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A comparison of the National Center for Health Statistics and new World Health Organization growth references for school-age children and adolescents with the use of data from 11 low-income countries

Rousham, Emily K. and Roschnik, Natalie and Baylon, Melba Andrea B. and Bobrow, Emily A. and Burkhanova, Mavzuna and Campion, M. Gerda and Adle-Chua, Teresita and Degefie, Tedbabe and Hilari, Caroline and Kalengamaliro, Humphreys and Kassa, Tamiru and Maiga, Fadima and Mahumane, Bonifacio J. and Mukaka, Mary and Ouattara, Fatimata and Parawan, Amado R. and Sacko, Moussa and Patterson, David W. and Sobgo, Gaston and Khandaker, Ikhtiar Uddin and Hall, Andrew (2011) A comparison of the National Center for Health Statistics and new World Health Organization growth references for school-age children and adolescents with the use of data from 11 low-income countries. American Journal of Clinical Nutition, 94 (2). pp. 571-577. ISSN 0002-9165

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Official URL: http://dx.doi.org/10.3945/ajcn.110.008300

Abstract

Background: In 2007 new World Health Organization (WHO) growth references for children aged 5–19 y were introduced to replace the National Center for Health Statistics (NCHS) references. Objective: This study aimed to compare the prevalence of stunting, wasting, and thinness estimated by the NCHS and WHO growth references. Design: NCHS and WHO height-for-age z scores were calculated with the use of cross-sectional data from 20,605 schoolchildren aged 5–17 y in 11 low-income countries. The differences in the percentage of stunted children were estimated for each year of age and sex. The z scores of body mass index–for-age and weight-for-height were calculated with the use of the WHO and NCHS references, respectively, to compare differences in the prevalence of thinness and wasting. Results: No systematic differences in mean z scores of height-for-age were observed between the WHO and NCHS growth references. However, z scores of height-for-age varied by sex and age, particularly during early adolescence. In children for whom weight-for-height could be calculated, the estimated prevalence of thinness (WHO reference) was consistently higher than the prevalence of wasting (NCHS reference) by as much as 9% in girls and 18% in boys. Conclusions: In undernourished populations, the application of the WHO (2007) references may result in differences in the prevalence of stunting for each sex compared with results shown when the NCHS references are used as well as a higher estimated prevalence of thinness than of wasting. An awareness of these differences is important for comparative studies or the evaluation of programs. For school-age children and adolescents across all ranges of anthropometric status, the same growth references should be applied when such studies are undertaken.

Item Type:Article
Research Community:University of Westminster > Life Sciences, School of
ID Code:9557
Deposited On:26 Jul 2011 14:54
Last Modified:26 Jul 2011 14:54

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