J. Vandenbroeck et al., VALIDITY OF SINGLE-WEIGHT MEASUREMENTS TO PREDICT CURRENT MALNUTRITION AND MORTALITY IN CHILDREN, The Journal of nutrition, 126(1), 1996, pp. 113-120
In this cross-sectional study of a random cluster sample of 4238 rural
Zairian children aged 0-5 y, we assessed underweight and wasting, def
ined as weight-for-age < 75%, and weight-for-height < 80% of the U.S.
National Center for Health Statistics reference median, respectively.
We determined the diagnostic validity of underweight and wasting for p
rotein-energy malnutrition, taking a low arm circumference and clinica
l signs of muscle loss as criteria. Both underweight and wasting had l
ow sensitivity in recognizing low arm circumference, any clinical musc
le loss and even severe marasmus, especially in the weaning period of
12-30 mos. Receiver operating characteristic (ROC) analysis showed tha
t the diagnostic validity of weight-for-height can be improved by usin
g a cutoff for wasting at Z-score -0.75 instead of Z-score -2 or 80% o
f reference median. ROC analysis of 30-mo mortality revealed a poor pr
ognostic validity of weight-for-height and weight-for-age and better p
erformances of arm circumference (cm) and of age. These data suggest t
hat nutritional intervention programs targeted at wasted or underweigh
t children can have only a limited effect on the prevalence of protein
-energy malnutrition in the community or on the long-term mortality as
sociated with it.