scholarly journals RISK FACTORS FOR UNDERNUTRITION IN CHILDREN UNDER FIVE YEARS OF AGE IN TENOM, SABAH, MALAYSIA

2020 ◽  
Vol 20 (1) ◽  
pp. 71-81
Author(s):  
Eric Tan Chee How ◽  
Suzana Shahar ◽  
Fredie Robinson ◽  
Abdul Marsudi bin Manah ◽  
Mohd Yusof Ibrahim ◽  
...  
Keyword(s):  
Composite Index ◽  
Multivariate Logistic Regression Analysis ◽  
Cross Sectional Study ◽  
Child Growth ◽  
Household Food Security ◽  
Bivariate Analysis ◽  
Cross Sectional ◽  
Growth Standards ◽  
Nutritional Status Of Children ◽  
Children Under 5

Undernutrition is the result of complex interplay of factors such as household food security, childcare, feeding practices, nutrition and sanitation. Therefore, this study aimed to determine the prevalence of stunting, wasting, underweight based on WHO child growth standards 2006 and undernutrition based on Composite Index Anthropometric Failure (CIAF) and its association with the biological, behavioural, socio-economic and physical environment factors among children under-5 years. This was a cross sectional study involving children aged between 6 and 59 months recruited through stratified random sampling from the Tenom district. Sociodemographic background was obtained from mothers via a questionnaire. Height and weight measurements were measured using standardised instrument. The height-for-age, weight-for-age and BMI-for-age were classified according to the WHO Child Growth Standard 2006. Bivariate analysis and multivariate logistic regression analysis were conducted. The prevalence of undernutrition based on CIAF was 42.3%, underweight 34.7%, stunting 33.3% and wasting 10.0%. After adjusting for all confounders, childhood undernutrition was significantly associated with unimproved sanitation (adjusted OR 2.98, 95% CI: 1.082 to 8.225) and frequent illness (adjusted OR 2.07, 95% CI: 1.015 to 3.274). These findings support the association of biological and physical environmental factors with the nutritional status of children under-5 years old.

scholarly journals Extended composite index of anthropometric failure in Argentinean preschool and school children

2019 ◽  
Vol 22 (18) ◽  
pp. 3327-3335
Author(s):  
IF Bejarano ◽  
EE Oyhenart ◽  
MF Torres ◽  
MF Cesani ◽  
M Garraza ◽  
...  
Keyword(s):  
School Children ◽  
Composite Index ◽  
Cross Sectional Study ◽  
Excess Weight ◽  
Cross Sectional ◽  
Failure Group ◽  
Group A ◽  
Weight Excess ◽  
Children Under 5

AbstractObjective:The Composite Index of Anthropometric Failure (CIAF) can only be applied to children under 5 years of age and does not contemplate obesity. The aim of this study was to propose an Extended CIAF (ECIAF) that combines the characterization of malnutrition due to undernutrition and excess weight, and apply it in six Argentine provinces.Design:ECIAF excludes children not in anthropometric failure (group A) and was calculated from a percentage of children included in malnutrition categories B: wasting only; C: wasting and underweight; D: wasting, stunting and underweight; E: stunting and underweight; F: stunting only; Y: underweight only; G: only weight excess; and H: stunting and weight excess.Setting:Cross-sectional study conducted in Buenos Aires, Catamarca, Chubut, Jujuy, Mendoza and Misiones (Argentina).Participants:10 879 children of both sexes aged between 3 and 13·99.Results:ECIAF in preschool children (3 to 4·99 years) was 15·1 %. The highest prevalence was registered in Mendoza (16·7 %) and the lowest in Misiones (12·0 %). In school children (5 to 13·99 years) ECIAF was 28·6 %. Mendoza also recorded the highest rate (30·7 %), while Catamarca and Chubut had the lowest values (27·0 %). In the whole sample, about 25 % of the malnutrition was caused by undernutrition and 75 % by excess weight.Conclusions:The ECIAF summarizes anthropometric failure by both deficiency and excess weight and it highlights that a quarter of the malnutrition in the Argentine population was caused by undernutrition, although there are differences between Provinces (P < 0·05). ECIAF estimates are higher than those of CIAF or under-nutrition.

