Development of a Photographic Figure-rating Scale for Detection of Wasting Among Infants 9-12 Months in Buyende, Uganda

Wasting among infants and young children remains a significant public health concern, and accurate identification of infants with severe undernutrition is crucial for ensuring timely intervention and prevention of adverse health outcomes. For mothers with low literacy levels, detection using conventional anthropometric measures can be difficult due to interpretation challenges, leading to delayed maternal care-seeking, and poor health outcomes for the child. This study aimed to develop a photographic figure-rating scale based on WHO weight-for-height z-scores for infants and young children (9-12 months), to empower mothers prevent childhood wasting in the rural communities of Buyende District, Uganda. A cross-sectional study was conducted involving 210 mother-infant pairs. A culturally appropriate 5-point figure-rating scale was developed, depicting infant body sizes matching WHO z-scores from -2 to +2. The developed scale showed moderate accuracy (67%) CI: 60.4% – 73.0%; with a sensitivity and specificity value of 64.4% (CI: 57.9% – 70.9) and 77.8% (CI 72.1% – 83.5%); respectively. A positive predictive value of 93.3% (CI: 87.06 – 99.60) demonstrates that most positive results (56/60 were true positives. In conclusion, a 5-point photographic figure-rating scale developed was moderately accurate in detecting wasting in children.