Multiresponse semiparametric regression model approach to standard growth charts design for assessing nutritional status of East Java toddlers

Abstract

A nutritional status of toddlers characterized by a lack of weight based on anthropometric index weight-for-age (W/A) is called underweight. In Indonesia, the anthropometric index is recorded on a Card Towards Health called KMS (Kartu Menuju Sehat) which refers to WHO–2005 Standard Growth Charts (WHO–2005 SGC). Samples used to design the WHO–2005 SGC were toddlers taken from Brazil, Ghana, India, Norway, Oman, and USA, that physically they are different from the Indonesian toddlers especially toddlers from East Java. This study aims to design Percentile Standard Growth Charts (Percentile SGC) of W/A based on samples of toddlers taken from East Java by using both least square spline ((LS-spline) and local linear estimators of a multiresponse semiparametric regression (MSR) model. Those obtained Percentile SGC would be used to assess the nutritional status of toddlers in East Java by comparing them with the WHO–2005 SGC. Results show that these Percentile SGC based on both LS-spline and local linear estimators give a lower reference than WHO–2005 SGC such that percentages of malnutrition and less-nutrition status categories provided by these Percentile SGC are also less than those provided by WHO–2005 SGC. In general, the Percentile SGC of W/A for boy and girl toddlers in East Java have the evaluator standard and have lower standard than the WHO–2005 SGC.