Implications of the WHO Child Growth Standards in rural Honduras

2012 ◽  
Vol 15 (6) ◽  
pp. 1015-1022 ◽  
Author(s):  
Erin K Nichols ◽  
Joseph S Nichols ◽  
Beatrice J Selwyn ◽  
Carol Coello-Gomez ◽  
George R Parkerson ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Child Growth ◽  
Policy Implications ◽  
Kappa Statistics ◽  
Reference Standard ◽  
Cross Sectional ◽  
Growth Standards ◽  
Growth Reference ◽  
Who Standards ◽  
The Impact

AbstractObjectiveThe present study analysed the impact of using the 2006 WHO Child Growth Standards (‘the WHO standards’) compared with the 1977 National Center for Health Statistics (NCHS) international growth reference (‘the NCHS reference’) on the calculated prevalence of chronic malnutrition in children aged 6·0–59·9 months.DesignAnthropometric data were collected as part of a cross-sectional study exploring the association between household environments and nutritional status of children. Z-scores were computed for height-for-age (HAZ), weight-for-age (WAZ) and weight-for-height (WHZ) using each reference/standard. Results were compared using Bland–Altman plots, percentage agreement, kappa statistics, line graphs and proportion of children in Z-score categories.SettingThe study was conducted in thirteen rural villages within Honduras's department of Intibucá.SubjectsChildren aged 6·0–59·9 months were the focus of the analysis, and households with children in this age range served as the sampling unit for the study.ResultsThe WHO standards yielded lower means for HAZ and higher means for WAZ and WHZ compared with the NCHS reference. The WHO standards and NCHS reference showed good agreement between Z-score categories, except for HAZ among males aged 24·0–35·9 months and WHZ among males aged >24·0 months. Using the WHO standards resulted in higher proportions of stunting (low HAZ) and overweight (high WHZ) and lower proportions of underweight (low WAZ). The degree of difference among these measures varied by age and gender.ConclusionsThe choice of growth reference/standard employed in nutritional surveys may have important methodological and policy implications. While ostensibly comparable, data on nutritional indicators derived with different growth references/standards must be interpreted cautiously.

scholarly journals Assessment of Undernutrition Using Composite Index of Anthropometric Failure (CIAF) and its Determinants: A Cross-Sectional Study in the Rural Area of Bogor District in Indonesia

2022 ◽  
Author(s):  
Tria Astika Endah Permatasari ◽  
Yudi Chadirin
Keyword(s):  
Nutritional Status ◽  
Rural Area ◽  
Composite Index ◽  
Cross Sectional Study ◽  
Dominant Factor ◽  
P Value ◽  
Cross Sectional ◽  
Children Under Five ◽  
Under Five ◽  
Nutritional Status Of Children

Abstract Background: Composite Index of Anthropometric Failure (CIAF) can assess anthropometric failure by combining the three conventional index measurements of weight-for-age, length/height-for-age, and weight-for-length/height to determine the nutritional status of children under five years. This study aims to assess undernutrition using the CIAF and its determinants on children under five years in the rural area of ​​Bogor District, in Indonesia.Methods: A cross-sectional study was conducted during February-May 2019 among 330 pairs of mother-children (under five years). Sample selected by systematic random sampling from four villages as undernutrition pockets in the rural area of ​​Bogor District, Indonesia. The nutritional status of children was assessed by measuring weight and length/height. Then, Z-score was calculated using WHO Anthro software and categorized based on conventional indices that included weight-for-age (WAZ), length/height-for-age (HAZ), weight-for-length/height (WHZ). CIAF is measured based on a combination of conventional index measurements. In addition, the characteristics of mother’s and child, and clean living behavior measured by structured questionnaires. Meanwhile, environmental sanitation is assessed by the environment meter. Binary logistic regression analysis with SPSS version 22.0 was used to analyze the dominant factors associated with undernutrition.Results: The prevalence underweight, stunted, and wasted was 27.8%, 29.7%, and 10.6% respectively. Children who are undernutrition are 42.1% according to the CIAF of which about a quarter (17.8%) of undernutrition children experience a single anthropometric failure, about half (22.2%) had dual failure, and 2.1% had multiple failures. The most dominant factor associated with underweight, stunted, and wasted is family income [p-value=0.018; AOR=5.44; 95% CI: 1.34-22.11], mother's height [p-value=<0.001; AOR=3.29; 95% CI:1.83-5.91], and child's age [p-value=0.013; AOR=2.59; 95% CI: 1.22-5.47] respectively. Mother's height is the most dominant factor associated with anthropometric failure (CIAF) [p-value=0.008; AOR=1.95; 95% CI: 2.19-3.19].Conclusion: CIAF is worthwhile in preventing undernutrition in children under five years. The CIAF can identify more malnourished children than the conventional index. CIAF can use more widely in various regions in Indonesia and other developing countries. Furthermore, improvements in improving nutrition for mother’s in the child since the First 1000 days of life period are needed to determine optimal nutritional status as an indicator of growth success.

