child-growth-standards 0.2.0 → 0.2.3

package/README.md

@@ -48,9 +48,10 @@ Use **`YYYY-MM-DD`** strings or `Date` values for birth and measurement dates (c
 
 ### NNC (`standard: "nnc"`)
 
-- Age for WFA and length/height-for-age: **completed calendar months** (same idea as Excel `DATEDIF(..., "m")`).
+- Age for WFA and length/height-for-age: **completed calendar months** (same idea as Excel `DATEDIF(..., "m")`), with tables through **71 completed months**.
 - Weight-for-**length** applies below **24 months**; weight-for-**height** from **24 up to 59 months** (by month index at measurement).
 - Each indicator returns **`nutritionalStatus`**, **`nutritionalStatusCode`** (e.g. SUW, UW, N, OW, SSt, St, SW, MW, Ob), and **`sdBand`**. **`zScore` is always `null`**.
+- WFL/WFH wasting (**`MW`** / **`SW`**) also includes **`acuteMalnutritionStatus`** and **`acuteMalnutritionStatusCode`** (`MAM` / `SAM`), with eOPT labels unchanged.
 
 ### WHO (`standard: "who"`)
 
@@ -63,7 +64,7 @@ Use **`YYYY-MM-DD`** strings or `Date` values for birth and measurement dates (c
 
 | Age | Source |
 |-----|--------|
-| Birth–5 years | [WHO IMCI Table 1 (NBK487900)](https://www.ncbi.nlm.nih.gov/books/NBK487900/table/fm.s1.t1/) — underweight, stunting, wasting, overweight/obesity on WFL/H and BMI-for-age; weight-for-age underweight only |
+| Birth–5 years | [WHO IMCI Table 1 (NBK487900)](https://www.ncbi.nlm.nih.gov/books/NBK487900/table/fm.s1.t1/) — underweight, stunting, wasting (with **MAM/SAM** on WFL/WFH/BMI-for-age wasting bands), overweight/obesity; optional **MUAC** (6–59 completed months, <11.5 / 11.5–<12.5 cm) and **bilateral pitting oedema** (SAM) |
 | 5–19 years | [WHO BMI-for-age (5–19)](https://www.who.int/tools/growth-reference-data-for-5to19-years/indicators/bmi-for-age) — thinness, normal weight, overweight, obesity; height-for-age stunting |
 
 Head circumference-for-age uses WHO chart bands (below / normal / above expected), not Table 1.
@@ -80,7 +81,7 @@ await calculateAll({
 });
 ```
 
-Optional **head circumference** (WHO only, when provided):
+Optional **head circumference**, **MUAC (cm)**, and **bilateral pitting oedema** (WHO only, when provided):
 
 ```ts
 await calculateAll({
@@ -91,9 +92,13 @@ await calculateAll({
   weightKg: 9.5,
   lengthHeightCm: 75,
   headCircumferenceCm: 46,
+  muacCm: 12.1,
+  bilateralPittingEdema: false,
 });
 ```
 
+Wasting indicators also expose **`acuteMalnutritionStatus`** / **`acuteMalnutritionStatusCode`** (`MAM` / `SAM`) alongside the legacy “moderately/severely wasted” labels. MUAC and oedema appear as extra results: `mid-upper-arm-circumference`, `bilateral-pitting-oedema`.
+
 ## Single indicator (WHO only)
 
 ```ts

package/dist/acute-malnutrition.d.ts

@@ -0,0 +1,15 @@
+export declare const ACUTE_MAM: {
+    readonly status: "Moderate acute malnutrition";
+    readonly code: "MAM";
+};
+export declare const ACUTE_SAM: {
+    readonly status: "Severe acute malnutrition";
+    readonly code: "SAM";
+};
+export type AcuteMalnutritionFields = {
+    acuteMalnutritionStatus: string;
+    acuteMalnutritionStatusCode: string;
+};
+/** NNC eOPT wasting codes MW/SW → supplementary MAM/SAM (primary labels unchanged). */
+export declare function acuteFieldsForNncWastingCode(code: string): Partial<AcuteMalnutritionFields>;
+//# sourceMappingURL=acute-malnutrition.d.ts.map

package/dist/acute-malnutrition.d.ts.map

@@ -0,0 +1 @@
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package/dist/acute-malnutrition.js

