Anthropometric measures are simple and accurate paediatric weight-prediction proxies in resource-poor settings with a high HIV prevalence

• Published in: Archives of disease in childhood 2017-01, Vol.102 (1), p.10-16
• Main Authors: Whitfield, Kyly C, Wozniak, Roberta, Pradinuk, Mia, Karakochuk, Crystal D, Anabwani, Gabriel, Daly, Zachary, MacLeod, Stuart M, Larson, Charles P, Green, Timothy J
• Format: Article
• Language: English
• Subjects: Analysis; Anthropometry; Anthropometry - methods; Antiretroviral agents; Body Composition; Body Height - physiology; Body Weight; Body Weight - physiology; Botswana - epidemiology; Care and treatment; Child; Child, Preschool; Children; Children & youth; Childrens Rights; Cross-Sectional Studies; Diagnosis; Dose-response relationship; Dose-response relationship (Biochemistry); Drug dosages; Ethics; Female; Health aspects; HIV; HIV (Viruses); HIV Infections - epidemiology; HIV Infections - physiopathology; Human immunodeficiency virus; Humans; Infant; Interrater Reliability; Male; Medically Underserved Area; Nutrition; Observer Variation; Pediatrics; Predictive Value of Tests; Prevalence; Proxies; Scientific Concepts; Technical Assistance; Tibia - anatomy & histology; Ulna - anatomy & histology; Validity; Womens health
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/archdischild-2015-309645

RationaleAccurate weight measurements are essential for both growth monitoring and drug dose calculations in children. Weight can be accurately measured using calibrated scales in resource-rich settings; however, reliable scales are often not available in resource-poor regions or emergency situations. Current age and/or length/height-based weight-prediction equations tend to overestimate weight because they were developed from Western children's measures.ObjectiveTo determine the accuracy of several proxy measures for children's weight among a predominately HIV-positive group of children aged 18 months to 12 years in Botswana.DesignWeight, length/height, ulna and tibia lengths, mid-upper arm circumference (MUAC) and triceps skinfold were measured on 775 children recruited from Gaborone, Botswana, between 6 July and 24 August 2011.ResultsMean (95% CI) age and weight were 7.8 years (7.5 to 8.4) and 21.7 kg (21.2 to 22.2), respectively. The majority of children were HIV-positive (n=625, 81%) and on antiretroviral treatment (n=594, 95%). The sample was randomly divided; a general linear model was used to develop weight-prediction equations for one half of the sample (n=387), which were then used to predict the weight of the other half (n=388). MUAC and length/height, MUAC and tibia length and MUAC and ulna length most accurately predicted weight, with an adjusted R2 of 0.96, 0.95 and 0.93, respectively. Using MUAC and length/height, MUAC and tibia length and MUAC and ulna length equations, ≥92% of predicted weight fell within 15% of actual weight, compared with