Establishing Height-for-Age Z-Score Growth Reference Curves and Stunting Prevalence in Children and Adolescents in Pakistan

Muhammad Asif (), Muhammad Aslam, Iqra Mazhar, Hamza Ali, Tariq Ismail, Piotr Matłosz and Justyna Wyszyńska
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Muhammad Asif: Department of Statistics, Government Associate College, Qadir Pur Raan 60000, Pakistan
Muhammad Aslam: Department of Statistics, Bahauddin Zakariya University, Multan 60000, Pakistan
Iqra Mazhar: Department of Preventive Pediatrics, The Children Hospital and Institute of Child Health, Multan 60000, Pakistan
Hamza Ali: Department of Biology, Government Associate College, Qadir Pur Raan 60000, Pakistan
Tariq Ismail: Department of Food Sciences and Technology, Bahauddin Zakariya University, Multan 60000, Pakistan
Piotr Matłosz: Institute of Physical Culture Sciences, Medical College, University of Rzeszów, 35-959 Rzeszów, Poland
Justyna Wyszyńska: Institute of Health Sciences, Medical College, Rzeszów University, 35-959 Rzeszów, Poland

IJERPH, 2022, vol. 19, issue 19, 1-10

Abstract: Height-for-age Z-score (HAZ) curves are widely used for detecting children with stunting. The aim of this study was to provide smoothed HAZ growth reference values and their curves for Pakistani children and adolescents aged 2–18 years. The prevalence of stunting in Pakistani children was determined. A total of 10,668 healthy Pakistani participants were included. Information related to age, sex, city of residence and height (cm) was used. Age- and sex-specific smoothed HAZ growth reference values and associated graphs were obtained using the lambda-mu-sigma (LMS) method. The prevalence of stunting was calculated by applying WHO 2007 and USCDC 2000 height-for-age references and local reference of the study population. In both sexes, the smoothed HAZ curves increased with age. For 2 and 3 years of age, the height values of the girls were greater than those of the boys. The boys were then taller than the girls. Comparing our median height (z = 0) growth reference data from WHO, USCDC and corresponding data from other countries, Pakistani children and adolescents have significantly different reference values than their counterparts in the reference group. A marked overestimation of the prevalence of stunting was observed (10.8% and 17.9% according to WHO and USCDC, respectively) compared to the local reference (3.0%). It is recommended that the prevalence of stunting in children and adolescents is determined by applying local height growth references to plan health strategies and treatments in the local population.

Keywords: children; growth curves; height; LMS method; Pakistan; stunting (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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