Prevalence of acute protein-energy malnutrition
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The first perspective is the prevalence of acute protein-energy malnutrition. What level is high? What level is alarming? What levels can safely be ignored?
The World Health Organization has published the following recommendations regarding thresholds for severity of acute protein-energy malnutrition as a health problem in a population:
|Severity of malnutrition||Prevalence of acute malnutrition (<2.0 z-scores or oedema)||Mean weight-for-height z-score|
|Acceptable||< 5%||> -0.40|
|Poor||5 - 9%||-0.40 - -0.69|
|Serious||10 - 14%||-0.70 - -0.99|
There are several other sets of recommendations for thresholds to assist in interpreting the significance of the prevalence of acute protein-energy malnutrition (click here for references). Some take into account "aggravating factors" so that the threshold for defining a population as significantly malnourished or for taking specific actions is adjusted for the presence of certain factors which can make quickly malnutrition worse.
Regardless of the recommendations used, program managers cannot and should not base decisions about programme response solely on these thresholds. In fact, some humanitarian response organizations have rejected altogether the use of such arbitrary thresholds. The context and causes of malnutrition must be considered, as described below.