Z-Score and CIAF–A Descriptive Measure to Determine Prevalence of Under-Nutrition in Rural School Children, Puducherry, India

Abstract

Introduction: Under-nutrition is a major public health distress affecting significant number of school children markedly influencing their health, growth and development, and also their school academic performance. Composite Index of Anthropometric Failure (CIAF) and z-score system provides a comprehensive magnitude of undernutrition. Aim: To determine the magnitude and compare the prevalence of undernutrition using z-score and CIAF in the rural school going children, Puducherry, India. Materials and Methods: Total 792 school children were enrolled from six schools during November 2013 and January 2014. All the students who were present during the survey were included. The z-score for nutritional indices were calculated using WHO Anthro-Software. Statistical analysis was done using EPI-Info 7. Chi-square test was used to find the associations. A p-value <0.05 was considered statistically significant. Results: Nearly 48.7% of the children had anthropometric failure. The most common anthropometric failure as per CIAF was underweight with wasting (18.7%). The prevalence of underweight and wasting were more among male children than female children with significant difference (p<0.05), whereas in stunting, no significant difference was found between male and female. Using underweight as the sole criteria for assessing the magnitude of undernutrition in this study would give us an underestimate of undernourished children of about 10%. Conclusion: Our study also suggests that using conventional method (Weight for Age), centres has chance of missing nearly 10% of the undernourished children. Thus, by using z-score system we have an advantage of identifying school children with wasting and stunting in addition to the children who are underweight. Also, by using CIAF classification, undernourished children were disseminated into different groups, which helps to identify children with multiple anthropometric failures and priority can be set for planning the management.

Keywords

• anthropometric failure
• nutritional status
• public health distress