**12. References**


**29** 

Khaled Khatab

*Germany* 

**Associations Between Nutritional Indicators** 

**Application to Child Malnutrition in Nigeria** 

**Using Geoadditive Latent Variable Models with** 

*Institute of Occupational and Social Medicine, Medical School, RWTH Aachen University* 

Childhood undernutrition is amongst the most serious health issues facing developing countries. It is an intrinsic indicator of well-being, but it is also associated with morbidity, mortality, impaired childhood development, and reduced labor productivity (Svedberg

To assess nutritional status, the 2003 DHS obtained measurements of height and weight for all children below five years of age.(Survey 2003) Researchers distinguish between three types of malnutrition: wasting or insufficient weight for height indicating acute malnutrition; stunting or insufficient height for age indicating chronic malnutrition; and underweight or insufficient weight for age which could be a result of both stunting and

These three anthropometric variables are measured through z-scores for wasting, stunting

= , *<sup>i</sup>*

where *AI* refers to the individual anthropometric indicator (e.g. height at a certain age),

of the reference population. Each of the indicators measures somewhat different aspects of nutritional status. Note that higher values of a z-score indicate better nutrition and vice versa. Therefore, a decrease of z-scores indicates an increase in malnutrition. This has to be taken into account when interpreting the results. The reference standard typically used for the calculation is the NCHS-CDC Growth Standard that has been recommended for international use by WHO. (WHO 1999) The reference population are children from the USA. More precisely, the children, up to the age of 24 months are from white parents with a high socio-economic status, while children older than 24 months are from a representive sample of all US children. The selection of the reference populations can affect the results,

for example a higher z-score can be caused by the change of the reference population. **Latent variable model**: Previous analyses are often based on Demographic and Health Surveys (DHS) as a well-established data sources with reliable information on childhood

(1)

refers to the standard deviation

*AI MAI <sup>Z</sup>* 

*i*

*MAI* refers to the median of a reference population, and

**1. Introduction** 

wasting.

1996; UNICEF 1998; Sen 1999)

and underweight, defined by


http://www.britannica.com/EBchecked/topic/255457/harmattan


newborn-health-report-context-integrated-maternal-newborn-and-chilHealth

Devices. (2010). Hazard report-Infants may fall through insecure ports on incubators. *Health devices*, Vol.39, No.1, pp. 25-26

