Evaluation of malnutrition using some anthropometric measures at Kirkuk Pediatric General hospital

الملخص

Background Worldwide, malnutrition is common and is responsible directly or indirectly for about a third of all deaths of children under 5 years of age. Primary malnutrition also continues to occur in developing countries as a result of poverty, parental neglect or poor education. Specific nutritional deficiencies, particularly of iron,  remain  also  common  in  developing  countries.  Restrictive  diets  may  be iatrogenic as a result of exclusion diets or parental food fads, or may be self- inflicted.  
Aim of The Study: This study was done to determine the role of Head to Chest Ratio as screening test in early detection of malnutrition . 
Patient  and  Methods: A  case  control  analytic  study  was  done  on  children attending the pediatric department , and Nutrition Department in Kirkuk Pediatric General Hospital from 29th of  March  2015  to the  last of  August 2015. The study included 150 malnourished children (study cases) and 100 control children (control cases) , their age from (2months -5years). Each child included in the study was assessed by a prepared questionnaire. Screening done by measuring Weight for  age,  Height  for  age,  Occipitofrontal  Circumference  for  age,  and  Mid-arm circumference , chest circumference and the diagnostic test  weight for height.  
Results: The  total number of cases 150 study cases (63% boys  and 37% girls )and  100  control  cases(65%  boys  and  35%  girls).  All  the  malnutrition  cases  looked  wasted  (100%)  followed  by  pallor(48.7%)  and  looking ill(44.7%).Anthropometric  measures  Weight/age  sensitivity(73%) and specificity(75%), Mid arm circumference sensitivity(75%) and specificity (79%) , Length/Height for age sensitivity (30%) and specificity(18%) .Head circumference in males sensitivity (1.4%) and specificity(78.3%) and  Head circumference in females sensitivity (100%) and specificity(10%) , Chest circumference in males sensitivity  (92%)  and  specificity(30%)  and  Chest  circumference  in  females sensitivity (87%) and specificity(20%) ,Head: Chest Ratio in males sensitivity (93%) and specificity(26%) and  Head :Chest Ratio in females sensitivity (92%) and specificity(25%) .
Conclusion: Finally  the present study concluded that  still Mid arm circumference is the most sensitive  and specific method for screening  of the malnutrition .Head to Chest Ratio is a good method for early detection of malnutrition all thought it is more sensitive and less specific than Mid arm circumference.