diferencias en las prevalencias de desnutrición al usarse referencias nacionales e internacionales differences in the prevalence of malnutrition resulting from using a national growth reference or an international growth reference

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ID: 226443
2005
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Abstract
OBJETIVO: Evaluar si el empleo de dos referencias distintas (internacional y nacional) ocasiona diferencias en las prevalencias de emaciación y retraso del crecimiento en una muestra de niños de 8 a 14 años. MÉTODOS: Se realizó un estudio transversal en una muestra de 1 470 escolares de ambos sexos de la ciudad de La Plata (Provincia de Buenos Aires, Argentina). A partir de los datos de peso y talla se calcularon las puntuaciones Z respecto a los valores de referencia de la primera y la segunda encuesta estadounidense de salud y nutrición (National Health and Nutrition Examination Survey, NHANES I y II), y de la Sociedad Argentina de Pediatría. Las prevalencias de emaciación y retraso del crecimiento se calcularon tomando un punto de corte de dos desviaciones estándar (DE) por debajo de la mediana de referencia. Se compararon las prevalencias mediante la prueba de ji al cuadrado con corrección de Yates y se calcularon la razón de posibilidades (odds ratio, RP) y los intervalos de confianza del 95% (IC95%). RESULTADOS: La referencia internacional se asoció positivamente a una mayor prevalencia de retraso del crecimiento, tanto en la muestra total (RP = 5,12; IC95%: 3,27 a 8,05) como en varones (RP = 4,36; IC95%: 2,43 a 7,93) y en mujeres (RP = 6,32; IC95%: 3,10 a 13,27). La prevalencia de emaciación fue similar con ambas referencias. La distribución de la talla para la edad presentó un sesgo a la izquierda respecto de la referencia internacional y a la derecha respecto de la nacional, mientras que la del peso para la talla se superpuso a ambas referencias. CONCLUSIONES: Las diferencias en las prevalencias de retraso del crecimiento calculadas según las dos referencias utilizadas reflejan cuadros disímiles del estado nutricional de la población evaluada. El incremento de la talla de los niños respecto a la referencia nacional apunta a la presencia de una tendencia secular positiva y puede explicar parte de las diferencias en la prevalencia de retraso del crecimiento.
OBJECTIVE: To evaluate if using an international growth reference versus a national growth reference leads to differences in the prevalences of low weight-for-height (wasting) and low height-for-age (stunting) in a sample of children 8 to 14 years old. METHODS: A cross-sectional study was carried out with a sample of 1 470 school-children (both boys and girls) in the city of La Plata, in the province of Buenos Aires, Argentina. Based on the data on weight and height, Z-scores were calculated with regard to the reference values from the United States of America's first and second National Health and Nutrition Examination Survey (NHANES I and NHANES II), and the reference values for Argentina from the Argentine Pediatric Society. The prevalences of wasting and stunting were calculated, using as the cutoff point two standard deviations below the median of the reference. The prevalences were compared using the chi-squared test with Yates' correction, and odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated. RESULTS: The international reference was positively associated with a higher prevalence of stunting in the entire sample (OR = 5.12; 95% CI: 3.27 to 8.05), in the boys (OR = 4.36; 95% CI: 2.43 to 7.93), and in the girls (OR = 6.32; 95% CI: 3.10 to 13.27). The prevalence of wasting was similar with both references. The distribution of height-for-age was skewed to the left with respect to the international reference and to the right with respect to the Argentine reference, while the distribution of weight-for-height overlapped both references. CONCLUSIONS: The differences in the prevalences of stunting calculated according to the two references that were used indicate a different nutritional status for the population studied. The increase in the height of the children with respect to the Argentine reference points to the presence of a positive secular trend, and the increase can explain part of the differences in the prevalence of stunting.
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oyhenart2005revistadiferencias Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors ;Evelia Edith Oyhenart;Alicia Bibiana Orden
Journal communications on pure and applied analysis
Year 2005
DOI
DOI not found
URL
http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S1020-49892005000800002
Keywords
reference standards estado nutricional nutritional status tropical medicinepublic aspects of medicine desnutrición

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