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Problems and Pitfalls in the Use of Estimated Age in Anthropometric Measurements of Children from 6 to 60 Months of Age: A Case from Mali^1,2,

Nordic School of Nutrition, University of Oslo, 0316 Oslo, Norway ^* Institut National de la Recherche en Santé Publique, Bamako, Mali

Estimates of the age of children are often used uncritically in anthropometric measures. This study shows that even with construction of calendars for use of determination of age, substantial training, a careful follow-up in the field by research assistants, and control of all questionnaires immediately after the interviews of the caretakers and weighing of the children, errors remain in estimating the age of children. Such errors may affect the results substantially, leading to errors in the estimation of age-based measures of nutritional status. In the case of Northern Mali, the effect was most likely an underestimation of malnutrition by perhaps as much as 10 to 30 percentage points. The biases in age estimation in many cases are not constant across subgroups of a population. Therefore age estimation problems may lead to wrong decisions regarding policy formulation, planning of development programs and activities, identification of target groups, and, in particular, evaluation of programs and activities. In situations where age has to be estimated, anthropometric measurements that are less influenced by errors in age estimation are recommended.

KEY WORDS: • anthropometry • Mali • humans • age estimation • child malnutrition

¹ This study was financed by the Norwegian Royal Ministry of Foreign Affairs under the SSE collaborative research Program in Mali, and Norwegian Research Council for Science and Humanities.

² The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked "advertisement" in accordance with 18 USC section 1734 solely to indicate this fact.

³ To whom correspondence should be addressed.

Manuscript received 25 January 1993. Revision accepted 7 December 1993.

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