Predictive Models and Tools for Early Detection of Stunting in Children: A Systematic Review
Abstract
Child stunting remains a critical public health challenge globally, with early detection essential for preventing irreversible developmental consequences. This review uniquely synthesizes predictive and measurement tools for early stunting detection across multiple low- and middle-income countries, addressing the gap in systematic evaluation of their diagnostic performance. Following PRISMA 2020 guidelines, we systematically searched PubMed, ProQuest, Emerald, and Springer databases for studies published between 2019-2024. We used the SPIDER method to define this study's inclusion, and eligible studies included those developing or validating predictive models and diagnostic tools for stunting detection in children aged 0-19 years. The articles included in this assessment use different methodologies conduct a critical appraisal to determine the quality of the articles using the instrument tool from Joana Briggs Institute (JBI). Thirteen studies met the inclusion criteria, identifying four primary tool categories clinical scoring systems, omposite anthropometric indices, diagnostic charts and machine learning models. The MEIRU chart demonstrated superior diagnostic accuracy (sensitivity 97.6%, specificity 96.3%, kappa 0.93) compared to traditional WHO methods. Clinical scores exhibited moderate performance with sensitivity ranging from 61.9% to 90.0%. Common predictors across models included maternal education, birth weight, child age, gender, and socioeconomic status. Predictive models and measurement tools are valuable for the early detection of stunting, enabling timely and targeted interventions to reduce its long-term impact on child health and development.
Keywords: Anthropometry, Diagnostic accuracy, Early detection, Prediction models, Risk factors
Full Text:
PDFReferences
Afework, E., Mengesha, S., & Wachamo, D. (2021). Stunting and Associated Factors among Under-Five-Age Children in West Guji Zone, Oromia, Ethiopia. Journal of Nutrition and Metabolism, 2021, 8890725. https://doi.org/10.1155/2021/8890725.
Aryanti, N., Hadju, V., Salam, A., Thaha, A. R., Ansariadi, & Masni. (2024). Determinants of Stunting in Young Women Age 13-15 Years in South Galesong District, Takalar Regency, Indonesia: a Cross-sectional Study. Acta Medica Philippina, 58(8), 132–138. https://doi.org/10.47895/amp.vi0.6805.
Aychiluhm, S. B., Tadesse, A. woday, Mare, K. U., Abebaw, D., & Worku, N. (2021). A systematic review and meta-analysis protocol on stunting and its determinants among school-age children (6-14years) in Ethiopia. PLoS ONE, 16(3 March), 1–7. https://doi.org/10.1371/journal.pone.0248390.
Bantie, G. M., Aynie, A. A., Akenew, K. H., Belete, M. T., Tena, E. T., Gebretsadik, G. G., Tsegaw, A. N., Woldemariam, T. B., Woya, A. A., Melese, A. A., Ayalew, A. F., & Dessie, G. (2021). Prevalence of stunting and associated factors among public primary school pupils of Bahir Dar city, Ethiopia: School-based cross-sectional study. PloS One, 16(4), e0248108. https://doi.org/10.1371/journal.pone.0248108.
Bazie, G. W., Seid, M., & Egata, G. (2021). Prevalence and Predictors of Stunting among Primary School Children in Northeast Ethiopia. Journal of Nutrition and Metabolism, 2021, 8876851. https://doi.org/10.1155/2021/8876851.
Budiailmiawan, L., Aryati, A., Kadir, N. A., Yusuf, L. I., Partakusuma, L. G., Markus, L., & Lismayanti, L. (2024). Anaemia Profile and Inflammation Markers in Stunted Children Under Two Years in Indonesia. Children, 11(11), 1315. https://doi.org/https://doi.org/10.3390/children11111315.
Casadei, K., & Kiel, J. (2022). Anthropometric Measurement. In Anthropometric Measurement.
Chanyarungrojn, P. A., Lelijveld, N., Crampin, A., Nkhwazi, L., Geis, S., Nyirenda, M., & Kerac, M. (2023). Tools for assessing child and adolescent stunting: Lookup tables, growth charts and a novel appropriate-technology “MEIRU” wallchart - a diagnostic accuracy study. PLOS Global Public Health, 3(7), e0001592. https://doi.org/10.1371/journal.pgph.0001592.
Chapagain, R., Giri, B., Bhattarai, T., Dhungana, J., Walters, M., Damasco, E., Blanco, J., Ladas, K. D., Antoniades, A., & Ladas, E. (2023). A cross-sectional study evaluating the prevalence and predictors of malnutrition among children and adolescents visiting an urban academic hospital in Nepal. Public Health Nutrition, 26(12), 2738–2747. https://doi.org/10.1017/S136898002300188.
Huriah, T., & Nurjannah, N. (2020). Risk factors of stunting in developing countries: A scoping review. Open Access Macedonian Journal of Medical Sciences, 8(F), 155–160. https://doi.org/10.3889/oamjms.2020.4466.
