Berger Michelle R, Fields-Gardner Cade, Wagle Ashwini, Hollenbeck Clarie B
Sacramento County Department of Health and Human Services, Sacramento, CA, USA.
J Am Diet Assoc. 2008 Jun;108(6):1014-7. doi: 10.1016/j.jada.2008.03.008.
The prevalence of undernutrition in children is commonly reported using a conventional index, which identifies three conventional categories: stunting, underweight, and wasting. Recently, a composite index of anthropometric failure was developed to categorize undernutrition into seven mutually exclusive categories, including single failures (stunting, underweight, or wasting) and multiple failures (stunting and underweight, stunting and wasting, underweight and wasting, and stunting and underweight and wasting). This cross-sectional study used baseline data gathered during a feeding program targeting orphans and vulnerable children impacted by human immunodeficiency virus and/or acquired immunodeficiency syndrome (HIV/AIDS) in Kenya to compare the conventional index with the composite index of anthropometric failure. Children younger than 5 years of age who participated in the feeding trial were included in the analysis (n=170). The conventional index found that the prevalence of undernutrition included 31.2% stunted, 14.1% underweight, and 5.9% wasted children, whereas the composite index of anthropometric failure estimated a more severe overall prevalence rate (38.2%); thus, the conventional index did not uncover the complexity of malnutrition experienced. Of the 53 children classified as stunted by the conventional index, the composite index of anthropometric failure identified 36 (67.9%) as stunted and 17 (32.1%) as stunted and underweight. Thus, the composite index of anthropometric failure was able to distinguish children with multiple anthropometric failures. In total, multiple anthropometric failures were found in 22 of the 65 children with anthropometric failure. These data suggest that the complexity and prevalence of undernutrition may be underestimated using the conventional index because it does not identify children experiencing multiple anthropometric failures. The ability of the composite index of anthropometric failure to identify children with multiple anthropometric failures may have profound implications for prioritizing, designing, and targeting nutritional interventions.
儿童营养不良的患病率通常使用传统指标来报告，该指标确定了三个传统类别：发育迟缓、体重不足和消瘦。最近，开发了一种人体测量失败综合指数，将营养不良分为七个相互排斥的类别，包括单一失败（发育迟缓、体重不足或消瘦）和多重失败（发育迟缓和体重不足、发育迟缓和消瘦、体重不足和消瘦、发育迟缓和体重不足以及消瘦）。这项横断面研究使用了在肯尼亚针对受人类免疫缺陷病毒和/或获得性免疫缺陷综合征（HIV/AIDS）影响的孤儿和弱势儿童的喂养计划期间收集的基线数据，以比较传统指标与人体测量失败综合指数。参与喂养试验的5岁以下儿童被纳入分析（n = 170）。传统指标发现，营养不良的患病率包括31.2%的发育迟缓儿童、14.1%的体重不足儿童和5.9%的消瘦儿童，而人体测量失败综合指数估计的总体患病率更高（38.2%）；因此，传统指标未能揭示所经历营养不良的复杂性。在传统指标分类为发育迟缓的53名儿童中，人体测量失败综合指数将36名（67.9%）确定为发育迟缓，17名（32.1%）确定为发育迟缓和体重不足。因此，人体测量失败综合指数能够区分存在多种人体测量失败的儿童。在65名有人体测量失败的儿童中，共有22名存在多种人体测量失败。这些数据表明，使用传统指标可能会低估营养不良的复杂性和患病率，因为它无法识别经历多种人体测量失败的儿童。人体测量失败综合指数识别存在多种人体测量失败儿童的能力可能对营养干预措施的优先排序、设计和目标定位产生深远影响。
