Myatt Mark, Duffield Arabella, Seal Andrew, Pasteur Frances
Division of Epidemiology, Institute of Ophthalmology, University College London, London, UK.
Ann Hum Biol. 2009 Jan-Feb;36(1):5-20. doi: 10.1080/03014460802471205.
Nutritional anthropometry surveys from Somalia and Ethiopia have reported that standard weight-for-height z-score (WHZ) and mid-upper arm circumference (MUAC) case definitions return different estimates of the prevalence of acute malnutrition in pastoralist livelihood zones but similar estimates of the prevalence of acute malnutrition in the agrarian livelihood zones. A study undertaken in Somalia to investigate this finding reported that children from pastoralist livelihood zones tended to have longer limbs and lower SSRs than children from agrarian livelihood zones.
The present study investigated the relationship between weight-for-height and body shape and the relationship between MUAC and body shape in different populations of Ethiopian children.
Six cross-sectional nutritional anthropometry surveys were undertaken. The combined survey datasets form the study sample. Data sources were grouped according to the livelihood zone from which data originated (either settled agrarian or semi-nomadic pastoralist). Case definitions of acute malnutrition using WHZ calculated using the NCHS and WHO reference populations and MUAC uncorrected for age or height were used. The SSR was used as an index of body shape. The association between body shape and the different case definitions of acute malnutrition were investigated using standard statistical techniques.
Weight-for-height and MUAC case definitions yielded similar estimates of the prevalence of acute malnutrition in agrarian children but different estimates of the prevalence of acute malnutrition in pastoralist children. These populations also exhibit different SSRs. The SSR is an important predictor of weight-for-height. The SSR is a poor predictor of MUAC.
WHZ and WHZ case status in children are associated with body shape and may overestimate the prevalence of acute malnutrition in some populations. Consideration should be given as to whether WHZ should be replaced by MUAC for the purposes of estimating the prevalence of acute malnutrition.
来自索马里和埃塞俄比亚的营养人体测量学调查显示，标准身高别体重Z评分（WHZ）和上臂中部周长（MUAC）病例定义得出的牧民生计区急性营养不良患病率估计值不同，但农业生计区急性营养不良患病率估计值相似。在索马里进行的一项调查此发现的研究报告称，牧民生计区的儿童往往比农业生计区的儿童四肢更长且SSR更低。
本研究调查了埃塞俄比亚不同儿童群体中身高别体重与体型之间的关系以及MUAC与体型之间的关系。
进行了六项横断面营养人体测量学调查。合并后的调查数据集构成研究样本。数据来源根据数据所源自的生计区进行分组（定居农业区或半游牧牧民区）。使用根据美国国家卫生统计中心（NCHS）和世界卫生组织（WHO）参考人群计算的WHZ以及未校正年龄或身高的MUAC作为急性营养不良的病例定义。SSR用作体型指标。使用标准统计技术研究体型与急性营养不良的不同病例定义之间的关联。
身高别体重和MUAC病例定义得出的农业儿童急性营养不良患病率估计值相似，但牧民儿童急性营养不良患病率估计值不同。这些人群的SSR也不同。SSR是身高别体重的重要预测指标。SSR对MUAC的预测能力较差。
儿童的WHZ和WHZ病例状态与体型有关，可能高估了某些人群中急性营养不良的患病率。在估计急性营养不良患病率时，应考虑是否应以MUAC取代WHZ。