scholarly journals Forecasting the progress towards the target of Millennium Development Goal 1C in children under 5 years of age in Bangladesh

2015 ◽  
Vol 18 (10) ◽  
pp. 1728-1736 ◽  
Author(s):  
Md Tanvir Hasan ◽  
Ricardo J Soares Magalhaes ◽  
Gail M Williams ◽  
Abdullah A Mamun
Keyword(s):  
Rural Areas ◽  
National Level ◽  
Wealth Quintile ◽  
Child Growth ◽  
Millennium Development Goal ◽  
Data Sets ◽  
Cross Sectional ◽  
Development Goal ◽  
Growth Standards ◽  
Children Under 5

AbstractObjectiveTo estimate the average annual rates of reduction of stunting, underweight and wasting for the period 1996 to 2011, and to evaluate whether Bangladesh will be expected to achieve the target of Millennium Development Goal 1C of reducing the prevalence of underweight by half by 2015.DesignWe used five nationwide, cross-sectional, Demographic and Health Survey data sets to estimate prevalence of undernutrition defined by stunting, underweight and wasting among children under 5 years of age using the WHO child growth standards. We then computed the average annual rates of reduction of prevalence of undernutrition using the formula derived by UNICEF. Finally, we projected the prevalence of undernutrition for the year 2015 using the estimated average annual rates of reduction.SettingNationwide covering Bangladesh.SubjectsChildren under 5 years of age (n 28 941).ResultsThe prevalence of stunting decreased by 18·8 % (from 60·0 % to 41·2 %), underweight by 16·0 % (from 52·2 % to 36·2 %) and wasting by 5·1 % (from 20·6 % to 15·5 %) during 1996 to 2011. The overall average annual rates of reduction were 2·84 %, 2·69 % and 2·47 %, respectively, for stunting, underweight and wasting. We forecast that in 2015, the prevalence of stunting, underweight and wasting will be 36·7 %, 32·5 % and 14·0 %, respectively, at the national level. The prevalence of undernutrition is likely to remain high in rural areas, in the Sylhet division and in the poorest wealth quintile.ConclusionsBangladesh is likely to achieve the Millennium Development Goal 1C target of reducing the prevalence of underweight by half by 2015. However, it is falling behind in reducing stunting and further investment is needed to reduce individual, household and environmental determinants of stunting in Bangladesh.

scholarly journals Variations in estimates of underweight, stunting, wasting, overweight and obesity in children from Argentina comparing three growth charts

2012 ◽  
Vol 15 (11) ◽  
pp. 2086-2090 ◽  
Author(s):  
Gisel Padula ◽  
Analía I Seoane ◽  
Susana A Salceda
Keyword(s):  
Cross Sectional Study ◽  
Child Growth ◽  
Overweight And Obesity ◽  
Growth Charts ◽  
Cross Sectional ◽  
Mean Values ◽  
Growth Standards ◽  
Pediatric Society ◽  
Who Standards ◽  
Society Committee

AbstractObjectiveTo compare estimates of underweight, stunting, wasting, overweight and obesity based on three growth charts.DesignCross-sectional study to estimate weight-for-age, length/height-for-age and weight-for-height comparing the 2006 WHO Child Growth Standards (‘the WHO standards’), the 1977 National Center for Health Statistics (NCHS) international growth reference (‘the NCHS reference’) and the 1987 Argentine Pediatric Society Committee of Growth and Development reference (‘the APS reference’). Cut-off points were defined as mean values ±2 sd. Epi-Info software version 6·0 (Centers for Disease Control and Prevention) was used for statistical evaluations (χ2, P ≤ 0·05).SettingGreater La Plata conurbation, Buenos Aires, Argentina.SubjectsA total of 2644 healthy, full-term children from 0 to 5 years of age.ResultsPrevalence of underweight was higher with the WHO standards than with the other references up to the first 6 months. For the rest of the ages, prevalence was lower with the WHO standards. Stunting prevalence was higher with the WHO standards at all ages. Prevalence of wasting was higher with the WHO standards compared with the NCHS reference up to the first 6 months and lower at 2–5 years of age. Overweight and obesity prevalences were higher with the WHO standards at all ages.ConclusionsThe new WHO standards appear to be a solid and reliable tool for diagnosis and treatment of nutritional diseases, also being the only one built with infants fed according to WHO recommendations. Therefore, our results support the decision of the National Ministry of Health about the utilization of the new WHO standards to monitor the nutritional status of Argentinean children aged less than 5 years.