@@ -0,0 +1,24 @@
+export const ACUTE_MAM = {
+    status: "Moderate acute malnutrition",
+    code: "MAM",
+};
+export const ACUTE_SAM = {
+    status: "Severe acute malnutrition",
+    code: "SAM",
+};
+/** NNC eOPT wasting codes MW/SW → supplementary MAM/SAM (primary labels unchanged). */
+export function acuteFieldsForNncWastingCode(code) {
+    if (code === "MW") {
+        return {
+            acuteMalnutritionStatus: ACUTE_MAM.status,
+            acuteMalnutritionStatusCode: ACUTE_MAM.code,
+        };
+    }
+    if (code === "SW") {
+        return {
+            acuteMalnutritionStatus: ACUTE_SAM.status,
+            acuteMalnutritionStatusCode: ACUTE_SAM.code,
+        };
+    }
+    return {};
+}

package/dist/doh/calculate-doh.d.ts

@@ -1,5 +1,11 @@
 import type { AssessmentResult, CalculateAllInput, Sex } from "../types.js";
+/** Last month index in bundled NNC WFA/LHFA tables (inclusive). */
+export declare const NNC_MAX_COMPLETED_MONTH_INDEX = 71;
+/** Exclusive upper bound for completed months when NNC age tables apply. */
+export declare const NNC_EXCLUSIVE_MAX_COMPLETED_MONTHS = 72;
 export declare function calculateDohAll(input: CalculateAllInput): AssessmentResult;
+export declare function isNncGrowthAge(months: number): boolean;
+/** @deprecated Use isNncGrowthAge — NNC WFA/LHFA tables run through 71 completed months. */
 export declare function isDohPreschoolAge(months: number): boolean;
 export declare function mapSex(input: string): Sex | null;
 //# sourceMappingURL=calculate-doh.d.ts.map

package/dist/doh/calculate-doh.d.ts.map

@@ -1 +1 @@
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package/dist/doh/calculate-doh.js

@@ -1,8 +1,13 @@
+import { acuteFieldsForNncWastingCode } from "../acute-malnutrition.js";
 import { ageInCompletedMonths, ageInDays, resolveDates } from "../age.js";
 import { classifyDohLhfa, classifyDohWfa, classifyDohWflh, } from "./classify-cutoffs.js";
 import { loadDohTable, lookupDohRow, mRoundHalf } from "./load-tables.js";
 const TWENTY_FOUR_MONTHS = 24;
 const SIXTY_MONTHS = 60;
+/** Last month index in bundled NNC WFA/LHFA tables (inclusive). */
+export const NNC_MAX_COMPLETED_MONTH_INDEX = 71;
+/** Exclusive upper bound for completed months when NNC age tables apply. */
+export const NNC_EXCLUSIVE_MAX_COMPLETED_MONTHS = 72;
 export function calculateDohAll(input) {
     const dates = resolveDates(input.dateOfBirth, input.dateOfMeasurement);
     if (!dates) {
@@ -54,6 +59,7 @@ export function calculateDohAll(input) {
                 nutritionalStatus: c.label,
                 nutritionalStatusCode: c.code,
                 sdBand: c.sdBand,
+                ...acuteFieldsForNncWastingCode(c.code),
             });
         }
     }
@@ -64,8 +70,12 @@ export function calculateDohAll(input) {
         results,
     };
 }
+export function isNncGrowthAge(months) {
+    return months >= 0 && months < NNC_EXCLUSIVE_MAX_COMPLETED_MONTHS;
+}
+/** @deprecated Use isNncGrowthAge — NNC WFA/LHFA tables run through 71 completed months. */
 export function isDohPreschoolAge(months) {
-    return months >= 0 && months < SIXTY_MONTHS;
+    return isNncGrowthAge(months);
 }
 export function mapSex(input) {
     const n = String(input ?? "")

