Date of Award

Fall 1-8-2021

Degree Type


Degree Name

Master of Public Health (MPH)


Public Health

First Advisor

Richard Rothenberg MD, MPH

Second Advisor

Michelle Weinberg MD, MPH


INTRODUCTION: According to The World Health Organization, malnutrition refers to deficiencies, excesses, or imbalances in an individual’s nutrient intake. Refugees are at a higher risk for all forms of malnutrition. According to the WHO, report on global burden of malnutrition, in 2019 the rates of malnutrition included 21.3% of stunting, 6.9% of wasting and 5.6% of overweight in children under 5 globally.

AIM: To describe the nutritional status and anthropometric data quality of US-bound refugee children arriving from the top 10 processing countries. Recommendations to overseas partners may be made to improve anthropometric data quality thus improving prevalence estimates.

METHODS: We used data from the CDC’s Electronic Disease Notification (EDN) System. The study population includes all refugees from the top ten processing countries that arrived in the U.S. during fiscal year 2019. The refugees included in this analysis are <18 years old. The mean z-scores and estimated prevalence of acute and chronic malnutrition were calculated per country in this analysis. Data quality was assessed through the assessment of number of missing data, percentage of flagged data, digit preference score and standard deviation.

RESULTS: Overall, the majority of refugees were Congolese (54.2%) and Burmese (18.2%). The percentage of missing data and biologically implausible values were low, yet standard deviations were high in some countries. Prevalence estimates for wasting and stunting were generally considered medium risk according to WHO thresholds.

DISCUSSION: Findings revealed areas where data quality can be improved through intervention with trainings. Further studies over longer periods of time and stratified by refugee setting (camp vs urban) can provide the program with a better understanding of malnutrition in US-bound refugees.


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