Prognostic accuracy of WHO growth standards to predict mortality in a large-scale nutritional program in Niger
2009

WHO Growth Standards and Child Mortality in Niger

Sample size: 64484 publication 10 minutes Evidence: high

Author Information

Author(s): Nathanael Lapidus, Francisco J. Luquero, Valérie Gaboulaud, Susan Shepherd, Rebecca F. Grais

Primary Institution: Epicentre, Paris, France

Hypothesis

How do the WHO growth standards compare to the NCHS reference in predicting mortality among malnourished children?

Conclusion

The WHO growth standards are more accurate than the NCHS reference for predicting mortality risk in malnourished children.

Supporting Evidence

  • WHO standards showed higher accuracy in predicting mortality than NCHS reference.
  • AUC values for WHO indicators were 0.76 and 0.77, compared to 0.63 and 0.71 for NCHS.
  • The study included a large sample size of 64,484 children.

Takeaway

This study found that using WHO growth standards helps doctors better predict which malnourished children might die, compared to older methods.

Methodology

Data from 64,484 malnourished children aged 6-59 months were analyzed to compare the accuracy of WHO and NCHS growth standards in predicting mortality.

Potential Biases

Selection bias due to the study population being limited to children admitted to a nutritional program.

Limitations

Results may not be generalizable to all malnourished children as the study focused on those already receiving treatment.

Participant Demographics

Children aged 6-59 months, with a higher proportion of girls (55.5%) and an average age of 19.5 months.

Statistical Information

P-Value

p<0.001

Confidence Interval

95% CI 0.60–0.66 for NCHS WHZ; 95% CI 0.75–0.80 for WHO WHZ

Statistical Significance

p<0.001

Digital Object Identifier (DOI)

10.1371/journal.pmed.1000039

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