Kebede, D., Prasad, R. P. C. J., Asres, D. T., Aragaw, H., & Worku, E. (2021). Prevalence and associated factors of stunting and thinness among adolescent students in Finote Selam Town, Northwest Ethiopia. Journal of Health, Population, and Nutrition, 40(1), 44. https://doi.org/10.1186/s41043-021-00269-4.
Marume, A., Archary, M., & Mahomed, S. (2022). Validation of growth standards and growth references: A review of literature. Journal of Child Health Care : For Professionals Working with Children in the Hospital and Community, 26(3), 498–510. https://doi.org/10.1177/13674935211024816.
Mengesha, A., Hailu, S., Birhane, M., & Belay, M. M. (2021). The Prevalence of Stunting and Associated Factors among Children Under Five years of age in Southern Ethiopia: Community Based Cross-Sectional Study. Annals of Global Health, 87(1), 111. https://doi.org/10.5334/aogh.3432.
Mhamad, H. J., Najmadden, Z. B., Hama Salih, K. H., Hama, D. A., Abdullah, H. O., Hasan, K. M., Kareem, H. O., Mohammed, B. A., Fattah, F. H., Abdalla, B. A., Kakamad, F. H., & Mohammed, S. H. (2024). Prevalence and predictive factors associated with stunting in preschool children in a governorate of Iraq: a community-based cross-sectional study. Frontiers in Nutrition, 11, 1322625. https://doi.org/10.3389/fnut.2024.1322625.
Mkungudza, J., Twabi, H. S., & Manda, S. O. M. (2024). Development of a diagnostic predictive model for determining child stunting in Malawi : a comparative analysis of variable selection approaches. BMC Medical Research Methodology, 1–12. https://doi.org/10.1186/s12874-024-02283-6.
Muche, A., Gezie, L. D., Baraki, A. G.-E., & Amsalu, E. T. (2021). Predictors of stunting among children age 6-59 months in Ethiopia using Bayesian multi-level analysis. Scientific Reports, 11(1), 3759. https://doi.org/10.1038/s41598-021-82755-7.
Permatasari, T. A. E., Chadirin, Y., Ernirita, E., Syafitri, A. N., & Fadhilah, D. A. (2025). The accuracy of a novel stunting risk detection application based on nutrition and sanitation indicators in children aged under five years. BMC Nutrition, 11(1), 93. https://doi.org/10.1186/s40795-025-01074-6.
Santra, A., Rai, S., Misra, P., Yadav, K., Goswami, K., & Kaur, G. (2023). Comparison of Different Anthropometric Indicators for Assessment of Nutritional Status Among Adolescent Girls in an Urban Resettlement Colony in New Delhi: A Cross-Sectional Study. Cureus, 4(4), 3–5. https://doi.org/10.7759/cureus.37242.
Simbolon, D., Suryani, D., & Yorita, E. (2019). Prediction Model and Scoring In Prevention and Control of Stunting Problems in Under Five-Year-Olds in Indonesia. Jurnal Kesehatan Masyarakat, 15(2), 160–170.
Sk, R., Banerjee, A., & Rana, M. J. (2021). Nutritional status and concomitant factors of stunting among pre-school children in Malda, India: A micro-level study using a multilevel approach. BMC Public Health, 21(1), 1690. https://doi.org/10.1186/s12889-021-11704-w.
Suratri, M. A. L., Putro, G., Rachmat, B., Nurhayati, Ristrini, Pracoyo, N. E., Yulianto, A., Suryatma, A., Samsudin, M., & Raharni. (2023). Risk Factors for Stunting among Children under Five Years in the Province of East Nusa Tenggara (NTT), Indonesia. International Journal of Environmental Research and Public Health, 20(2). https://doi.org/10.3390/ijerph20021640.
Tamrat, M., Assefa, G., Sisay, L., Tamiru, D., & Belachew, T. (2024). Anthropometric failure and associated factors among children aged 6 – 23 months in Ethiopia. October 2023, 1581–1591. https://doi.org/10.1002/fsn3.3821.
UNICEF, WHO, & WORLD BANK. (2023). Level and trend in child malnutrition. World Health Organization, 4. https://www.who.int/publications/i/item/9789240073791.
WHO. (2025). Stunting. World Health Organization. https://www.who.int/data/nutrition/tracking-tool/stunting.
Yani, D. I., Rahayuwati, L., Sari, C. W. M., Komariah, M., & Fauziah, S. R. (2023). Family Household Characteristics and Stunting: An Update Scoping Review. Nutrients, 15(1), 1–17. https://doi.org/10.3390/nu15010233.
Yisak, H., Tadege, M., Ambaw, B., & Ewunetei, A. (2021). Prevalence and Determinants of Stunting, Wasting, and Underweight Among School-Age Children Aged 6-12 Years in South Gondar Zone, Ethiopia. Pediatric Health, Medicine and Therapeutics, 12, 23–33. https://doi.org/10.2147/PHMT.S287815.
DOI: http://dx.doi.org/10.30829/contagion.v7i3.25901
Refbacks
- There are currently no refbacks.
Copyright (c) 2025 Nurannisa Nurannisa, Titih Huriah

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.




