Abstract
A combined survey of weight for height measurement (W/H) was done by two emergency aid organizations. The same 131 children were measured independently by two survey teams. One team measured 24.4% and the other team 47.7% of the 131 children as under 80% W/H. The serious logistical consequences of these differences for the emergency aid programme are discussed.
The main cause of the difference was observer error. A reason for systematic bias could be that an observer using the Nabarro chart tends to classify children who are slightly above 80% as under 80%. This bias is understandable because “one doesn't want to miss out malnourished children”. This sytematic bias does not occur when weight and height are measured separately and the percentage read from a card. The importance of following a strict protocol when measuring is stressed.
Another (much less important) cause for the different results was that the teams used two weight for height standards. The Nabarro chart (multicoloured chart), based on an adaptation of the NCHS standard, overestimates the prevalence of wasting as compared to the NCHS/CDS/WHO standard (the plastified card). A plea is made for the use of uniform standards.
In fact there is not yet a reliable, simple tool for assessment of wasting.
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