A field test of three LQAS designs to assess the prevalence of acute malnutrition

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Abstract
Background The conventional method for assessing the prevalence of Global Acute Malnutrition (GAM) in emergency settings is the 30 × 30 cluster-survey. This study describes alternative approaches: three Lot Quality Assurance Sampling (LQAS) designs to assess GAM. The LQAS designs were field-tested and their results compared with those from a 30 × 30 cluster-survey. Methods Computer simulations confirmed that small clusters instead of a simple random sample could be used for LQAS assessments of GAM. Three LQAS designs were developed (33 × 6, 67 × 3, Sequential design) to assess GAM thresholds of 10, 15 and 20%. The designs were field-tested simultaneously with a 30 × 30 cluster-survey in Siraro, Ethiopia during June 2003. Using a nested study design, anthropometric, morbidity and vaccination data were collected on all children 6–59 months in sampled households. Hypothesis tests about GAM thresholds were conducted for each LQAS design. Point estimates were obtained for the 30 × 30 cluster-survey and the 33 × 6 and 67 × 3 LQAS designs. Results Hypothesis tests showed GAM as Conclusions The LQAS designs provide statistically appropriate alternatives to the more time-consuming 30 × 30 cluster-survey. However, additional field-testing is needed using independent samples rather than a nested study design.

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