Original Research

Development of a Zimbabwean child growth curve and its comparison with the World Health Organization child growth standards

Anesu Marume, Archary Moherndran, Partson Tinarwo, Saajida Mahomed
African Journal of Primary Health Care & Family Medicine | Vol 14, No 1 | a3278 | DOI: https://doi.org/10.4102/phcfm.v14i1.3278 | © 2022 Anesu Marume, Archary Moherndran, Partson Tinarwo, Saajida Mahomed | This work is licensed under CC Attribution 4.0
Submitted: 05 October 2021 | Published: 13 September 2022

About the author(s)

Anesu Marume, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa; and Ministry of Health and Child Care Zimbabwe, Health Promotion, Government of Zimbabwe, Harare, Zimbabwe
Archary Moherndran, Department of Padeatrics, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa; and King Edward VIII Hospital, Durban, South Africa
Partson Tinarwo, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
Saajida Mahomed, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa

Abstract

Background: There is limited research that describes the growth trajectories of African children. The development of World Health Organization (WHO) growth standards considered a sample of children who lived in environments optimum for human growth.

Aim: This study aimed to develop weight-for-age and height-for-age growth curves from the Zimbabwean 2018 National Nutrition Survey and compare them with the WHO growth standards.

Setting: Study participants were recruited from all districts in Zimbabwe.

Methods: Height-for-age and weight-for-age data collected from 32 248 children were used to develop the Zimbabwean references. Smooth growth curves (height, weight and body mass index [BMI]-for-age) were estimated with the Lambda Mu Sigma (LMS) method and compared with the WHO growth standards.

Results: Zimbabwean children were shorter and weighed less in comparison with the WHO growth standards. The –2 standard deviation (s.d.) Z-score curves (height-for-age) for Zimbabwean children (boys and girls) were below the –1 s.d. Z-score curves of the WHO growth standards. The Zimbabwean Z-scores (BMI-for-age) values above –1 s.d. were significantly higher in comparison with the corresponding WHO growth standards.

Conclusion: Utilising the WHO growth standards would diagnose a higher proportion of Zimbabwean children as stunted whilst underestimating the proportion at risk of obesity. The WHO growth standards lack a consideration of the geographical, economic, political and environmental constraints existing between countries.


Keywords

children; LMS method; growth curve; obesity; smooth growth curves; stunting; WHO growth standards; Zimbabwe.

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