Comparison of Growth Diagrams Of Indonesian Children to 2006 World Health Organization Growth Standards in diagnosing stunting

  • Rizki Aryo Wicaksono Departemen Ilmu Kesehatan Anak/RSUP H. Adam Malik Medan
  • Karina Sugih Arto Department of Child Health, Universitas Sumatera Utara Medical School/H. Adam Malik Hospital, Medan, North Sumatera
  • Rina Amalia Karomina Saragih Department of Child Health, Universitas Sumatera Utara Medical School/H. Adam Malik Hospital, Medan, North Sumatera
  • Melda Deliana Department of Child Health, Universitas Sumatera Utara Medical School/H. Adam Malik Hospital, Medan, North Sumatera
  • Munar Lubis Department of Child Health, Universitas Sumatera Utara Medical School/H. Adam Malik Hospital, Medan, North Sumatera
  • Jose Rizal Latief Batubara Universitas Indonesia Medical School/Dr. Cipto Mangunkusumo Hospital, Jakarta
Keywords: 2006 WHO Growth Standards; Growth Diagrams of Indonesian Children; stunting

Abstract

Background Stunting represents a linear growth disturbance due to chronic malnutrition, recurrent infection, and inadequate psychosocial stimulation. The 2006 World Health Organization (WHO) Growth Standards are utilized as a modality in monitoring children's growth, but to date, there has been no recommendation on use of the Growth Diagrams of Indonesian Children to monitor the growth of Indonesian children.

Objective To determine the proportion of stunting, the sensitivity and specificity of Growth Diagrams of Indonesian Children for diagnosing stunting. In addition, we aimed to compare proportions of stunting using the 2006 WHO Growth Standards and Growth Diagrams of Indonesian Children.

Method A cross-sectional study was conducted in Lawe Alas District, Southeast Aceh, Indonesia, from December 2017 to May 2018. Subjects were children aged 1-59 months who fulfilled the inclusion criteria. Subjects were obtained using a consecutive sampling method. Weight and height measurements were plotted on the Growth Diagrams of Indonesian Children and on the 2006 WHO Growth Standards to determine the stature o subjects. Stunting was defined as the index Z-score for HAZ of less than -2 SD for the 2006 WHO Growth Standards, and an HAZ index of below the 10th percentile (p10th) for the Growth Diagrams of Indonesian Children.

Results Of 141 subjects, 66 (46.8%) had stunting based on the 2006 WHO Growth Standards and 51 (34.8%) had stunting based on Growth Diagrams of Indonesian Children. The sensitivity and specificity of the Growth Diagrams of Indonesian Children were 75.5% and 98.66%, respectively. Significantly more children were considered to be stunted using the 2006 WHO Growth Standards than using the Growth Diagrams of Indonesian Children.

Conclusion Stunting prevalence is high in Southeast Aceh. The Growth Diagrams of Indonesian Children is a spesific and sensitive tool to diagnosed stunting in accordance with Indonesian children's growth patterns.

