On May 22, WHO and UNICEF change the definition of new case severe acute malnutrition based on the 2006 WHO growth standards.’ Before the global food crisis, a 2006 review estimated that 13 million children had such malnutrition.’ By January, 2009, aid agencies reported about 19 million affected. Calls were made for the disease-burden demand to be met with increased supply of treatment services.
Numbers of children diagnosed as malnourished vary greatly depending on which case definition is used. Each has advantages and disadvantages, and is useful for particular purposes. Malnutrition for admission to feeding programmes was originally defined by low weiqht-for-aqe. This definition was changed to weiqht-for-heiqht to better identify children who would benefit most from treatment. Weight-for height expressed as Z scores is useful for surveys, yet many treatment programmes admit children with conceptually simpler %-of-median measures. (Minus 1 Z score=l standard deviation below a normally distributed population median. Nutritional oedema is also part of the case definition for severe acute malnutrition.) More recently, focus has been on mid-upper-arm circumference.’
WHO growth standards are an international gold standard describing how children should grow when measured by weight and height. Previously, severe acute malnutrition was defined as weight-for-height Increases in the diagnoses of severe acute malnutrition with the new WHO weight-for-height criteria have been noted. As different countries use different case definition it is difficult to know the true extent of severe acute malnutrition.
Most countries currently use %-of-median. Changing from
Kerac et al 2009 New WHO growth standards: roll-out needs more resources. Lancet vol 374 pp 100-101
- Martin Eastwood