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Malnutrition continues to pose a significant problem in Egypt despite the immense efforts to provide nutritional support for malnutrition in the last years. Moreover, among hospitalised children malnutrition represents a great impediment to clinical improvement and causes a significant delay in physical and mental development. The prevalence of malnutrition is as high as 12-24% among hospitalised children (Shaughnessy and Kirkland, 2016).
Conventional indicators like weight-for-age, height-for-age, and weight-for-height indicate different facts of nutritional status. The most common indicator is weight-for-age, whether used independently or in combination conventional indices fall short of portraying the full consequence of undernutrition in the population. Composite Index of Anthropometric Failure (CIAF) is another nutritional assessment tool which efforts to solve this dilemma.
Therefore, we performed this study with the purpose of comparing the prevalence of undernutrition using CIAF and conventional indices. We included 264 children aged between 1 to 193 months from inpatient wards in Ain Shams University Paediatric Department which is located in Cairo, Egypt. Weight and height measurements were obtained. Z-scores were calculated for weight-for-age (WAZ), height-for-age (HAZ) and weight-for-height (WHZ) using the anthropometric standards which are the ones recommended by the Centers for Disease Control and Prevention (CDC).
Children were classified according to conventional indices and CIAF. The prevalence of moderate underweight, stunting and wasting was 9.85%, 10.98%, and 10.98% respectively and the prevalence of severe underweight, stunting and wasting was 25.76%, 20.45%, and 18.56% respectively. As per CIAF, 50.76 % of children were malnourished. According to CIAF, approximately 33.3% of the undernourished children had a single anthropometric failure while under 50% of them had dual failure and quarter of the malnourished had multiple failures. CIAF could recognise 15.15%, 19.32%, and 21.21% more undernourished children than below -2 WAZ, HAZ, and WHZ respectively and 25%, 30.31%, and 32.2% more undernourished children than below -3 WAZ, HAZ and WHZ correspondingly in contrast to conventional indices.
To put it briefly, CIAF is seen to superior over other conventional indices. Furthermore, 120 malnourished children were reassessed after one month of joining a nutritional rehabilitation program, and CIAF value was decreased by 22.5%. Moreover, group D which represents acute malnutrition significantly improved. CIAF is a useful index to assess the real magnitude of undernutrition and recognise children with multiple anthropometric failures. Moreover, CIAF can recognise more undernourished children than conventional indices. Consequently, CIAF is a handy tool for the detection of malnutrition especially in developing nations that suffer from a high prevalence of malnutrition.