javascript and run the "app" from a local or online HTML file. If you need a smartphone app then you can use make an app and installer from your HTML use Adobe PhoneGap.

Also see this guide.

I used, with Ernest Guevarra, the online PhoneGap Build system to create a WAZ calculator app for ENN's WaST project. We found the biggest issue was specifying screen sizes and object sizes as most smartphone manufactures are dishonest about screen resolutions.

The process of making an HTML / Javascript app is straightforward and your IT department should be able to do this, and make a smartphone app, without much difficulty

I hope this is of some use.

Kirrily de Polnay

Nutrition Adviser

Frequent user

21 Sep 2020, 11:18

Thanks Mark!

Anonymous 28689

Normal user

21 Sep 2020, 14:43

I'm not sure if this will work in other countries, but this app is built just for that.https://play.google.com/store/apps/details?id=com.motherbabyfriendlyphilippines.eopt&hl=en

You will just input the lenght/height and the weight of the child and it will generate a trend if measure in a regular basis. It will also automatically identify if the child is MAM or SAM based on CGS

Anonymous 28689

Normal user

21 Sep 2020, 14:51

You can also try this app

https://play.google.com/store/apps/details?id=org.motherbabyfriendlyphilippines.android&hl=en

It also has a function of calculating the growth of the child. You just need to explore the app to find that function.

Paul

Technical expert

21 Sep 2020, 16:04

Hi Kirrily,

From a practical standpoint a weight measurement will only be accurate to 100g and any weekly calculation will not return an accurate weight gain to compare with the standard. It is possible for either digital or hanging scales to return an incorrect result. 

E.g. The minimum weight gain expected of say a 5kg child would be 175g per week - or approximately the same as a glass of water. If the child had gained say 160g, that might be recorded as a 0.1kg increase with hanging scales or a 0.2kg increase with digital scales. One would trigger a home visit and one would not. Other questions arise, was the measuring technique good? Was the child dehydrated?

For identifying the need for referral or home visit, it is (IMO) the trend that is more important, as captured in weight based action protocols (e.g. static weight for 3 or 5 weeks, weight loss for 2 or 3 weeks) and only requires that staff review the weights of previous weeks on the OTP card.

Static weight or weight loss in absolute terms should be assessed in accordance with other factors at each weekly visit (e.g. reported appetite, appetite test, episodes of illness - especially involving fluid losses) to determine the appropriate action, which may be medical rather than social / educational.

Staff could also look at the trend in MUAC changes to compare with weight changes. They should change in the same direction, but MUAC will be less sensitive to fluid losses than weight. 

 I'm all in favour of technology that make the job of staff easier or that improves the quality of care but they can also come with issues around their deployment. There are some interesting experiences from WVI;

https://www.wvi.org/nutrition/mhealth-CMAM-app

https://www.wvi.org/nutrition/video/mnutrition-growth-monitoring-indonesia


Cheers

Paul

Mark Myatt

Consultant Epidemiologist

Frequent user

22 Sep 2020, 10:12

Thanks for those links. The mHealth app looks like a better bet for patient monitoring than an app that applies only a single criterion.

The issue of measurement error is important and any app / rule would need to be tested  (e.g.) to avoid overwhelming staff with false positive cases for poor response.

Weight is strongly affected by hydration.

One thing to try would be to monitor MUAC change which mirrors weight change and is less affected by hydration than weight or WFH. but the issue of measurement error would remain.

I am concerned about using a single simple weight-velocity rule. Growth / recovery tends to be curvilinear with rapid growth early in treatment being followed by slowing growth and slow growth later in the treatment episode. A rule devised from an average (linear) expectation of growth might lack sensitivity early in treatment and specificity later in treatment.

I hope this is of some help.

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