title: Field-testing the WHO child growth standards in four countries.
abstract: In April 2006 the WHO released a set of growth standards for children from birth to the age of 5 y. Prior to their release, the standards were field-tested in 4 countries. The main objective was to compare children's length/height-for-age and weight-for-length/height based on the new standards with clinician assessments of the same children. The study sampled children <5-y-old attending well-child clinics in 2 affluent populations (Argentina and Italy) and 2 less-affluent ones (Maldives and Pakistan). Length/height and weight were measured by doctors and epidemiologists who also recorded a clinical assessment of each child's length/height in relation to age and weight relative to length/height. Anthropometric indicators of nutritional status were generated based on the WHO standards. As expected, Pakistan and the Maldives had higher rates of stunting, wasting, and underweight than Italy and Argentina, and the reverse was true for overweight and obesity. Where stunting was prevalent, the children classified as short were a mean <-2 SD for height-for-age. In all sites, the children classified as thin were indeed wasted (<-2 SD for weight-for-height) and a positive association in trend was evident between weight-for-height and the line-up of groups from thin to obese. The overall concordance between clinical assessments and the WHO standards-based indicators attested to the clinical soundness of the standards.
authors.affiliation: Department of Nutrition, World Health Organization, CH-1211 Geneva 27, Switzerland. onyangoa@who.int
authors.forename: Adelheid W
authors.initials: AW
authors.lastname: Onyango
authors.forename: Mercedes
authors.initials: M
authors.lastname: de Onis
authors.forename: Margherita
authors.initials: M
authors.lastname: Caroli
authors.forename: Uzma
authors.initials: U
authors.lastname: Shah
authors.forename: Yanina
authors.initials: Y
authors.lastname: Sguassero
authors.forename: Nora
authors.initials: N
authors.lastname: Redondo
authors.forename: Berenise
authors.initials: B
authors.lastname: Carroli
mesh_terms: D001118:Argentina; D001835:Body Weight; D002657:Child Development; D002675:Child, Preschool; D006801:Humans; D007195:Indian Ocean Islands; D007223:Infant; D007558:Italy; D044342:Malnutrition / Q000453:epidemiology; D010154:Pakistan; D014944:World Health Organization