ABSTRACT
AIM: Growth reference values about mid-upper arm circumference (MUAC) are vital for assessing children's nutritional status. However, Pakistan lacks these reference values and growth charts. This study aims to develop these for children aged 6-60 months and compare them with global standards. METHODS: The data were acquired from the 2018 National Nutrition Survey of Pakistan, which was conducted by the United Nations Children's Fund (UNICEF) during 2018-2019. The final study cohort comprised 57 285 children, with 51% being boys. Percentile values and charts for MUAC-for-age were developed using generalised additive models for location, scale and shape with the Box-Cox power exponential distribution. RESULTS: The mean MUAC was 14.21 cm (±2.07 cm) and 14.13 cm (±2.12 cm) for the boys and girls, respectively. At 60 months of age, the P3 and P97 percentiles for girls were slightly higher than those for boys. The median percentiles of Pakistani children were smaller than the World Health Organisation 2007 standards and with international references. CONCLUSION: We observed disparities in MUAC-for-age growth references among Pakistani children compared to global standards, highlighting regional, age and gender variations. This underscores the need for developing countries like Pakistan to establish their growth references.
Subject(s)
Arm , Growth Charts , Humans , Male , Pakistan , Female , Infant , Arm/anatomy & histology , Child, Preschool , Reference Values , AnthropometryABSTRACT
AIM: The present study aimed to develop age- and sex-specific anthropometric reference growth curves for the Pakistani children, aged 1-60 months. METHODS: The weight and height of 60 595 children including 30 885 (50.96%) boys and 29 710 (49.04%) girls from Pakistan were collected through a cross-sectional study. Growth reference charts about weight-for-age, length/height-for-age, and body BMI-for-age were constructed for boys and girls using the generalised additive model for location, scale and shape (GAMLSS) with the Box-Cox power exponential distribution. RESULTS: The 3rd, 5th, 15th, 25th, 50th, 75th, 85th, 95th and 97th smoothed percentile values with L, M and S for weight, length/height, and BMI for boys and girls from aged 1 to 60 months are presented. The median percentile for all indicators increases as the age increases in both sexes. The median percentiles of the Pakistani children are lower than the WHO 2006 standards for both sexes. CONCLUSION: This study provides the first references for the Pakistani children from 1 to 60 months. The reference values could be taken as a starting point for examining the secular change in the Pakistani population.