package/dist/index.d.ts

@@ -1,6 +1,7 @@
 export { calculateAll, calculateZScore } from "./calculate.js";
 export { ageInCompletedMonths, ageInDays, daysToMonths, resolveDates, toDateOnly, FIVE_YEARS_DAYS, NINETEEN_YEARS_DAYS, WHO_DAYS_PER_MONTH, } from "./age.js";
-export { mapWhoNutritionalStatus } from "./who/nutritional-status.js";
+export { MUAC_CLASSIFICATION_MAX_MONTHS, MUAC_CLASSIFICATION_MIN_MONTHS, indicatorResultFromWhoStatus, mapWhoEdemaNutritionalStatus, mapWhoMuacNutritionalStatus, mapWhoNutritionalStatus, } from "./who/nutritional-status.js";
+export { calculateDohAll, isDohPreschoolAge, isNncGrowthAge, mapSex, NNC_EXCLUSIVE_MAX_COMPLETED_MONTHS, NNC_MAX_COMPLETED_MONTH_INDEX, } from "./doh/calculate-doh.js";
 export { computeZScore, lookupLms, normalCdf, zScoreToPercentile } from "./lms.js";
 export type { AssessmentResult, CalculateAllInput, CalculateZScoreInput, GrowthStandard, IndicatorResult, Sex, WhoAgeIndex, WhoNutritionalStatusReference, WhoNutritionalStatusResult, LmsRow, DohBandRow, } from "./types.js";
 //# sourceMappingURL=index.d.ts.map

package/dist/index.d.ts.map

@@ -1 +1 @@
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+{"version":3,"file":"index.d.ts","sourceRoot":"","sources":["../src/index.ts"],"names":[],"mappings":"AAAA,OAAO,EAAE,YAAY,EAAE,eAAe,EAAE,MAAM,gBAAgB,CAAC;AAC/D,OAAO,EACL,oBAAoB,EACpB,SAAS,EACT,YAAY,EACZ,YAAY,EACZ,UAAU,EACV,eAAe,EACf,mBAAmB,EACnB,kBAAkB,GACnB,MAAM,UAAU,CAAC;AAClB,OAAO,EACL,8BAA8B,EAC9B,8BAA8B,EAC9B,4BAA4B,EAC5B,4BAA4B,EAC5B,2BAA2B,EAC3B,uBAAuB,GACxB,MAAM,6BAA6B,CAAC;AACrC,OAAO,EACL,eAAe,EACf,iBAAiB,EACjB,cAAc,EACd,MAAM,EACN,kCAAkC,EAClC,6BAA6B,GAC9B,MAAM,wBAAwB,CAAC;AAChC,OAAO,EAAE,aAAa,EAAE,SAAS,EAAE,SAAS,EAAE,kBAAkB,EAAE,MAAM,UAAU,CAAC;AACnF,YAAY,EACV,gBAAgB,EAChB,iBAAiB,EACjB,oBAAoB,EACpB,cAAc,EACd,eAAe,EACf,GAAG,EACH,WAAW,EACX,6BAA6B,EAC7B,0BAA0B,EAC1B,MAAM,EACN,UAAU,GACX,MAAM,YAAY,CAAC"}

package/dist/index.js

@@ -1,4 +1,5 @@
 export { calculateAll, calculateZScore } from "./calculate.js";
 export { ageInCompletedMonths, ageInDays, daysToMonths, resolveDates, toDateOnly, FIVE_YEARS_DAYS, NINETEEN_YEARS_DAYS, WHO_DAYS_PER_MONTH, } from "./age.js";
-export { mapWhoNutritionalStatus } from "./who/nutritional-status.js";
+export { MUAC_CLASSIFICATION_MAX_MONTHS, MUAC_CLASSIFICATION_MIN_MONTHS, indicatorResultFromWhoStatus, mapWhoEdemaNutritionalStatus, mapWhoMuacNutritionalStatus, mapWhoNutritionalStatus, } from "./who/nutritional-status.js";
+export { calculateDohAll, isDohPreschoolAge, isNncGrowthAge, mapSex, NNC_EXCLUSIVE_MAX_COMPLETED_MONTHS, NNC_MAX_COMPLETED_MONTH_INDEX, } from "./doh/calculate-doh.js";
 export { computeZScore, lookupLms, normalCdf, zScoreToPercentile } from "./lms.js";

