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American Journal of Epidemiology Vol. 144, No. 2: 116-123
Copyright © 1996 by The Johns Hopkins University School of Hygiene and Public Health

other

Comparison of Weight- and Height-based Indices for Assessing the Risk of Death in Severely Malnourished Children

C. Prudhon1,2,, A. Briend2,3, D. Laurier4, M. H. N. Golden5 and J. Y. Mary4

1Action Internationale Contre la Faim (AICF), Paris, France
2INSERM U 290, Paris, France
3ORSTOM, Paris, France
4INSERM U 263, Centre de Bioinformatique, Université Paris 7, Paris, France
5University of Aberdeen, Aberdeen, Scotland

Reprint requests to Dr. C. Prudhon, AICF, 9 rue Dareau, 75014 Paris, France.

To compare the effectiveness of treating malnourished children in different centers, the authors believe there is a need to have a simple method of adjusting mortality rates so that differences in the nutritional status of the children are taken into account. The authors compared different anthropometric indices based on weight and height to predict the risk of death among severely malnourished children. Anthropometric data from 1,047 children who survived were compared with those of 147 children who died during treatment in therapeutic feeding centers set up in African countries in 1993. The optimal ratio of weight to height determined by logistic regression was weight (kg)/height (m)1.74 (95% confidence interval of ß estimate 1.65–1.84). The receiver operating curves (sensitivity vs. specificity) showed that the body mass index (weight (kg)/height (m)2), optimal ratio of weight to height, and weight/height index expressed as the percentage of the median of the National Center for Health Statistics' standard were equivalent and superior to the weight/height index expressed as the z score of the National Center for Health Statistics' standard to predict death. As the optimal ratio of weight to height is easier to calculate than the weight/height index expressed as the percentage of the median or z score and does not depend upon either standards or tables, the optimal ratio of weight to height could be conveniently used to adjust mortality rates for nutritional status in therapeutic feeding centers. Am J Epidemiol 1996; 144: 116–23.

anthropometry; child nutrition disorders; mortality; risk; statistics


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