Height screening programmes found to be important for monitoring the health of UK children – University of Reading
27 March 2008New research from the University of Reading has shown that a height screening programme for all UK children could lead to better and earlier identification of illnesses that effect growth. The research was carried out to determine the health benefits and cost-effectiveness of a UK height screening in primary school-aged children in order to identify abnormal growth problems.
A lack of evidence for the cost-effectiveness of generalised child growth screening was given as the reason for downgrading a screening programme 10 years ago. The recently updated Child Health Promotion Programme from the Department of Health has stressed the importance of growth, but clear directives as to the importance of early measurement need to be developed.
A child's height and weight are widely used as indicators of general health and well-being. Differences in height and weight can lead to the early identification of treatable health problems in otherwise apparently healthy children. Despite this, children with a treatable cause of abnormal growth are frequently diagnosed at a late age, lessening the chance of a successful outcome. Monitoring the rise in childhood obesity to allow help to be given sooner is another major benefit of a growth screening programme.
There are a number of conditions which can lead to an increased or decreased growth rate. Height screening has traditionally been used to identify growth-related conditions of which abnormal height is an indicator such as a deficiency of growth-hormone and Turner syndrome. A number of other conditions where differences in growth may indicate an underlying health problem may also be identified by height screening.
In some cases a short stature can be caused by under-activity by the thyroid gland (hypothyroidism), by child abuse or neglect, or by persistent growth retardation from other chronic illness. Tall stature is a feature of a number of medical conditions (for example Marfan and Klinefelter) which may also benefit from early treatment. Early detection and diagnosis of abnormal growth is important to allow catch-up to an optimal final adult height and minimise the impact of any underlying conditions.
Professor Gary Butler from the University of Reading's Institute of Health Sciences said "We are failing to identify growth and obesity problems in children in the UK because we do not measure children early enough and often enough. The evidence we have now suggests that if we don't identify problems until children are older, it is often too late to help. Implementing a proper early growth screening programme would identify an additional 1 in 500 children whose growth problems would otherwise remain un-recognised. Our research has shown that such a programme would be cost-effective 100% of the time. It is essential that this evidence is used to form an urgent revision of children's growth screening guidelines by policy makers in the UK."
ENDS
Notes to Editors
For all media enquiries, please contact Dr Lucy Chappell on +44 (0)118 378 7391, or email
l.chappell@reading.ac.uk
This work was carried out in collaboration with researchers at The University of York.
This research is published in Archives of Disease in Childhood (Fayter D., Nixon J., Hartley S., Rithalia A., Butler G., Rudolf M., Glasziou P., Bland M., Stirk L., Westwood M. 2008. Effectiveness and cost-effectiveness of height-screening programmes during the primary school years: a systematic review. Arch Dis Child 93: 278-284).
The Child Health Promotion Programme from the Department of Health can be found at: www.dh.gov.uk/en/Publicationsandstatistics/Publications/DH_083645.This research was funded by the NHS Health Technology Assessment Programme.