ESPE Abstracts

Background: Growth problems, such as stunting, are commonly found in daily pediatric practice. Stunting is a significant problem in developing countries, and is part of the Sustainable Development Goals (SDG) Goal 2 of ending hunger. In Indonesia, the rate of stunting in children under 5 years old is still considered high, despite improvement in quality of life due to rapid economic development. The rate of this improvement is unequal throughout the nation, where the capital city of Jakarta tend to see better growth compared to more rural areas including Papua. The Indonesian government has set ambitious goals to reduce the number of stunting by 2030 as part of its SDG targets, but the use of international (WHO and CDC) growth charts may be inappropriate in assessing growth of Indonesian children, and can lead to overdiagnosis and overtreatment of stunting. A more suitable reference chart is needed to accurately assess growth problems in Indonesia.

Methods and Aims: We performed an analytical cross-sectional study on 1.829 children in Nabire and 1.283 children in Jakarta, aged 6-12 years old. Anthropometric measurements were obtained and plotted on the CDC growth charts and Indonesian National Growth Charts to determine which chart is more suitable to monitor children growth in Indonesia.

Results: Children in Nabire were shorter and had lower BMI than children in Jakarta, with a mean height difference of 7.03 cm in boys and 6.89 cm in girls (P=0.001) and a mean BMI difference of 1.66 in boys and 1.39 in girls (P=0.001). Despite being shorter, more children in Nabire had normal BMI, showing normal nutritional status. Less children were categorized as stunted-and-wasted using the Indonesian National Growth Charts.

Conclusion: Primary school-aged children in Nabire are shorter than children in Jakarta. Most of the short-stature observed in children in Nabire is not caused by stunting because the children showed no evidence of malnutrition. The Indonesian National Growth Charts better represent the growth status of Indonesian children compared to the CDC growth charts.