Assessment of malnutrition using Z-scores and Composite Index of Anthropometric Failure among street children in Delhi

Background: Street children are poverty-stricken and have insuf ficient money to meet their daily nutritional requirements. They do not have a proper place to sleep and defecate. They sleep at traf fic signals, in religious places, and on footpaths. This exposes them to pollution, dirt, and other pathogens. Objectives: This study aimed to measure the nutritional status of street children in Delhi using Z -scores and Composite Index of Anthropometric Failure (CIAF). Methods: Anthropometric measurements are direct methods of measuring the nutritional status of humans. Anthropometric indicators such as underweight (weight -for -age), stunting (height -for -age) and BMI/wasting (weight -for -height) are used to measure the nutritional status of street children. Z -scores and CIAF are calculated for street children based on the WHO 2009 reference. Results: According to Z -scores, stunting (56%) is the most common anthropometric failure among street children followed by underweight (31%) and wasting (19%). According to the CIAF, 63% of street children are malnourished, where stunting (37%) is the highest single burden of anthropometric failure, followed by wasting (3%) and underweight (1%); children suffering from the double burden of anthropometric failure are 9%, and children suffering from the triple burden of anthropometric failure (i.e., wasting, stunting, and underweight) are 13%. Conclusion: A high incidence of stunting points to poor quality of food and suggests prolonged nutrition de fi- ciency among street children. The Z -score or conventional measures of anthropometry underestimate the total burden of malnutrition among street children, while CIAF provides an estimation of children with single -burden, double -burden, and triple -burden malnutrition or total burden of malnutrition. (c) 2024 Elsevier Inc. All rights reserved.