References

1. Asworth A. Nutrition, food security, and health. In: Kliegman RM, Stanton BF, Schor NF, St Geme III JW, editors. Nelson textbook of pediatrics. 20th ed. Philadelphia: Elsevier; 2016. p. 295-306.
2. Pulungan AB. Exploring the big picture of stunting: Indonesian perspective. In: 15th Pediatric update exploring the big picture of childhood stunting: Indonesian perspective. Jakarta: Ikatan Dokter Anak Indonesia; 2016. p. 3-7.
3. World Health Organization. Interpretation Guide Nutrition Landscape Information System (NLIS). Geneva: WHO; 2010. p.1-2.
4. Grantham-McGregor S, Cheung YB, Cueto S, Glewwe P, Richter L, Strupp B. Developmental potential in the first 5 years for children in developing countries. Lancet. 2007;369:60-70. DOI: 10.1016/S0140-6736(07)60032-4.
5. Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, de Onis M, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet. 2013;382:427-51. DOI: 10.1016/S0140-6736(13)60937-X.
6. Badan Penelitian dan Pengembangan Kesehatan Kemenkes RI. Laporan Hasil Riset Kesehatan Dasar (Riskesdas) Indonesia tahun 2007. Jakarta: Kemenkes RI; 2008.
7. Badan Penelitian dan Pengembangan Kesehatan Kemenkes RI. Laporan Hasil Riset Kesehatan Dasar (Riskesdas) Indonesia tahun 2010. Jakarta: Kemenkes RI; 2010.
8. Badan Penelitian dan Pengembangan Kesehatan Kemenkes RI. Laporan Hasil Riset Kesehatan Dasar (Riskesdas) Indonesia tahun 2013. Jakarta: Kemenkes RI; 2013.
9. Badan Penelitian dan Pengembangan Kesehatan Kemenkes RI. Laporan Hasil Riset Kesehatan Dasar (Riskesdas) Indonesia tahun 2018. Jakarta: Kemenkes RI; 2018.
10. Fenn B, Penny ME. Using the new World Health Organisation growth standards: differences from 3 countries. J Pediatr Gastroenterol Nutr. 2008;46:316-21. DOI: 10.1097/MPG.0b013e31815d6968.
11. Batubara JRL, Alisjahbana A, Gerver-Jansen AJGM, Alisjahbana B, Sadjimin T, Tasli Y, et al. Growth diagrams of Indonesian children The nationwide survey of 2005. Paediatr Indones. 2006;46:118-26. DOI: 10.14238/pi46.3.2006.118-26
12. Natale V, Rajagopalan A. Worldwide variation in human growth and the World Health Organization growth standards: a systematic review. BMJ Open. 2014;4:e003735. DOI: 10.1136/bmjopen-2013-003735.
13. Rosario AS, Schienkiewitz A, Neuhauser H. German height references for children aged 0 to under 18 years compared to WHO and CDC growth charts. Ann Hum Biol. 2011; 38:121–30. DOI: 10.3109/03014460.2010.521193.
14. Hughes I, Harris M, Cotterill A, Garnett S, Bannink E, Pennell C, et al. Comparison of Centers for Disease Control and Prevention and World Health Organization references/standards for height in contemporary Australian children: analyses of the Raine Study and Australian National Children's Nutrition and Physical Activity cohorts. J Paediatr Child Health. 2014;50:895–901. DOI: 10.1111/jpc.12672.
15. Dahlan SM. Penelitian diagnostik: dasar-dasar teoritis dan aplikasi dengan program SPSS dan stata. Jakarta: Salemba Medika; 2009. p.103-6.
16. National Bureau of Statistics Nigeria. National Nutrition and Health Survey 2018. Abuja: UNICEF; 2018. p.41-6.
17. Ministry of Health and Family Welfare. National Family Health Survey (NFHS-4) 2015-2016. Mumbai: International Institute of Population Sciences. 2017.
18. Tariku EZ, Abebe GA, Melketsedik ZA, Gutema BT. Prevalence and factors associated with stunting and thinness among school-age children in Arba Minch Health and Demographic Surveillance Site, Southern Ethiopia. PLoS One. 2018;13:e0206659. DOI: 10.1371/journal.pone.0206659.
19. Gatica-Domínguez G, Victora C, Barros A. Ethnic inequalities and trends in stunting prevalence among Guatemalan children: an analysis using National Health Surveys 1995–2014. Int J Equity Health. 2019;18:110. DOI: 10.1186/s12939-019-1016-0.
20. Schwarz NG, Grobusch MP, Decker ML, Goesch J, Poetschke M, Oyakhirome S, et al. WHO 2006 Child Growth Standards: implications for the prevalence of stunting and underweight-for-age in a birth cohort of Gabonese children in comparison to the Centers for Disease Control and Prevention 2000 growth charts and the National Center for Health Statistics 1978 growth references. Public Health Nutr. 2008;11:714-19. DOI: 10.1017/S1368980007001449.
21. Padula G, Seoane AI, Salceda SA. Variatons in estimates of underweight, stunting, wasting, overweight and obesity in children from Argentina comparing three growth charts. Public Healt Nutr. 2012;15:2086-90. DOI: 10.1017/S136898001200095X.
22. Pulungan AB, Julia M, Batubara JRL, Hermanussen M. Indonesian national synthetic growth charts. Acta Sci Pediatr. 2018;1:20-34.
23. Millward DJ. Nutrition, infection and stunting: the role of deficiencies of individual nutrients and foods, and of inflammation, as determinants of reduced linear growth of children. Nutr Res Rev. 2017;30:50-72. DOI: 10.1017/S0954422416000238.
24. Aguayo VM, Menon P. Stop stunting: improving child feeding, women's nutrition and household sanitation in South Asia. Matern Child Nutr. 2016;12;3-11. DOI: 10.1111/mcn.12283.
25. Bagcchi S. India's poor sanitation and hygiene practices are linked to stunting in children, study finds. BMJ. 2015;350:1564. DOI: 10.1136/bmjopen-2014-005180.
Published
2020-04-17
How to Cite
1.
Wicaksono R, Arto K, Saragih R, Deliana M, Lubis M, Batubara J. Comparison of Growth Diagrams Of Indonesian Children to 2006 World Health Organization Growth Standards in diagnosing stunting. PI [Internet]. 17Apr.2020 [cited 1Dec.2024];60(2):97-01. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/2345
Section
Pediatric Endocrinology
Received 2019-11-28
Accepted 2020-04-17
Published 2020-04-17