Weight estimation in Paediatrics: how accurate is the Broselow-tape weight estimation in the Nigerian child

Abstract

BackgroundDetermination of weight in children is an important aspect of their assessment. It has a wide range of usefulness including assessing their nutritional status and drug dose calculation. Despite its usefulness, weight estimation in children in certain conditions can be challenging particularly in emergency situations or in children who are severely ill or cannot stand on standard scales. The Broselow Tape which is a validated tape that is used to estimate weight based on length was developed using height/weight correlations from Western data. However, considering the variations in anthropometric measurements of children from different geographic locations, there is need to ascertain how accurate it is to estimate weight using the Broselow tape among children in Nigeria.AimThe study was carried out to determine the accuracy in the use of the Broselow Tape in weight estimation among Nigerian children.MethodA total 1456 children aged 1–12 years who satisfied the inclusion criteria were enrolled over a 2½ year period from two tertiary health facilities in Enugu state Nigeria. Weight was taken using standard weighing scale and Broselow tape. Data collected was analysed using SPSS.ResultOf the 1456 children studied, majority (84.2%) had normal Body-Mass-Index (BMI) while about 4.6% had a low BMI percentile for age. The mean weight difference between the two methods was not significantly different between the 1 to 6 years old category. Significant differences were observed from 7 up to 12 years. The Broselow Tape overestimated weights in 1 year old by 3.88%, 2 years 1.58%, 3 years by 2.13%, 4 years (1.94%) and 5 year (0.07%). After 5 years, the degree of overestimation rises sharply to 4.25% in 6, 9.25% in 7, 7.29% in 8 and 9.29%. 9.18, 11.61% & 6.75% in 9, 10, 11 and 12 years old respectively. The proportion of estimated weights that was within 10- 20% of the actual weight was higher in the 1-6 years age categories compared to weight estimates in older age categories.ConclusionWeight estimates obtained using the Broselow tape correlated better in children that are 6 years or younger compared to those in the older age categories. There is need for re-validation and/or adjustments of the Broselow tape especially in children over 6 years old.

Validity of Broselow tape for estimating the weight of children in pediatric emergency: A cross-sectional study

“…Moreover, the MPE of the Broselow tape method was 1%; and the proportions of children with P10 and P20 was significantly higher than the APLS method. Our results indicated that the consistency of the Broselow tape was better than the APLS, as supported by the literature from other countries ( 1 , 22 , 24 ). Is the result of the present study due to the inclusion of a uniform body shape population?…”

“…Therefore, this study does not include a uniform body shape population. The proportions of children with P10 using the Broselow tape was the highest in the > 19-kg group; while the proportions of children with P20 was highest in the < 10-kg group, which differed from studies in other countries ( 1 , 22 , 24 ). The present results did not meet the acceptable accuracy of estimation (P20 > 95% and P10 > 70%), as has previously been suggested ( 4 , 27 ).…”

“…In the present study, the Broselow tape overestimated the weight as the weight level was higher than the actual measured weight in all three weight groups ( Table 1 ), supported by previous studies ( 24 , 28 , 29 ). Basing on the data of P20 using the Broselow tape, we found that the total overestimated ratios (4.5%, 20/442) was higher than that of the underestimated ratios (2.7%, 12/442) in all children; for three weight groups, the underestimated ratios were the lowest in the < 10-kg group (0.0%) and the highest in the 10–19-kg and > 19-kg group (1.4%, respectively); while the overestimated ratios were the lowest in the < 10-kg group (0.0%) and the highest in the 10–19-kg group (3.4%) ( 22 , 24 , 30 ). Still, the exact reasons regarding why the consistency was better in the > 19-kg group are mostly unknown.…”

“…Different races, different economic levels and different geographical characteristics of different countries will lead to these differences. Indeed, Pukar et al ( 1 ) (Nepalese children) and Iloh et al ( 22 ) (Nigerian children) showed that the accuracy was better in the low weight zones. In Indian children, Shah et al ( 24 ) showed that the accuracy was the lowest in the 10–18-kg group.…”

“…In Kenya, the overall MPE for the actual weight and Broselow tape was −2.2% ( 21 ). In Nigeria, weight estimates obtained using the Broselow tape correlated better in children that are 6 years or younger compared to those in the older age categories ( 22 ). In Mexico, The Broselow tape-estimated weight was different from the scale weight by more than 10% in a substantial percentage of Mexican children; nevertheless, the MPE was < 3%, and Broselow tape color zone estimation was accurate in most subjects, and the P10 was 63.6% ( 23 ).…”