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Int J Epidemiol.
2007 Aug;36(4):858-64. Epub 2007 May 21.
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Int J Epidemiol. 2007 Aug;36(4):864-5.
A field test of three LQAS designs to assess the prevalence of acute malnutrition.
Deitchler M
,
Valadez JJ
,
Egge K
,
Fernandez S
,
Hennigan M
.
Academy for Educational Development, FANTA Project, Washington DC 20009, USA. mdeitchl@aed.org
BACKGROUND: The conventional method for assessing the prevalence of Global Acute Malnutrition (GAM) in emergency settings is the 30 x 30 cluster-survey. This study describes alternative approaches: three Lot Quality Assurance Sampling (LQAS) designs to assess GAM. The LQAS designs were field-tested and their results compared with those from a 30 x 30 cluster-survey. METHODS: Computer simulations confirmed that small clusters instead of a simple random sample could be used for LQAS assessments of GAM. Three LQAS designs were developed (33 x 6, 67 x 3, Sequential design) to assess GAM thresholds of 10, 15 and 20%. The designs were field-tested simultaneously with a 30 x 30 cluster-survey in Siraro, Ethiopia during June 2003. Using a nested study design, anthropometric, morbidity and vaccination data were collected on all children 6-59 months in sampled households. Hypothesis tests about GAM thresholds were conducted for each LQAS design. Point estimates were obtained for the 30 x 30 cluster-survey and the 33 x 6 and 67 x 3 LQAS designs. RESULTS: Hypothesis tests showed GAM as <10% for the 33 x 6 design and GAM as > or =10% for the 67 x 3 and Sequential designs. Point estimates for the 33 x 6 and 67 x 3 designs were similar to those of the 30 x 30 cluster-survey for GAM (6.7%, CI = 3.2-10.2%; 8.2%, CI = 4.3-12.1%, 7.4%, CI = 4.8-9.9%) and all other indicators. The CIs for the LQAS designs were only slightly wider than the CIs for the 30 x 30 cluster-survey; yet the LQAS designs required substantially less time to administer. CONCLUSIONS: The LQAS designs provide statistically appropriate alternatives to the more time-consuming 30 x 30 cluster-survey. However, additional field-testing is needed using independent samples rather than a nested study design.
Publication Types:
Comparative Study
Evaluation Studies
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.
PMID: 17517808 [PubMed - indexed for MEDLINE]
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