Validation of a Pediatric Nutrition Screening Tool in Hospital Outpatients of Myanmar

Background: Nutrition screening is important in identifying children at risk of developing malnutrition. No pediatric nutrition screening tool is previously applied or validated in Myanmar. Objective: This study aimed to validate Screening of Risk for Nutritional Status and Growth (STRONGkids) tool and to analyze the association of nutrition status with the clinical characteristics of Myanmar pediatric outpatients. Method: The STRONGkids screening score was calculated and the nutrition risk from the tool was compared with the WHO growth standards determined by weight and height related zscores. The nutrition status of the participants and its association with clinical factors were also investigated. Results: A total of 120 children (60 boys, 50%), aged between 1 and 12-year-old, were included. The screening tool identified 58.3% of children as nutritionally-at-risk. It had 90.9% sensitivity and 45% specificity to detect thinness, and 81% sensitivity and 46.5% specificity for stunting. The nutrition risk from the screening was also significantly associated with the weight, height, and BMI-related WHO z-scores (p < 0.05). Overall, 26.6% of our study children had thinness and/or stunting, and > 5year old children had significantly reduced weight status compared to the younger age group. Conclusion: This study suggested that the STRONGkids screening tool is a sensitive and valid tool that can be used for early detection of malnutrition in Myanmar pediatric outpatients. The effectiveness of nutrition intervention following screening should be further investigated.