title: Maternal perception of malnutrition among infants using verbal and pictorial methods in Kenya.
abstract: OBJECTIVE
  To compare mothers' perceptions of their own infants' nutritional status with anthropometric indicators of undernutrition.
  
  
  METHODS
  A qualitative study and cross-sectional quantitative survey. The qualitative study involved developing tools to assess mother's perception. Two methods of verbal description and a pictorial scale were developed. The quantitative survey involved measuring maternal perception and comparing it with the anthropometric measures of weight-for-age Z-score (WAZ) and mid-upper arm circumference-for-age Z-score (MUACZ).
  
  
  METHODS
  A rural community setting in Kenya.
  
  
  METHODS
  Seventy-four infants aged between 4 and 6 months, and their mothers, living in rural Kenya were enrolled.
  
  
  RESULTS
  Using verbal description, the positive and negative likelihood ratios were 3.57 (95 % CI 1.44, 9.98) and 0.69 (95 % CI 0.50, 0.96) respectively for MUACZ<-2; and 4.60 (95 % CI 1.60, 13.3) and 0.67 (95 % CI 0.49, 0.92) respectively for WAZ<-2. Using the pictorial scale, the positive and negative likelihood ratios were 8.30 (95 % CI 1.91, 36.3) and 0.69 (95 % CI 0.52, 0.93) respectively for MUACZ<-2; and 4.31 (95 % CI 1.22, 15.0) and 0.78 (95 % CI 0.61, 1.00) respectively for WAZ<-2.
  
  
  CONCLUSIONS
  In a rural community, mothers better identify undernutrition in their infants using a pictorial scale than verbal description. However, neither can replace formal anthropometric assessment. Objective anthropometric tools should be validated for identification of severe acute malnutrition among infants aged less than 6 months.
authors.affiliation: 1KEMRI/Wellcome Trust Research Programme,PO Box 230,Kilifi 80108,Kenya.
authors.forename: Martha K
authors.initials: MK
authors.lastname: Mwangome
authors.affiliation: 1KEMRI/Wellcome Trust Research Programme,PO Box 230,Kilifi 80108,Kenya.
authors.forename: Gregory
authors.initials: G
authors.lastname: Fegan
authors.affiliation: 2MRC International Nutrition Group,London School of Hygiene and Tropical Medicine,University of London,London,UK.
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Prentice
authors.affiliation: 1KEMRI/Wellcome Trust Research Programme,PO Box 230,Kilifi 80108,Kenya.
authors.forename: James A
authors.initials: JA
authors.lastname: Berkley
mesh_terms: D000328:Adult; D001296:Audiovisual Aids; D002657:Child Development; D003144:Communication Barriers; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena / Q000208:ethnology; D007630:Kenya / Q000453:epidemiology; D008297:Male; D009035:Mothers / Q000193:education*; D015596:Nutrition Assessment; D009749:Nutrition Surveys; D010353:Patient Education as Topic; D010865:Pilot Projects; D012306:Risk; D012423:Rural Health / Q000208:ethnology; D000067011:Severe Acute Malnutrition / Q000175:diagnosis* / Q000453:epidemiology / Q000208:ethnology; D014706:Verbal Learning; D055815:Young Adult
keywords: Infants