Indications of missed malnutrition cases and growth monitoring challenges in a middle-income country

Malnutrition in children is closely associated with low socioeconomic status (SES). Effective growth monitoring is essential for identifying cases of wasting, stunting, or overweight. This study aimed to identify previously undiagnosed cases of malnutrition and to examine challenges related to growth monitoring in a low-SES region of Türkiye. This descriptive cross-sectional study included children aged 0–18 years who presented to a pediatric outpatient clinic in a low-SES region of Türkiye and were identified with malnutrition (stunting, wasting, or overweight) based on WHO criteria. Standardized measurements were used to assess height-for-age, weight-for-height, and BMI-for-age. A structured questionnaire was used to gather information on prior diagnoses, timing and setting of the last growth assessment, diagnostic work-up, and treatment. Data were analyzed with descriptive statistics. Malnutrition was detected in 105 (6.2%) of the 1,687 children evaluated during the study period. Two-thirds of the 105 malnourished children were undernourished (wasting and stunting), and one-third were overweight. Three-quarters of the malnourished children were aged ≥ 5 years. The majority (78%) reported that it was the first time they had been diagnosed with malnutrition, although 91% of them had seen a physician within the past year. Less than half could recall any previous measurements in the child's lifetime. In conclusion, inadequate anthropometric measurements and missed malnutrition diagnoses indicate problems in growth monitoring in this low SES region. Missed malnutrition diagnoses, particularly above 5 years of age, require further action.