ArticleInternational journal of environmental research and public health2022
Establishing Height-for-Age Z-Score Growth Reference Curves and Stunting Prevalence in Children and Adolescents in Pakistan.
Article in International journal of environmental research and public health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed, 13 citations in OpenAlex.
- Aflatoxin exposure and health impacts: global burden and advances in detection technologies.Genes and environment : the official journal of the Japanese Environmental Mutagen Society · 2026Review
- Determinants of stunting among Indonesian children: a cross-sectional study on the role of child, maternal, and vaccination factors.BMC pregnancy and childbirth · 2026Article
- Establishing age- and sex-specific anthropometric growth references standards for South Punjab adolescents utilizing the LMS method: findings from the Pakistani population.Frontiers in public health · 2024Article
- Height-for-age and weight-for-age growth charts for Pakistani infants under six months: derived from a novel case selection method using multiple indicator cluster survey data.BMC medical research methodology · 2023Article
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Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
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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.
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