April, 2021

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HelecareX- Efficient Triaging with Z-Scores

Following the introduction of various Z scores into the Uganda HIMS, HelcareX is now able to automatically calculate and support heath workers with these calculations. The Z-Score standards as defined and approved by the WHO are mainly used to triage nutrition related concerns especially among children less than 5 years of age.

HelecareX has completed the inclusion of Length/height-for-age, Weight-for-age, Weight-for-length/height and BMI for Age.

Weight For Height/Length Z-Score is a measure for wasting and is categorized as SAM-O, SAM, MAM, N and ND. For effective computing of this value, the clinical officers must check oedema, otherwise the calculation proceeds with no oedema by default. We distinguish length (when measurements are taken with the child lying) from height when the measurements are taken when the baby is standing by introducing a checkbox for recumbent.

Weight For Age Z Scores measures for underweight and is stated as “N” for normal nutritional status, “U” for underweight, “SU” to indicate severe underweight; and “ND” for Not Done.

Height/Length For Age Z Scores is a measure for stunting in children where we indicate “N” for normal nutritional status, S for moderate,“SS” to indicate severe stunting and “ND” for Not Done.

BMI for Age Z-Score for children aged 5-9 years and adolescents aged 10-19 years where ‘N’ for Normal, ‘MM’ for moderately Malnourished, SM’ for Severely Malnourished; ‘OW’ for Overweight and ‘O’ for Obese. The standard Body Mass Index (BMI) is calculated for adults 19 years and above (excluding pregnant women and lactating mothers 6 months postpartum. Here we capture the same codes as BMI for age.

MUAC measurement is also now color coded for as Green, Yellow and Red. or W/H or L Z-score indicates Red (SAM) or Yellow. These changes are now available in the latest version of helecarex to be released soon starting with Bishop Ceaser Asili Memorial Hospital in Luwero and Uganda, and St Johns Hospital Aber in Aber Uganda.

The  codes is listed below for quick reference.

N Normal
ND Not Done
O Obese
OW Overweight (OW)
SU Severely Underweight
U Underweight
SAM-O Severe Acute Malnutrition with Oedema
SAM Severe Acute Malnutrition
MAM Moderately Actute Malnutrition (MAM)
SAM Severe Actute Malnutrition (SAM)
MM Moderately Malnourished
SM Severely Malnourished
SS Severely Stunted
S Moderately Stunted
N/A Not Applicable