ALTERNATIVE METHODS FOR ASSESSING GROWTH IN CHILDREN UNDER FIVE YEARS OF AGE

Objective: To establish alternative methods for growth assessment in children under fiveyears of age.Design: A cross sectional study of healthy Malawian children.Setting: Postnatal wards and under-five clinics at the Queen Elizabeth Central Hospital,Ndirande and Chilomoni Health Centres in Blantyre city, Malawi.Main outcome measures: Cephalic, thoracic and pelvic measurements and their indices wereexamined for assessment of growth in these children. Thoracic and pelvic measurementswere found to be the most appropriate alternative parameters to weight.Results: All measurements significantly correlated positively with weight but their indicesdid not. The degree of significance, however, was higher in pelvic and thoracic dimensions(P = 0.000) than in cephalic ones (P< 0.001 for maximal cephalic length (MCL) and P <0.022for maximal cephalic breadth (MCB), respectively. The MCL also showed a high correlationwith age (R = 0.842, P = 0.002) but age only correlated moderately with the MCB (R = 0.569).The thoracic circumference (TC) and inter-nipple distance (IND) showed a very highpositive correlation with age (R = 0.908, P = 0.005) and R = 0.870, P = 0.001), respectively.Similarly, a high positive correlation was shown with age by pelvic circumference (PC) andinter-spinous distance (ISD), (R = 0.891, P = 0.006 and R= 0.692, P = 0.027), respectively.Whereas the pelvic index positively correlated with age (R = 0.040), cephalic and thoracicindices significantly correlated negatively with age. Skull shapes were dolicocephalic in43.6% of the children, mesocephalic in 31.1% and branchycephalic in 25.3%, a cleardifference from Caucasian children reported earlier by other authors.Conclusion: We have established that cephalic, thoracic and pelvic dimensions significantlycorrelate positively with weight as age does but their indices remained relatively constant.More importantly, thoracic and pelvic measurements were the most appropriate alternativemethods for growth assessment in our studied population