Comparison of anthropometric data quality in children aged 6-23 and 24-59 months: lessons from population-representative surveys from humanitarian settings

BACKGROUND: Ensuring the quality of anthropometry data is paramount for getting accurate estimates of malnutrition prevalence among children aged 6-59 months in humanitarian and refugee settings. Previous reports based on data from Demographic and Health Surveys suggested systematic differences in anthropometric data quality between the younger and older groups of preschool children. METHODS: We analyzed 712 anthropometric population-representative field surveys from humanitarian and refugee settings conducted during 2011-2018. We examined and compared the quality of five anthropometric indicators in children aged 6-23 months and children aged 24-59 months: weight for height, weight for age, height for age, body mass index for age and mid-upper arm circumference (MUAC) for age. Using the z-score distribution of each indicator, we calculated the following parameters: standard deviation (SD), percentage of outliers, and measures of distribution normality. We also examined and compared the quality of height, weight, MUAC and age measurements using missing data and rounding criteria. RESULTS: Both SD and percentage of flags were significantly smaller on average in older than in younger age group for all five anthropometric indicators. Differences in SD between age groups did not change meaningfully depending on overall survey quality or on the quality of age ascertainment. Over 50% of surveys overall did not deviate significantly from normality. The percentage of non-normal surveys was higher in older than in the younger age groups. Digit preference score for weight, height and MUAC was slightly higher in younger age group, and for age slightly higher in the older age group. Children with reported exact date of birth (DOB) had much lower digit preference for age than those without exact DOB. SD, percentage flags and digit preference scores were positively correlated between the two age groups at the survey level, such as those surveys showing higher anthropometry data quality in younger age group also tended to show higher quality in older age group. CONCLUSIONS: There should be an emphasis on increased rigor of training survey measurers in taking anthropometric measurements in the youngest children. Standardization test, a mandatory component of the pre-survey measurer training and evaluation, of 10 children should include at least 4-5 children below 2 years of age

Workshop on the design and use of clinical trials with multiple endpoints, with a focus on prevention of RSV

A meeting held in Lisbon, Portugal, in February 2023 focused on critical aspects of clinical trial design for respiratory syncytial virus (RSV) preventative therapies. The meeting addressed two primary areas: enhancing the efficiency and success of randomized controlled trials (RCTs) for RSV preventative therapies and designing RCTs to better inform post-licensure decision-making. Topics included the selection of primary endpoints, innovative approaches to incorporating multiple endpoints and historical data, and the challenges and benefits of sequential trial designs. The discussion also touched on meta-regression models for obtaining more robust, context-specific estimates of vaccine efficacy. Overall, the meeting underscored the importance of balancing efficiency and robustness in RSV vaccine trial design, while recognizing the need for further discussions involving regulatory and advisory bodies

Workshop on the design and use of clinical trials with multiple endpoints, with a focus on prevention of RSV

A meeting held in Lisbon, Portugal, in February 2023 focused on critical aspects of clinical trial design for respiratory syncytial virus (RSV) preventative therapies. The meeting addressed two primary areas: enhancing the efficiency and success of randomized controlled trials (RCTs) for RSV preventative therapies and designing RCTs to better inform post-licensure decision-making. Topics included the selection of primary endpoints, innovative approaches to incorporating multiple endpoints and historical data, and the challenges and benefits of sequential trial designs. The discussion also touched on meta-regression models for obtaining more robust, context-specific estimates of vaccine efficacy. Overall, the meeting underscored the importance of balancing efficiency and robustness in RSV vaccine trial design, while recognizing the need for further discussions involving regulatory and advisory bodies

Infant and young child nutritional status and their caregivers' feeding knowledge and hygiene practices in internally displaced person camps, Somalia

