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Published in: Emerging Themes in Epidemiology 1/2018

Open Access 01-12-2018 | Research article

Change in quality of malnutrition surveys between 1986 and 2015

Authors: Emmanuel Grellety, Michael H. Golden

Published in: Emerging Themes in Epidemiology | Issue 1/2018

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Abstract

Background

Representative surveys collecting weight, height and MUAC are used to estimate the prevalence of acute malnutrition. The results are then used to assess the scale of malnutrition in a population and type of nutritional intervention required. There have been changes in methodology over recent decades; the objective of this study was to determine if these have resulted in higher quality surveys.

Methods

In order to examine the change in reliability of such surveys we have analysed the statistical distributions of the derived anthropometric parameters from 1843 surveys conducted by 19 agencies between 1986 and 2015.

Results

With the introduction of standardised guidelines and software by 2003 and their more general application from 2007 the mean standard deviation, kurtosis and skewness of the parameters used to assess nutritional status have each moved to now approximate the distribution of the WHO standards when the exclusion of outliers from analysis is based upon SMART flagging procedure. Where WHO flags, that only exclude data incompatible with life, are used the quality of anthropometric surveys has improved and the results now approach those seen with SMART flags and the WHO standards distribution. Agencies vary in their uptake and adherence to standard guidelines. Those agencies that fully implement the guidelines achieve the most consistently reliable results.