scholarly journals Stunting and ‘overweight’ in the WHO Child Growth Standards – malnutrition among children in a poor area of China

2009 ◽  
Vol 12 (11) ◽  
pp. 1991-1998 ◽  
Author(s):  
Xiaoli Wang ◽  
Bengt Höjer ◽  
Sufang Guo ◽  
Shusheng Luo ◽  
Wenyuan Zhou ◽  
...  
Keyword(s):  
Child Growth ◽  
High Rate ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Growth Standards ◽  
International Growth ◽  
Who Standards ◽  
Poor Area ◽  
Nutritional Status Of Children ◽  
Height For Age

AbstractObjectiveThe aims of the present paper were to assess the nutritional status of children under 5 years old using the 2006 WHO Child Growth Standards (‘the WHO standards’) and to compare the results with those obtained using the National Center for Health Statistics/WHO international growth reference (‘the NCHS reference’).DesignThis was a community-based cross-sectional survey. The WHO standards were used to calculate Z-scores of height-for-age (HAZ), weight-for-age (WAZ), weight-for-height (WHZ) and BMI-for-age (BMIZ).SettingFifty counties of thirteen mid-western provinces, China.SubjectsA total 8041 children aged <5 years were measured during a 2-month period from August to October 2006.ResultsThe prevalence of stunting, underweight and wasting were 30·2 %, 10·2 % and 2·9 %, respectively. The prevalence of overweight and the possible risk of overweight were as high as 4·1 % and 16·8 %. Further analysis among the children with possible risk of overweight found that the percentage of stunting (HAZ < −2) was 57·6 %, the percentage with −2 ≤ HAZ ≤ 2 was 41·0 % and the percentage with HAZ > 2 was only 1·4 %. The prevalence of stunting was 21·9 % and of underweight was 12·7 % by the NCHS reference.ConclusionsStunting was the most serious problem that was impeding child growth and development. The high rate of ‘overweight’ was a false impression, the truth being ‘stunting overweight’, and the way to solve it should be to increase protein and other nutrients in the diet at an early age.

scholarly journals Factors associated with the nutritional status of children under-five years of age with diarrhoea in Ohangwena Region, Namibia

2020 ◽  
Vol 6 (2) ◽  
pp. 23
Author(s):  
Maria Francineth Bauleth ◽  
Honore Kabwebwe Mitonga ◽  
Lusia Ndahambelela Pinehas
Keyword(s):  
Nutritional Status ◽  
Acute Diarrhoea ◽  
Child Growth ◽  
Anthropometric Measures ◽  
Cross Sectional ◽  
Children Under Five ◽  
Growth Standards ◽  
Under Five ◽  
Factors Associated ◽  
Nutritional Status Of Children

Purpose: This study aims at assessing the nutritional status of children under-five years of age with acute diarrhoea, determine the prevalence of malnutrition and identifying factors associated with undernutrition among children under 5 years old in Ohangwena Region, Namibia.Methods: Cross-sectional, non-interventional study was conducted. A structured questionnaire was administered through face to face interviews. A total of 530 children under-five years from 530 households were included in this study. The nutritional index was measured based on Child Growth Standards proposed by WHO. The anthropometric measures used included mid-upper arm circumference (MUAC) and weight-for-age Z score (WAZ). Logistic regression was applied to determine the factors associated with the prevalence of malnutrition.Results: The overall prevalence of diarrhoea among the children under-five years was 24%, of these, 77% were suffering from malnutrition. Malnutrition prevalence was observed to be significantly associated with a child suffering from diarrhoea (p < .05) and children aged between 12-23 months p .001. Equally, the highest prevalence of malnutrition 29.4% [95% CI = 24.65; 34.15] was found amongst children under-five years old with mothers/caregivers aged 18-30 years. The strongest predictor of malnutrition was the mother/caregiver not being an educated recording odds ratio of 20.2.Conclusions: This study identified the need to develop and intensify strategies that may improve nutritional status in children under-five years such as health education, improved literacy, and women empowerment.