Background: In an attempt to design an educational programme targeting caregivers of children aged 6 to 59 months in internally displaced persons camps in Somalia, the objective of this study was twofold. First, to explore the nutritional situation of all children aged 6-59 months enrolled in a nutrition programme provided by Save the Children in 2017 in internally displaced persons camps. Second, to identify gaps in the caregivers' hygiene and feeding practices. Methods: In a study of 1655 households, 1655 caregivers for 2370 children aged 6 to 59 months enrolled in a nutrition programme provided by Save the Children answered an adapted questionnaire on hygiene and feeding practices. At the same time, based on standard criteria in the questionnaire, naturalistic observations of caregivers’ hygiene practices were conducted. Every child in the study was measured with anthropometric Mid-Upper-Arm Circumference measurements for the classification of Moderate Acute Malnutrition, Severe Acute Malnutrition and Global Acute Malnutrition. Descriptive statistics were used for analysis. Results: 1) There was Severe (12.1%) and Global Acute (19.9%) Malnutrition among children included in the nutrition programme, more frequently in the 6-24 month age group compared to the 25-59 month age group (p<0.01). 2). The practices in the households were below what could generally be considered hygienic. 3) There was poor caregivers’ knowledge of breastfeeding benefits and complementary foods. Conclusion: Child malnutrition might derive from gaps in the caregiver's knowledge, attitudes, and practices regarding hygiene and infant feeding. An awareness of these gaps can be helpful in designing future educational programmes that target caregivers, particularly in at-risk population groups

(Table A1) Optical attenuation coefficients of glacier ice layer B (53-124 cm ice depth) from 350-600 nm (West Greenland)

Formal estimates of attenuation coefficient for Layer A, interpolated to 1 nm resolution using a convolution (Savitsky-Golay) filter, and reported for the useable range of values, as described in the article

(Table A2) Optical attenuation coefficients of glacier ice layer A (12-77 cm ice depth) from 350-700 nm (West Greenland)

Formal estimates of attenuation coefficient for Layer A, interpolated to 1 nm resolution using a convolution (Savitsky-Golay) filter, and reported for the useable range of values, as described in the article

(Table A3) Raw irradiance values of glacier ice layer B (53-124 cm depth) from 350-900 nm (West Greenland)

This dataset contains the raw irradiance values that can be used to compute transmittance and attenuation coefficient, and are not interpolated or filtered, so the user can decide how to use the data

(Table A3) Raw irradiance values of glacier ice layer A (12-77 cm depth) from 350-900 nm (West Greenland)

This dataset contains the raw irradiance values that can be used to compute transmittance and attenuation coefficient, and are not interpolated or filtered, so the user can decide how to use the data

Optical attenuation coefficients of glacier ice from 350-700 nm and raw irradiance values from 350-900 nm

Optical attenuation coefficients of glacier ice from 350-700 nm were estimated from in-ice solar irradiance measured over the spectral range 350-900 nm and 12-124 cm depth collected at a site in the western Greenland ablation zone (67.15 oN, 50.02 oW). The acquired spectral irradiance measurements are used to calculate irradiance (flux) attenuation coefficients using an exponential decay Bouguer law model. Spectral absorption coefficients are estimated using the method of Warren et. al. (2006), which relates the attenuation coefficient to the absorption coefficient in the visible spectrum. The attenuation coefficients are calculated with linear regression between ice thickness in units of solid ice equivalent referenced to 917 kg/m3 and co-located transmittance. Solid ice equivalent thickness is calculated from in-situ ice density measured in the field on an ice core extracted from the measurement location. The ice density was 699 kg/m3 from 0-8 cm depth, 801 kg/m3 from 4-45 cm , 883 kg/m3 from 45-74 cm, and 888 kg/m3 from 74-122 cm. The depth-weighted ice density in the regions where attenuation was measured was 835 kg/m3 (12-77 cm) and 855 kg/m3 (53-124 cm). The field measurements were completed between 13:45 and 14:35 local time (UTC -3), at solar zenith angles of ~48–51o. Solar noon at this time and location is ~13:26