Original Article

Indonesian National Growth Reference Charts better reflect height and weight of Children in West Java Indonesia than WHO Growth Charts Standards

10.4274/jcrpe.galenos.2020.2020.0044

  • Novina Novina
  • Michael Hermanussen
  • Christiane Scheffler
  • Aman B. Pulungan
  • Yoyos Dias Ismiarto
  • Yudhie Andriyana
  • Vitriana Biben
  • Budi Setiabudiawan

Received Date: 01.04.2020 Accepted Date: 10.08.2020 J Clin Res Pediatr Endocrinol 0;0(0):0-0 [e-Pub] PMID: 32772522

Objective

The Indonesia Basic Health Research 2018 indicates that Indonesian children are still among the shortest in the world. When referred to WHOGCS, the prevalence of stunting reaches up to 43% in several Indonesian districts. INGRC were established in order to better distinguish between healthy short children and children with growth disorders. We analyzed height and weight measurements of healthy Indonesian children using INGRC and WHOGCS.

Materials and Methods

6972 boys and 5800 girls (N=12,772) aged 0-59 months old in Bandung district were measured. Z-scores of length/height and body mass index (BMI) were calculated based on INGRC and WHOGCS.

Results

Under 5-year-old Indonesian children raised in Bandung are short and slim. Mean height z-scores of boys is -2.03 (SD1.31), mean height z-scores of girls is -2.03 (SD1.31) when referred to WHOGCS indicating that over 50% of these children are stunted. Bandung children are heterogeneous, with substantial subpopulations of tall children. Depending on the growth reference used, between 9 and 15% of them are wasted. Wasted children are on average half a SD taller than their peers.

Conclusion

WHOGCS seriously overestimates the true prevalence of undernutrition in Indonesian children. The present investigation fails to support evidence of undernutrition at a prevalence similar to the over 50% prevalence of stunting (WHOGCS) versus 13.3% (INGRC). We suggest refraining from using WHOGCS, and instead applying INGRC that closely mirror height and weight increments in Bandung children. They appear superior for practical and clinical purposes such as detecting growth and developmental disorders.

Keywords: Anthropometric Measurement, Indonesian National Growth Reference Charts, WHO Growth Charts Standard, Bandung District Children, undernutrition