PT - JOURNAL ARTICLE AU - Stephan M. Funk AU - Belén Palomo Guerra AU - Amy Ickowitz AU - Nicias Afoumpam Poni AU - Mohamadou Aminou Abdou AU - Yaya Hadam Sibama AU - René Penda AU - Guillermo Ros Brull AU - Martin Abossolo AU - Eva Ávila Martín AU - Robert Okale AU - Blaise Ango Ze AU - Ananda Moreno Carrión AU - Cristina García Sebastián AU - Cristina Ruiz de Loizaga García AU - Francisco López-Romero Salazar AU - Hissein Amazia AU - Idoia Álvarez Reyes AU - Rafaela Sánchez Expósito AU - John E. Fa TI - WHO child growth standards for Pygmies: one size fits all? AID - 10.1101/591172 DP - 2019 Jan 01 TA - bioRxiv PG - 591172 4099 - http://biorxiv.org/content/early/2019/03/27/591172.short 4100 - http://biorxiv.org/content/early/2019/03/27/591172.full AB - Background African Pygmies exhibit a unique, genetically determined child growth dynamics and adult stature but the impact on assessing undernutrition remains unknown. Baka Pygmy health is highly compromised compared to sympatric populations. Evaluating child undernutrition is an important step to address this health quandry. We estimate stunting and wasting in Cameroon’s Baka children and investigate the applicability of the standards for Pygmy people.Methods Anthropometric and health data from 685 2-to12 year old children were collected at 25 health centres in southern Cameroon. Growth was analysed using both, WHO Child Growth Standards and the population itself as reference to define frequencies of stunting, wasting and obesity.Findings Baka children revealed with 68.4% the highest recorded level globally of stunting relative to the WHO child growth standard in 2-to-4 year olds. Wasting was at 8.2% in the upper third range in Sub-Saharan Africa. Obesity was with 6.5% similar to wasting, but no comparable data have been published for Sub-Saharan Africa. When referenced to the Baka population itself, values for stunting were dramatically lower at 1.0% and 2.9% for 2-to-4 and 5-to-12 year olds, respectively. Wasting was also lower at 2.8% and 1.8% and was exceeded by obesity at 3.4% and 3.5%, respectively. Brachial perimeters and oedemas indicated rare severe malnutrition (< 2%) whilst moderate and severe anaemia were frequent (26.6% and 3.3%, respectively).Interpretation WHO child growth standards for stunting are clearly not applicable to Pygmies thus contradicting the widespread emphasis of their ethnicity-independent applicability. The inferred values for wasting and obesity are also difficult to interpret and are likely overestimated by the WHO criteria. To achieve UN Sustainable Development Goals and to fulfil our humanitarian responsibility for fellow man, we recommend that Pygmy specific growth standards are developed for the genetically differing Pygmy tribes.