AnthropometryTechnique of measuring people

MeasureIndexIndicatorReferenceInformation

MeasurementsWeight Height Length and stature or heightMid Upper Arm Circumference MUAC

Characteristics we need: easycheapacceptablereproducible

Relation between two measurementsweight for age W/A or W//A general appreciation of nutritional statusheight for age H/A or H//A measure of linear growth deficit or STUNTINGweight for height/length W/H or W//H measure of weight deficit according to length WASTING INDEX

Sensitive to changesChanges in two directions up and downFast changeUsually easy to collectStandardisation of scales needed, calibrationSmall changes are difficult to measure: food intake of the child, urine, dehydration, temp, etc: not very specificcommunity aversion: connotationscan be difficult: co-operation of childrento nearest 100 gr.

WEIGHT

_1064068778.doc

Difficult to measure, accuracy, large variationsDifferences are small: 24 cm increment in the first year of life, 11 cm second year, 8 thirdLow sensitivityLarge measurement errorsStunted versus stuntingstunted is a heterogeneous groupstunting is the active process: determinants are actingMeasure to the nearest mmBelow 2 recumbent, above standing

Height

Usually the most difficult and inaccurate measurementLess of a problem if a trend in the same child is measured, the mistake is repeated every time and thus cancels outAGE

Growth of a child

Indicator

WHO-NCHSThe reference

1.Measurements should relate to a well-nourished population. 2.Sample : at least 200 individuals in each age and sex group. 3.Sample: cross-sectional, since the comparisons that will be made are of a cross-sectional nature. 4.Sampling procedures should be defined and reproducible. 5.Measurements should be carefully made and recorded by observers trained in anthropometric techniques, using equipment of well tested design and calibrated at frequent intervals. 6.The measurements made on the sample should include all the anthropometric variables that will be used in the evaluation of nutritional status. 7.The data from which reference graphs and tables are prepared should be available for anyone wishing to use them, and the procedures used for smoothing curves and preparing tables should be adequately described and documented.

Criteria for a reference

Classifications: GOMEZ

PRIVATE Percentage W/A

TYPE

>= 90 %

Normal

75 - 90 %

First degree / mild malnutrition

60 - 74 %

Second degree / moderate malnutrition

< 60 %

Third degree / severe malnutrition

Classifications: WATERLOW

PRIVATE Waterlow

Weight for

Height

Classification

>= 80 %

< 80 %

Height for

>= 90 %

Normal

Wasted

Age

< 90 %

Stunted

Wasted and stunted

Identification serve a purpose , the identified should be dealt with. Capacity of numbers.Sensitivity (Se) is the ability of a test to identify as positive those who are diseased.Specificity (Sp) is the ability of a test to identify as negative those who are healthy.Positive predictive value: If you test positive, what is the chance of really being positive. Negative predictive value is the chance of being healthy whilst being identified as negative. The chance of being really negative is higher when there are no false negatives, i.e. when the sensitivity is higher.

Anthropometry is an operational tool

Truly MalnourishedYesNoDiagnosed asYesTPFPmalnourishedNoFNTN

TP= true positiveFP= false positiveTN= true negativeFN= false negative

Se= TP/(TP+FN)Sp= TN/(TN+FP)Positive predictive value (PPV) = TP/(TP+FP)Negative predictive value (NPV) = TN/(TN+FN)

Se and Sp

Summary of applications

IndexApplication

Indicator

ACEmergencies (screening)CUa flexible

W/HEmergencies (screening)CUa flexible

One time assessment ofMean (SD) or

wastingConventional CU

Assessment of impact ofMean (SD)

short term programmeConventional CU

Rapid targeting andConventional CU

early warning

Growth monitoringNone

W/AGrowth monitoringNone

H/ALong-term planningMean (SD)

Surveillance of trendsMean (SD)

(long term)

Programme managementMean(SD)

growth monitoringNone

a CU = Cut-off, conventional CU = - 2SD.

Z-skor = nilai individu- nilai median baku rujukan : nilai simpang baku rujukan

Nulai individu = nilai hasil pengukuranNilai median baku = dilihat di baku acuan menurut umur anak tsb

Contoh soal : seorang balita laki-laki berusia 24 bulan, berat badan 10 kg, panjang badan 80 cm. Tentukanlagh status gizi anak tersebut berdasarkan indeks berat badan menurut umur, BB/TB dan PB/URumus perhitungan z-skor

10-12,2 ; 12,2-10,8 = - 0,20Klasifikasi status gizi berdasar indeks bb/u : gizi baik

Z=skor indeks BB/TB : 10-10,4 : 10,4-9,6 = -0,5Status gizi indeks BB/TB = normalZskor PB/U = -2,6Status gizi = pendek.

Seorang remaja perempuan berusia 15 tahun, mempunyai berat badan 40 kg, tinggi badan 150 cm. Hitunglah IMT nya !IMT = BB/TBxTB= 40/1,5x1,5=17,7

Interpretasi hasil penilaian tingkat konsumsiBaik : >= 100% AKGSedang : 80 -99% AKGKurang : 70-80%Defisit :