The utility of cross-sectional measurements of weight and length for age in screening for growth failure (chronic malnutrition) and clinically severe protein-energy malnutrition.

The accuracy of identifying children with growth failure and/or clinically severe protein-energy malnutrition (PEM) from a single measure of length or weight for age from birth to 36 months was determined. Growth data were treated cross-sectionally and compared with National Center for Health Statistics growth standards in order to determine the sensitivity, specificity and positive predictive value of a single cross-sectional measure of weight-for-age or length-for-age in identifying children diagnosed via longitudinal records. Under 6 months of age, neither weight nor length for age was an adequate predictor of growth failure or clinical malnutrition; from 12 to 36 months, screening measures based on anthropometry were much improved. It was concluded that a single measure of weight or length for age taken close to the first birthday could identify up to 78% of the future second and third year cases of clinically severe PEM. Implications and limitations are discussed.