Maternal perception of malnutrition among infants using verbal and pictorial methods in Kenya

<jats:title>Abstract</jats:title><jats:sec id="S1368980014001074_abs1" sec-type="general"><jats:title>Objective</jats:title><jats:p>To compare mothers’ perceptions of their own infants’ nutritional status with anthropometric indicators of undernutrition.</jats:p></jats:sec><jats:sec id="S1368980014001074_abs2" sec-type="general"><jats:title>Design</jats:title><jats:p>A qualitative study and cross-sectional quantitative survey. The qualitative study involved developing tools to assess mother’s perception. Two methods of verbal description and a pictorial scale were developed. The quantitative survey involved measuring maternal perception and comparing it with the anthropometric measures of weight-for-age <jats:italic>Z</jats:italic>-score (WAZ) and mid-upper arm circumference-for-age <jats:italic>Z</jats:italic>-score (MUACZ).</jats:p></jats:sec><jats:sec id="S1368980014001074_abs3" sec-type="general"><jats:title>Setting</jats:title><jats:p>A rural community setting in Kenya.</jats:p></jats:sec><jats:sec id="S1368980014001074_abs4" sec-type="subjects"><jats:title>Subjects</jats:title><jats:p>Seventy-four infants aged between 4 and 6 months, and their mothers, living in rural Kenya were enrolled.</jats:p></jats:sec><jats:sec id="S1368980014001074_abs5" sec-type="results"><jats:title>Results</jats:title><jats:p>Using verbal description, the positive and negative likelihood ratios were 3·57 (95 % CI 1·44, 9·98) and 0·69 (95 % CI 0·50, 0·96) respectively for MUACZ&lt;−2; and 4·60 (95 % CI 1·60, 13·3) and 0·67 (95 % CI 0·49, 0·92) respectively for WAZ&lt;−2. Using the pictorial scale, the positive and negative likelihood ratios were 8·30 (95 % CI 1·91, 36·3) and 0·69 (95 % CI 0·52, 0·93) respectively for MUACZ&lt;−2; and 4·31 (95 % CI 1·22, 15·0) and 0·78 (95 % CI 0·61, 1·00) respectively for WAZ&lt;−2.</jats:p></jats:sec><jats:sec id="S1368980014001074_abs6" sec-type="conclusions"><jats:title>Conclusions</jats:title><jats:p>In a rural community, mothers better identify undernutrition in their infants using a pictorial scale than verbal description. However, neither can replace formal anthropometric assessment. Objective anthropometric tools should be validated for identification of severe acute malnutrition among infants aged less than 6 months.</jats:p></jats:sec>