Diagnostic performance of midupper arm circumference for detecting severe wasting among infants aged 1–6 months in Ethiopia

2020 ◽  
Vol 113 (1) ◽  
pp. 55-62
Author(s):  
Beshada R Jima ◽  
Hamid Y Hassen ◽  
Yalemwork Getnet ◽  
Paluku Bahwere ◽  
Seifu H Gebreyesus
Keyword(s):  
Predictive Value ◽  
Diagnostic Performance ◽  
Operating Characteristic ◽  
Cross Sectional Study ◽  
Child Growth ◽  
Youden Index ◽  
Cross Sectional ◽  
Growth Standards ◽  
Arm Circumference ◽  
Sensitivity Specificity

ABSTRACT Background Midupper arm circumference (MUAC) is used as an independent diagnostic tool to detect wasting in children aged 6–59 mo. However, little is known about the diagnostic performance of MUAC for detecting wasting among infants aged 1–6 mo. Objective The objective of this study was to evaluate the diagnostic performance of MUAC in detecting severe wasting in infants aged 1–6 mo. Methods We conducted a facility-based cross-sectional study among 467 hospitalized infants aged 1–6 mo in Ethiopia. Severe wasting was defined as having a weight for length z score (WLZ) below the cutoff value of −3 SDs from the median as per the WHO 2006 child growth standards. Receiver operating characteristic (ROC) analysis along with the calibration test was used to test the discriminatory performance of MUAC. Furthermore, we calculated the sensitivity, specificity, positive predictive value, and negative predictive value for the proposed optimal cutoffs. Results The median age, MUAC, and WLZ were 100 d (IQR: 69–145 d), 119 mm (IQR: 103–130 mm), and −1.27 (IQR: −2.66 to 0.34), respectively. The prevalence of severe and moderate wasting was n = 101 (21.6%) and n = 61 (13.0%), respectively. The MUAC area under the ROC curve accuracy level in identifying severe wasting was 0.86 (95% CI: 0.82, 0.89). The optimal MUAC cutoff of ≤112 mm yielded the highest Youden index of 0.61, with a sensitivity of 85.1% (95% CI: 76.7%, 91.4%) and a specificity of 76.0% (95% CI: 71.2%, 80.2%). Conclusions A MUAC cutoff of ≤112 mm performed well in detecting severe wasting among infants aged 1–6 mo. Further research is needed to evaluate the performance of MUAC for detecting wasting at community level and for predicting mortality among infants aged &lt;6 mo.

scholarly journals Faktor-Faktor yang Berhubungan dengan Status Gizi Anak Balita di Wilayah Kerja Puskesmas Nanggalo Padang

2015 ◽  
Vol 4 (1) ◽  
Author(s):  
Rona Firmana Putri ◽  
Delmi Sulastri ◽  
Yuniar Lestari
Keyword(s):  
Nutritional Status ◽  
Maternal Education ◽  
Cross Sectional Study ◽  
Bivariate Analysis ◽  
Cross Sectional ◽  
Children Under Five ◽  
Under Five ◽  
Number Of Children ◽  
Maternal Occupation ◽  
Nutritional Status Of Children

