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Background: An efficacy evaluation of the AutoAnthro system to measure
child (0–59 months) anthropometry in USA found three-dimensional imaging
performed as well as gold-standard manual measurements for biological
plausibility and precision. Objectives: Conduct an effectiveness
evaluation of the accuracy of the AutoAnthro system to measure 0–59 months
child anthropometry in population-based surveys and surveillance systems
in households in Guatemala and Kenya, and in hospitals in China. Methods:
The evaluation was done using health or nutrition surveillance system
platforms among 600 children 0–59 months (Guatemala, Kenya) and 300
children 0-23 months (China). Field team anthropometrists and their
assistants collected from each child manual and scan anthropometric
measurements including length/height, mid-upper arm circumference (MUAC),
and head circumference (HC, China only). An anthropometry expert and
assistant later collected both manual and scan anthropometric measurements
on the same child. The expert manual measurements were considered the
standard compared to field team scans. Results: Overall, in Guatemala,
Kenya and China, respectively, for inter-rater accuracy, average bias for
length/height was -0.3 cm, -1.9 cm, -6.2 cm; for MUAC was 0.9 cm, 1.2 cm,
-0.8 cm; for HC was 2.4 cm; the inter-technical error of measurement (TEM)
for length/height was 2.8 cm, 3.4 cm, 5.5 cm; for MUAC was 1.1 cm, 1.5 cm,
1.0 cm; for HC was 2.8 cm. For intra-rater precision, absolute mean
difference and intra-TEM were 0.1 cm for all countries for all manual
measurements. For scan, overall, absolute mean difference ranged for
length/height 0.4-0.6 cm; MUAC 0.1-0.1 cm; HC was 0.4 cm. For intra-TEM,
length/height was 0.5 cm in Guatemala and China, 0.7 cm in Kenya, and
other measurements were <0.3 cm. Conclusions: Understanding the
factors that cause the many poor scan results and how to correct them will
be needed prior to using this instrument in routine population-based
survey and surveillance systems.
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