Severe acute malnutrition morphological patterns in children under five

Abstract

Current methods for infant and child nutritional assessment rely on anthropometric measurements, whose implementation faces technical challenges in low- and middle-income countries. Anthropometry is also limited to linear measurements, ignoring important body shape information related to health. This work proposes the use of 2D geometric morphometric techniques applied to a sample of Senegalese participants aged 6-59 months with an optimal nutritional condition or with severe acute malnutrition to address morphometric variations due to nutritional status. Significant differences in shape and size body changes were described according to nutritional status, resulting age, sex and allometric effect crucial factors to establish nutritional morphological patterns. The constructed discriminant functions exhibited the best classification rates in the left arm. A landmark-based template registering body shape could be useful to both assess acute malnutrition and better understand the morphological patterns that nutritional status promotes in children during their first 5 years of growth and development.

Figure 1

Shape variation of body shape in anterior view of infants and children aged 6–59 months. Principal component analysis both considering (a) and correcting for (b) allometric effect, showing main shape changes along PCs1-3. Plots of PC1 vs PC2 (left) and PC1 vs PC3 (right) exhibit the distribution of the sample according to their nutritional status, optimal nutritional condition (ONC) as black ellipses and dots and severe acute malnutrition (SAM) as grey ellipses and dots; together with age groups, under (filled dots) and over 24 months (unfilled dots).

Figure 2

Mean shape variations of body shape in anterior view of infants and children aged 6–59 months before correcting for allometry. Consensus shape (grey) superimposed on the mean shape (black) for each level of the factors: nutritional status (a), age groups (b) and sex (c).

Figure 3

Mean shape variations of body shape in anterior view of infants and children aged 6–59 months after correcting for allometry. Consensus shape (grey) superimposed on the mean shape (black) for each level of the factors: nutritional status (a), age groups (b) and sex (c).