TAILIEUCHUNG - Comparison of the World Health Organization (WHO) Child Growth Standards and the National Center for Health Statistics/WHO international growth reference: implications for child health programmes

Each year, millions of women and children die from preventable causes. These are not mere statistics. They are people with names and faces. Their suffering is unacceptable in the 21st century. We must, therefore, do more for the newborn who succumbs to infection for want of a simple injection, and for the young boy who will never reach his full potential because of malnutrition. We must do more for the teenage girl facing an unwanted pregnancy; for the married woman who has found she is infected with the HIV virus; and for the mother who faces complications in childbirth | Public Health Nutrition 9 7 942-947 DOI PHN20062005 Comparison of the World Health Organization WHO Child Growth Standards and the National Center for Health Statistics WHO international growth reference implications for child health programmes Mercedes de Onis1 Adelheid W Onyango1 Elaine Borghi1 Cutberto Garza2 and Hong Yang1 for the WHO Multicentre Growth Reference Study Groupt 1Department of Nutrition World Health Organization 20 Avenue Appia 1211 Geneva 27 Switzerland 2Boston College Chestnut Hill MA USA Submitted 23 May 2006 Accepted 27 June 2006 Abstract Objectives To compare growth patterns and estimates of malnutrition based on the World Health Organization WHO Child Growth Standards the WHO standards and the National Center for Health Statistics NCHS WHO international growth reference the NCHS reference and discuss implications for child health programmes. Design Secondary analysis of longitudinal data to compare growth patterns birth to 12 months and data from two cross-sectional surveys to compare estimates of malnutrition among under-fives. Settings Bangladesh Dominican Republic and a pooled sample of infants from North America and Northern Europe. Subjects Respectively 4787 10 381 and 226 infants and children. Results Healthy breast-fed infants tracked along the WHO standard s weight-for-age mean Z-score while appearing to falter on the NCHS reference from 2 months onwards. Underweight rates increased during the first six months and thereafter decreased when based on the WHO standards. For all age groups stunting rates were higher according to the WHO standards. Wasting and severe wasting were substantially higher during the first half of infancy. Thereafter the prevalence of severe wasting continued to be to times that of the NCHS reference. The increase in overweight rates based on the WHO standards varied by age group with an overall relative increase of 34 . . A Growth standards Conclusions The WHO standards provide a better tool to

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