Conclusions

Standard methods should be universally used to produce reliable data and tests of data quality and SMART type flagging procedures should be applied and reported to ensure that the data are credible and therefore inform appropriate intervention. Use of SMART guidelines has coincided with reliable anthropometric data since 2007.
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Literature
4.
go back to reference Stuart HC, Stevenson SS, Nelson WE. Textbook of pediatrics. Textbook of pediatrics Philadelphia: Saunders; 1959. p. 50–1. Stuart HC, Stevenson SS, Nelson WE. Textbook of pediatrics. Textbook of pediatrics Philadelphia: Saunders; 1959. p. 50–1.
10.
go back to reference Coulombier D, Pécoul B, Desvé G, Moren A. Enquêtes nutritionnelles anthropométriques rapides (ENAR) en situation précaire. Cahiers d’études et de recherches francophones/Santé. 1992;2(6):377–84. Coulombier D, Pécoul B, Desvé G, Moren A. Enquêtes nutritionnelles anthropométriques rapides (ENAR) en situation précaire. Cahiers d’études et de recherches francophones/Santé. 1992;2(6):377–84.
11.
go back to reference Coulombier D, Pécoul B, Desvé G, Moren A. Enquêtes nutritionnelles : analyse et interprétation de l’indice poids-taille. Cahiers d’études et de recherches francophones/Santé. 1992;2(6):385–9. Coulombier D, Pécoul B, Desvé G, Moren A. Enquêtes nutritionnelles : analyse et interprétation de l’indice poids-taille. Cahiers d’études et de recherches francophones/Santé. 1992;2(6):385–9.
12.
go back to reference Toole M, Malkki RM. Famine-affected, Refugee and displaced populations: Recommendations for Public Health Issues, Morbidity and Mortality Weekly Report. Centers for Disease Control (U.S.), International Health Program Office. 1992; 41/No. RR-13. https://stacks.cdc.gov/view/cdc/13566. Toole M, Malkki RM. Famine-affected, Refugee and displaced populations: Recommendations for Public Health Issues, Morbidity and Mortality Weekly Report. Centers for Disease Control (U.S.), International Health Program Office. 1992; 41/No. RR-13. https://​stacks.​cdc.​gov/​view/​cdc/​13566.
14.
go back to reference United Nations. Administrative Committee on Co-ordination. Sub-committee on Nutrition, Office of the United Nations High Commissioner for Refugees. Report of a Workshop on the Improvement of the Nutrition of Refugees and Displaced People in Africa: Machakos, Kenya, 5–7 December 1994: with Background Documentation. University of Nairobi, Applied Human Nutrition Programme (ANP). 1995. https://searchworks.stanford.edu/view/3751470. United Nations. Administrative Committee on Co-ordination. Sub-committee on Nutrition, Office of the United Nations High Commissioner for Refugees. Report of a Workshop on the Improvement of the Nutrition of Refugees and Displaced People in Africa: Machakos, Kenya, 5–7 December 1994: with Background Documentation. University of Nairobi, Applied Human Nutrition Programme (ANP). 1995. https://​searchworks.​stanford.​edu/​view/​3751470.
15.
go back to reference Médecins Sans Frontières (MSF). Nutrition Guidelines. Paris, France: MSF;1995. Médecins Sans Frontières (MSF). Nutrition Guidelines. Paris, France: MSF;1995.
16.
go back to reference World Health Organization. Field Guide on Rapid Nutritional Assessment in Emergencies. Geneva: WHO; 1995. World Health Organization. Field Guide on Rapid Nutritional Assessment in Emergencies. Geneva: WHO; 1995.
17.
go back to reference Coulombier D, Dionisius JP, Desvé G. Epinut, un logiciel de calcul et d’analyse d’indices anthropométriques. Paris: Epicentre; 1990. Coulombier D, Dionisius JP, Desvé G. Epinut, un logiciel de calcul et d’analyse d’indices anthropométriques. Paris: Epicentre; 1990.
21.
go back to reference World Food Program. A manual: Measuring and interpreting malnutrition and mortality. Rome: WHO; 2005. World Food Program. A manual: Measuring and interpreting malnutrition and mortality. Rome: WHO; 2005.
28.
go back to reference Yip R. Expanded usage of anthropometry Z-scores for assessing population nutritional status and data quality. In: Abstracts book no. 1, 15th International Congress of Nutrition (Adelaide). Adelaide, International Union of Nutritional Sciences. 1993:279. Yip R. Expanded usage of anthropometry Z-scores for assessing population nutritional status and data quality. In: Abstracts book no. 1, 15th International Congress of Nutrition (Adelaide). Adelaide, International Union of Nutritional Sciences. 1993:279.
29.
go back to reference Mei Z, Grummer-Strawn LM. Standard deviation of anthropometric Z-scores as a data quality assessment tool using the 2006 WHO growth standards: a cross country analysis. Bull World Health Organ. 2007;85(6):441–8.CrossRefPubMedPubMedCentral Mei Z, Grummer-Strawn LM. Standard deviation of anthropometric Z-scores as a data quality assessment tool using the 2006 WHO growth standards: a cross country analysis. Bull World Health Organ. 2007;85(6):441–8.CrossRefPubMedPubMedCentral
36.
go back to reference Trochim WM, Donnelly JP. The research methods knowledge base. 3rd ed. Cincinnati (OH): Atomic Dog Publishing; 2008. p. 361. Trochim WM, Donnelly JP. The research methods knowledge base. 3rd ed. Cincinnati (OH): Atomic Dog Publishing; 2008. p. 361.
37.
go back to reference Bulmer MG. Principles of statistics. Mineola: Dover Books on Mathematics: Courier Corporation; 2012. Bulmer MG. Principles of statistics. Mineola: Dover Books on Mathematics: Courier Corporation; 2012.
38.
go back to reference Gravetter F, Wallnau L. Essentials of statistics for the behavioral sciences. 8th ed. Belmont, CA: Wadsworth; 2014. Gravetter F, Wallnau L. Essentials of statistics for the behavioral sciences. 8th ed. Belmont, CA: Wadsworth; 2014.
39.
go back to reference Westfall PH. Kurtosis as peakedness, 1905–2014. Am Stat. 2014;68(3):191–5. pmid:25678714. Westfall PH. Kurtosis as peakedness, 1905–2014. Am Stat. 2014;68(3):191–5. pmid:25678714.
40.
go back to reference Cole TJ. The LMS method for constructing normalized growth standards. Eur J Clin Nutr. 1990;44:45–60.PubMed Cole TJ. The LMS method for constructing normalized growth standards. Eur J Clin Nutr. 1990;44:45–60.PubMed
45.
go back to reference Crowe S, Seal A, Grijalva-Eternod C, Kerac M. Effect of nutrition survey ‘cleaning criteria’ on estimates of malnutrition prevalence and disease burden: secondary data analysis. Peer J. 2014;2:e380. pmid:24883244. Crowe S, Seal A, Grijalva-Eternod C, Kerac M. Effect of nutrition survey ‘cleaning criteria’ on estimates of malnutrition prevalence and disease burden: secondary data analysis. Peer J. 2014;2:e380. pmid:24883244.
46.
go back to reference Ulijaszek SJ, Kerr DA. Anthropometric measurement error and the assessment of nutritional status. Br J Nutr. 1999;82:165–177. pmid:10655963. Ulijaszek SJ, Kerr DA. Anthropometric measurement error and the assessment of nutritional status. Br J Nutr. 1999;82:165–177. pmid:10655963.
Metadata
Title
Change in quality of malnutrition surveys between 1986 and 2015
Authors
Emmanuel Grellety
Michael H. Golden
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Emerging Themes in Epidemiology / Issue 1/2018
Electronic ISSN: 1742-7622
DOI
https://doi.org/10.1186/s12982-018-0075-9

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