Department of Community and Global Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo, Japan.
David Geffen School of Medicine, Division of General Internal Medicine and Health Services Research, The University of California Los Angeles, 1100 Glendon Ave, Los Angeles, CA, USA.
J Nutr Sci. 2022 Aug 15;11:e66. doi: 10.1017/jns.2022.67. eCollection 2022.
The poor assessment of child malnutrition impacts both national-level trends and prioritisation of regions and vulnerable groups based on malnutrition burden. Namibia has reported a high prevalence of malnutrition among children younger than 5 years of age. The present study's aim was to identify the optimal methods for estimating child stunting and wasting prevalence in Namibia using two datasets with suspected poor data quality: Namibia Demographic and Health Surveys (NDHS) (1992-2013) and Namibia Household Income and Expenditure Survey (NHIES), 2015/16. This comparative secondary data analysis used two prevalence estimation methods: WHO flags and PROBIT. WHO flags is the standard analysis method for most national household surveys, while the PROBIT method is recommended for poor quality anthropometry. In NHIES ( 4960), the prevalence of stunting ( 4780) was 30·3 and 20·9 % for the WHO flags and PROBIT estimates, respectively, and the national wasting prevalence ( 4637) was 11·2 and 4·2 %, respectively. The trends in nutritional status from NDHS and NHIES showed improvement across WHO flags and PROBIT until 2013; however, from 2013 to 2016, PROBIT showed smaller increases in stunting and wasting prevalence (2·5 and 0·6 percentage points) than WHO flags (6·6 and 5·0 percentage points). PROBIT identified the Khoisan ethnic group and Northern geographical regions with the highest stunting and wasting prevalence, while WHO flags identified similar prevalence across most groups and regions. The present study supports the recommendation to use PROBIT when poor data quality is suspected for constructing trends, and for targeting regions and vulnerable groups.
儿童营养不良评估不佳会影响到国家层面的趋势，以及根据营养不良负担情况对地区和弱势群体的优先排序。纳米比亚报告称，5 岁以下儿童的营养不良患病率较高。本研究的目的是使用两个数据质量可疑的数据集（1992-2013 年的纳米比亚人口与健康调查（NDHS）和 2015/16 年的纳米比亚家庭收入和支出调查（NHIES））来确定评估纳米比亚儿童发育迟缓与消瘦患病率的最佳方法。本比较性二次数据分析使用了两种流行率估计方法：世卫组织标志和 PROBIT。世卫组织标志是大多数国家家庭调查的标准分析方法，而 PROBIT 方法则推荐用于质量较差的人体测量数据。在 NHIES（4960 人）中，发育迟缓（4780 人）的世卫组织标志和 PROBIT 估计患病率分别为 30.3%和 20.9%，国家消瘦流行率（4637 人）分别为 11.2%和 4.2%。NDHS 和 NHIES 的营养状况趋势表明，两种方法的流行率均有所改善，但从 2013 年开始，PROBIT 方法的改善幅度较小（发育迟缓增加 2.5 个百分点，消瘦增加 0.6 个百分点），而世卫组织标志的改善幅度较大（发育迟缓增加 6.6 个百分点，消瘦增加 5.0 个百分点）。PROBIT 方法确定了 Khoisan 族和北部地区的发育迟缓与消瘦患病率最高，而世卫组织标志则在大多数群体和地区确定了相似的流行率。本研究支持在数据质量较差时使用 PROBIT 方法构建趋势和确定目标地区与弱势群体的建议。