AbstrakStatus gizi anak balita salah satunya dipengaruhi oleh faktor kondisi sosial ekonomi, antara lain pendidikan ibu, pekerjaan ibu, jumlah anak, pengetahuan dan pola asuh ibu serta kondisi ekonomi orang tua secara keseluruhan. Penelitian ini dilakukan untuk mengetahui apakah ada hubungan kondisi sosial ekonomi keluarga terhadap status gizi anak balita. Penelitian ini adalah survei analitik menggunakan desain cross sectional study dengan jumlah sampel 227 orang yang terdiri dari anak balita dan ibu balita di Wilayah Kerja Puskesmas Nanggalo Padang. Data dikumpulkan melalui kuesioner yang telah diisi oleh ibu balita yang kemudian di analisis secara bivariat dan multivariat. Berdasarkan analisis bivariat didapatkan pendidikan ibu (p=0,022), pekerjaan ibu (p=0,000), pendapatan keluarga (p=0,012), jumlah anak (p=0,008) dan pola asuh ibu (p=0,000). Sementara dari analisis multivariat didapatkan pendidikan ibu (p=0,004; OR=2,594; CI95%=1,356-4,963), pekerjaan ibu (p=0,000; OR=74,769; CI95%=24,141-231,577), pendapatan keluarga (p=0,013; OR=3,058; CI95%=1,246-7,4) dan pola asuh ibu (p=0,000; OR=15,862; CI95%=5,973-42,128). Analisis bivariat menunjukan bahwa terdapat hubungan antara pendidikan ibu, pekerjaan ibu, pendapatan keluarga, jumlah anak dan pola asuh ibu dengan status gizi anak balita. Berdasarkan hasil analisis multivariat faktor pekerjaan ibu merupakan faktor yang paling berhubungan dengan status gizi anak balita.Kata kunci: status gizi, anak balita, faktor sosial ekonomiAbstractNutritional status of children under five years has affected by a political and socio-economic condition factors, among others, maternal education, maternal occupation, number of children, maternal knowledge and parenting also parents' economic conditions as a whole. This research is conduct to determine whether there is a relationship between the socio-economic conditions of families on the nutritional status of children under five.This research is a analytic survey using a cross sectional study design with the number of samples are 227 people consisting of children under five and the mothers in the working areas Puskesmas Nanggalo Padang. Data were collected through questionnaires which is completed by mothers whose later been analyzed in bivariate and multivariateBased on bivariate analysis we can get the maternal education (p = 0.022), maternal occupation (p = 0.000), household income (p = 0.012), number of children (p = 0.008) and maternal parenting (p = 0.000). While the multivariate analysis obtained from the maternal education (p = 0.004; OR = 2.594; CI95% = 1.356 to 4.963), maternal occupation (p = 0.000; OR = 74.769; CI95% = 24.141 to 231.577), household income (p = 0.013; OR = 3.058; CI95% = 1.246 to 7.4) and maternal parenting (p = 0.000; OR = 15.862; CI95% = 5.973 to 42.128).Bivariate analysis showed that there is a relationship between maternal education, maternal occupation, family income, number of children and parenting mothers with a nutritional status of children under five. Based on the results of the multivariate analysis, maternal occupation is the most associated factor with nutritional status of children under five.Keywords: Nutritional Status, Children Under Five, Socio-economic Factor

scholarly journals Cross-sectional study of child and adolescent growth in Ecuador

2019 ◽  
Vol 21 (2) ◽  
pp. 006
Author(s):  
Wilmer Alexander Tarupi ◽  
Yvan Lepage ◽  
Roland Hauspie ◽  
María Luisa Félix ◽  
Claude Monnier ◽  
...  
Keyword(s):  
Growth Curves ◽  
Cross Sectional Study ◽  
Child Growth ◽  
World Health ◽  
Growth Monitoring ◽  
Cross Sectional ◽  
Important Indicator ◽  
Growth Standards ◽  
Who Standards ◽  
Health Organization

Child growth is internationally recognized as an important indicator for monitoring health in populations. There exists a wide controversy regarding the use of international growth standards versus local references. This study seeks to construct reference growth curves for school-age Ecuadorian children and adolescents, and to compare them with World Health Organization (WHO) standards, in order to identify the differences and their public health implications. The study authors enrolled 2891 children (1644 girls and 1247 boys) aged 5 to 18 years, from a variety of climatic zones and ethnic groups. LMS method was used to construct Ecuadorian curves for height, weight and Body Mass Index. Comparisons of Ecuadorian and WHO curves were graphically illustrated. U.S children were taller than Ecuadorian children across all age ranges, with larger differences between the two populations in children over 13 years. Consequently, estimates of low height and extremely low height, as well as overweight, obese and undernourished, were significantly different between WHO standards and the Ecuadorian references. Population-specific growth curves may be more adequate for growth monitoring of Ecuadorian children than WHO growth curves. We advocate for the construction of an Ecuadorian growth reference for clinical use based on national population, from conception to maturity, as an accurate instrument for monitoring growth.

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