Complementary and alternative metrics for tracking population-level trends in child linear growth.
Stunting prevalence is commonly used to track population-level child nutritional status. However, other metrics derived from anthropometric datasets may be used as alternatives to stunting or provide complementary perspectives on the status of linear growth faltering in low- and middle-income countr...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2023-01-01
|
| Series: | PLOS Global Public Health |
| Online Access: | https://doi.org/10.1371/journal.pgph.0001766 |
| _version_ | 1797701114788839424 |
|---|---|
| author | Ashley M Aimone Diego G Bassani Huma Qamar Alison Dasiewicz Nandita Perumal Sorrel M L Namaste Devanshi Shah Daniel E Roth |
| author_facet | Ashley M Aimone Diego G Bassani Huma Qamar Alison Dasiewicz Nandita Perumal Sorrel M L Namaste Devanshi Shah Daniel E Roth |
| author_sort | Ashley M Aimone |
| collection | DOAJ |
| description | Stunting prevalence is commonly used to track population-level child nutritional status. However, other metrics derived from anthropometric datasets may be used as alternatives to stunting or provide complementary perspectives on the status of linear growth faltering in low- and middle-income countries (LMICs). Data from 156 Demographic and Health Surveys in 63 LMICs (years 2000 to 2020) were used to generate 2 types of linear growth metrics: (i) measures of location of height distributions (including stunting) for under-5 years (<5y) and 2 to 5 years (2-5y); (ii) model-derived metrics including predicted mean height-for-age z-score (HAZ) at 0, 2, and 5 years; interval slopes of HAZ, height-for-age difference (HAD), and growth delay (GD) from 1 month to 2 years (1mo-2y) and 2-5y; and the SITAR intensity parameter (SITAR-IP) for <5y. Using Spearman's rank correlation coefficient (r), metrics were considered alternatives to stunting if very strongly correlated with stunting (|r|≥0.95) and at least as strongly correlated as stunting with selected population indicators (under 5y mortality, gross domestic product, maternal education). Metrics were considered complementary if less strongly correlated with stunting (|r|<0.95) yet correlated with population indicators. We identified 6 of 15 candidate metrics (stunting 2-5y, mean HAZ <5y and 2-5y, p25 HAZ <5y and 2-5y, predicted HAZ at 2y) as potential alternatives to stunting and 6 as complementary metrics (SITAR-IP, predicted HAZ at 5y, HAZ slope 1m-2y, HAD slope 1m-2y, GD slopes 1m-2y and 2-5y). Three metrics (HAZ slope 2-5y, HAD slope 2-5y years and predicted HAZ at birth) had weak correlations with population indicators (|r| ≤ 0.43). In conclusion, several linear growth metrics could serve as alternatives to stunting prevalence and others may be complementary to stunting in tracking global progress in child health and nutrition. Further research is needed to explore the real-world utility of these alternative and complementary metrics. |
| first_indexed | 2024-03-12T04:30:37Z |
| format | Article |
| id | doaj.art-4698e64450a64cb0aebb4c3c0f74871c |
| institution | Directory Open Access Journal |
| issn | 2767-3375 |
| language | English |
| last_indexed | 2024-03-12T04:30:37Z |
| publishDate | 2023-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLOS Global Public Health |
| spelling | doaj.art-4698e64450a64cb0aebb4c3c0f74871c2023-09-03T10:06:25ZengPublic Library of Science (PLoS)PLOS Global Public Health2767-33752023-01-0134e000176610.1371/journal.pgph.0001766Complementary and alternative metrics for tracking population-level trends in child linear growth.Ashley M AimoneDiego G BassaniHuma QamarAlison DasiewiczNandita PerumalSorrel M L NamasteDevanshi ShahDaniel E RothStunting prevalence is commonly used to track population-level child nutritional status. However, other metrics derived from anthropometric datasets may be used as alternatives to stunting or provide complementary perspectives on the status of linear growth faltering in low- and middle-income countries (LMICs). Data from 156 Demographic and Health Surveys in 63 LMICs (years 2000 to 2020) were used to generate 2 types of linear growth metrics: (i) measures of location of height distributions (including stunting) for under-5 years (<5y) and 2 to 5 years (2-5y); (ii) model-derived metrics including predicted mean height-for-age z-score (HAZ) at 0, 2, and 5 years; interval slopes of HAZ, height-for-age difference (HAD), and growth delay (GD) from 1 month to 2 years (1mo-2y) and 2-5y; and the SITAR intensity parameter (SITAR-IP) for <5y. Using Spearman's rank correlation coefficient (r), metrics were considered alternatives to stunting if very strongly correlated with stunting (|r|≥0.95) and at least as strongly correlated as stunting with selected population indicators (under 5y mortality, gross domestic product, maternal education). Metrics were considered complementary if less strongly correlated with stunting (|r|<0.95) yet correlated with population indicators. We identified 6 of 15 candidate metrics (stunting 2-5y, mean HAZ <5y and 2-5y, p25 HAZ <5y and 2-5y, predicted HAZ at 2y) as potential alternatives to stunting and 6 as complementary metrics (SITAR-IP, predicted HAZ at 5y, HAZ slope 1m-2y, HAD slope 1m-2y, GD slopes 1m-2y and 2-5y). Three metrics (HAZ slope 2-5y, HAD slope 2-5y years and predicted HAZ at birth) had weak correlations with population indicators (|r| ≤ 0.43). In conclusion, several linear growth metrics could serve as alternatives to stunting prevalence and others may be complementary to stunting in tracking global progress in child health and nutrition. Further research is needed to explore the real-world utility of these alternative and complementary metrics.https://doi.org/10.1371/journal.pgph.0001766 |
| spellingShingle | Ashley M Aimone Diego G Bassani Huma Qamar Alison Dasiewicz Nandita Perumal Sorrel M L Namaste Devanshi Shah Daniel E Roth Complementary and alternative metrics for tracking population-level trends in child linear growth. PLOS Global Public Health |
| title | Complementary and alternative metrics for tracking population-level trends in child linear growth. |
| title_full | Complementary and alternative metrics for tracking population-level trends in child linear growth. |
| title_fullStr | Complementary and alternative metrics for tracking population-level trends in child linear growth. |
| title_full_unstemmed | Complementary and alternative metrics for tracking population-level trends in child linear growth. |
| title_short | Complementary and alternative metrics for tracking population-level trends in child linear growth. |
| title_sort | complementary and alternative metrics for tracking population level trends in child linear growth |
| url | https://doi.org/10.1371/journal.pgph.0001766 |
| work_keys_str_mv | AT ashleymaimone complementaryandalternativemetricsfortrackingpopulationleveltrendsinchildlineargrowth AT diegogbassani complementaryandalternativemetricsfortrackingpopulationleveltrendsinchildlineargrowth AT humaqamar complementaryandalternativemetricsfortrackingpopulationleveltrendsinchildlineargrowth AT alisondasiewicz complementaryandalternativemetricsfortrackingpopulationleveltrendsinchildlineargrowth AT nanditaperumal complementaryandalternativemetricsfortrackingpopulationleveltrendsinchildlineargrowth AT sorrelmlnamaste complementaryandalternativemetricsfortrackingpopulationleveltrendsinchildlineargrowth AT devanshishah complementaryandalternativemetricsfortrackingpopulationleveltrendsinchildlineargrowth AT danieleroth complementaryandalternativemetricsfortrackingpopulationleveltrendsinchildlineargrowth |