The tallstick: A tool for community-based assessment of nutritional stunting

A new, simplified anthropometric field tool for detecting nutritional stunting, the "tallstick," has been developed in community-based pilot programmes in Nicaragua and Nigeria. The folding stick, marked to indicate height-for-age cut-off points for ages from birth to seven years below which the child is considered nutritionally stunted, is compared with arm circumference measurements as a simplified field tool. Sensitivity-specificity analyses contrasting the ability of height-for-age and arm-circumference cut-off points to detect malnutrition showed height for age to be as good as arm circumference for detecting low weight for age, weaker for low weight for height, and stronger for a composite score of any degree of malnutrition in 1,070 children 0-72 months old in urban Managua with a prevalence of wasting of 0%-4%, of stunting of 17%-38%, and of underweight of 4%-22%. The importance of detecting stunting, the likelihood of reducing stunting rates, and the feasibility of using the tallstick and its variants are discussed