title: Malnutrition: missed opportunities for diagnosis.
abstract: BACKGROUND
  Malnutrition is a serious public health problem particularly in developing countries where it is responsible for 54% of under 5s mortality. Anthropometric measurements are key tools for the assessment of nutritional status and diagnosis of malnutrition. Height and weight measurements are not routinely done in most clinics and hospitals in Ghana. Children therefore miss the opportunity for accurate nutritional assessment and detection of malnutrition.
  
  
  OBJECTIVE
  To determine the prevalence of wasting among children <5 years and to document extent of under-diagnosis.
  
  
  METHODS
  From June to August 2004, children aged >3 months to <5 years attending the outpatient clinic of Komfo Anokye Teaching Hospital were systematically assessed for wasting using weight-for-height standard deviation score (Z-score).
  
  
  RESULTS
  Of 1182 children (mean age 24.9 months), 251 (21.2%) were wasted, 48 (4.1%) of them severely. Only 15 (5.9%) of the 251 children with wasting were so identified by the attending physician.
  
  
  CONCLUSIONS
  Malnutrition is widespread yet under-diagnosed. Anthropometric measurements should be promoted in all child health clinics.
authors.affiliation: Department of Child Health, Kwame Nkrumah University of Science & Technology and Komfo Anokye Teaching Hospital, P. O. Box 1934, Kumasi, Ghana.
authors.forename: S
authors.initials: S
authors.lastname: Antwi