Evaluating Child Malnutrition in Southern Belize Using an Anthropologic Screening Tool

The WHO describes the ‘double burden’ of malnutrition as obesity coexisting with undernutrition. This condition’s increasing prevalence makes it an important disorder to monitor and address. Screening tools exist to evaluate child malnutrition in hospital settings, but few are available to evaluate children elsewhere. This study taught community health workers (CHWs) in Southern Belize to implement the Hasegawa et. al. screening tool for child malnutrition. Data was collected at home visits, mobile clinics and at two rural polyclinics. Descriptive statistics were performed, and the data was analyzed using two tailed t-tests and the Anscombe-Glynn test for kurtosis. 171 child-mother pairs were screened. Of the children screened, 10 met the WHO definition of underweight, 29 met the WHO definition of overweight, and 30 met the WHO definition of stunted. The combination of measured weight and length, expressed as the weight for length z-score, showed a statistically significant increase of 0.83 [95% CL: 0.51 to 1.14, p < 0.0001] with 4% (6/167) of the children showing clinically significant wasting and 17% (29/167) being clinically overweight. The screening tool correctly identified all 10 underweight children. Further modeling is needed to develop an anthropological measure to assess the double burden of malnutrition.