methods to classify malnutrition

classification

1. Methods to classify Malnutrition Strength and Limitation PBL 6

2. Objectives Strengths and limitations of Gomez’ Classification Waterlow’s Classification Mid Arm Circumference WHO classification

3. Methods of Classification of malnutrition Classification of malnutrition help to identify the correct nutritional status help in planning appropriate response Most common Methods : Gomez’ Classification Waterlow’s Classification Mid Upper Arm Circumference WHO classification

4. Gomez Classification Based on Weight retardation Calculated as Weight for age : (wt. of child / wt. of normal child of same age )*100 Strength Based on only two simple parameters i.e. weight and age Relatively simple and easy to practice due to the easily measurable parameters Easy to understand and interpret the result

5. Limitations It assume that all the children of a particular age will have same weight It may be misleading in a sudden acute episode of malnutrition A cut off point of 90 % of reference is high In some situations (e.g. Orphan child) child age may be difficult to determine Modified Gomez classification lowers the cut off point and suggest children up to 80% or more for weight for age is Normal.

6. Waterlow’s classification It uses weight for height( recent alteration of nutritional status ) and height for age ( nutrition over a long period )

7. Strength More informative about the process leading to malnutrition More comprehensive as it measure weight, height and age Normal, Stunted , wasted or wasted and stunted child can be identified easily

8. Limitations It requires standards of weight for age ratio Difficult to use in field as it requires measurement of height or length

9. MID upper Arm circumference ( muac ) Benefits Relatively reliable for estimation of body’s muscle mass Quick and useful tool in field practice in community Useful in 1 to 5 year old child and in situations when exact age of child is not known Less mathematical and technical skill needed. Limitations I s not used in less than 1y and more than 5 year child Not applicable in generalized edema patient

10. WHO classification Use of Z-score or SD score SD score : (Observed value – median reference value )/ SD of reference population -2 to +2 : Normal -2 to -3 : moderate malnutrition < -3 : severe malnutrition +2 to +3 : overweight > +3 : obesity

11. Benefits U sually prevalence of malnutrition of world population is presented by this system Limitations Standard values of this system may be not appropriate for l ow and middle income country (LMIC)

12. References Park’s textbook of preventive and social medicine,23e Child nutrition and health, Ramesh k adhikari,Miriam E. Krantz

13. Thank you