Evaluation of waist to hip ratio as a screening tool for malnutrition among children under 5 years age at Kirkuk Pediatric General hospital


ABSTRACT: Background Worldwide, malnutrition is common and is responsible directly or indirectly for about a third of all deaths of children under 5 years of age. Aim of the study For early detection of patients with malnutrition by using WHR as screening tool.Patients and method : A case control analytic study was done on children attending the Pediatric General Hospital in Kirkuk, and Nutrition Department in Pediatric General Hospital in Kirkuk from 29th March 2015 to the last of August 2015. The study included 250 Children, their age from (2months -5years). Each child included in the study was assessed by a prepared questionnaire. Screening done by measuring Weight for age, Height for age, Occiputo _ frontal Circumference for age, and Mid-arm circumference , and the diagnostic test was weight for height as well as waist to hip ratio as screening test. Results : The total number of cases (150 case) were malnourished , their age range from 2month to 5 years , while (100 case) of same age range considered as control .Most cases of malnutrition were males 63% , and 37% were females ,while higher number of control cases were male 65% , while female were 35% .Regarding the anthropometric measures ; waist Circumference in male were74% sensitive and 57% specific , while in female were 71% sensitive and 30% specific . Hip Girth (HG) in male were 76% sensitive ,48% specific , but in female 76% were sensitive , 40% specific . Waist to Hip Ratio (WHR) not sensitive , but 100% specific in male and female . Mean waist circumference for control male:( 41±3) , and for malnourished male :( 37±1) ; while mean waist circumference for control female :( 42±2) , and for malnourished female:( 34±2). Mean hip girth (HG) for control male:( 41±3), and for malnourished male :( 37±2) ;while HG for control female :( 43±2) , and for malnourished female :( 36±1). Mean WHR in control male :( 1±0.3) ,but in malnourished male :( 1.02±0.2) ; while WHR in control female :( 0.97±0.5) , but in malnourished female :( 0.94±0.5. )Conclusion : Still MAC is the most sensitive and specific method for screening for malnutrition , and hip girth is a good method for early detection of malnutrition , although it is less sensitive than MAC