To determine the likely cause when the height for age is <-2SD, consider the following:
Explanation:
- The term "<-2SD" indicates that height is significantly below the expected average for the child's age, which is a statistical measure used to define malnutrition.
- Height-for-age is an indicator of linear growth and is primarily used to identify chronic malnutrition.
- Chronic malnutrition refers to stunted growth over a long period, usually due to prolonged insufficient intake of nutrients or recurrent illnesses. This results in poor linear growth rather than an immediate deficiency manifesting in weight loss, which would indicate acute malnutrition.
- Therefore, when a 4-year-old child's height is significantly less than the standard (i.e., <-2SD), it suggests the child has experienced a long-term deprivation affecting growth.
Conclusion: Considering the long-duration effect evident in deviations in height (height-for-age), the likely cause is:
Chronic malnutrition.