package/dist/types.d.ts

@@ -9,6 +9,10 @@ export type CalculateAllInput = {
     weightKg: number;
     lengthHeightCm: number;
     headCircumferenceCm?: number;
+    /** WHO only: mid-upper arm circumference in cm (IMCI Table 1 SAM/MAM cutoffs use mm internally). */
+    muacCm?: number;
+    /** WHO only: bilateral pitting oedema → severe acute malnutrition (Table 1). */
+    bilateralPittingEdema?: boolean;
     /** WHO only: age index for 0–5 age-based indicators. Default `days`. */
     whoAgeIndex?: WhoAgeIndex;
 };
@@ -22,6 +26,9 @@ export type WhoNutritionalStatusResult = {
     nutritionalStatusCode: string;
     sdBand: string;
     reference: WhoNutritionalStatusReference;
+    /** Table 1 MAM/SAM when anthropometric wasting or MUAC/edema applies. */
+    acuteMalnutritionStatus?: string;
+    acuteMalnutritionStatusCode?: string;
 };
 export type IndicatorResult = {
     indicator: string;
@@ -29,6 +36,8 @@ export type IndicatorResult = {
     nutritionalStatus: string;
     nutritionalStatusCode?: string;
     sdBand?: string;
+    acuteMalnutritionStatus?: string;
+    acuteMalnutritionStatusCode?: string;
     percentile?: number | null;
 };
 export type AssessmentResult = {

package/dist/types.d.ts.map

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package/dist/who/calculate-who.d.ts.map

@@ -1 +1 @@
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package/dist/who/calculate-who.js

@@ -1,6 +1,6 @@
 import { ageInCompletedMonths, ageInDays, resolveDates } from "../age.js";
 import { computeZScore, lookupLms, zScoreToPercentile } from "../lms.js";
-import { mapWhoNutritionalStatus } from "./nutritional-status.js";
+import { indicatorResultFromWhoStatus, mapWhoEdemaNutritionalStatus, mapWhoMuacNutritionalStatus, mapWhoNutritionalStatus, } from "./nutritional-status.js";
 import { resolveWhoLms } from "./resolve-table.js";
 const TWENTY_FOUR_MONTHS_DAYS = 731;
 function rawBmi(weightKg, heightCm) {
@@ -86,6 +86,12 @@ export function calculateWhoZScore(input) {
         nutritionalStatus: ns.nutritionalStatus,
         nutritionalStatusCode: ns.nutritionalStatusCode,
         sdBand: ns.sdBand,
+        ...(ns.acuteMalnutritionStatus
+            ? {
+                acuteMalnutritionStatus: ns.acuteMalnutritionStatus,
+                acuteMalnutritionStatusCode: ns.acuteMalnutritionStatusCode,
+            }
+            : {}),
         percentile: zScoreToPercentile(z),
     };
 }
@@ -116,5 +122,17 @@ export function calculateWhoAll(input) {
         if (row)
             results.push(row);
     }
+    if (input.muacCm != null) {
+        const muacNs = mapWhoMuacNutritionalStatus(input.muacCm, months);
+        if (muacNs) {
+            results.push(indicatorResultFromWhoStatus("mid-upper-arm-circumference", muacNs));
+        }
+    }
+    if (input.bilateralPittingEdema) {
+        const edemaNs = mapWhoEdemaNutritionalStatus(true);
+        if (edemaNs) {
+            results.push(indicatorResultFromWhoStatus("bilateral-pitting-oedema", edemaNs));
+        }
+    }
     return { standard: "who", ageDays: days, ageMonthsCompleted: months, results };
 }

package/dist/who/nutritional-status.d.ts

@@ -1,4 +1,12 @@
-import type { WhoNutritionalStatusResult } from "../types.js";
+import type { IndicatorResult, WhoNutritionalStatusResult } from "../types.js";
 export type WhoIndicatorKind = "wfa" | "hfa" | "lhfa" | "wfl" | "wfh" | "bfa" | "hcfa";
+/** IMCI MUAC classification typically applies at 6–59 completed months. */
+export declare const MUAC_CLASSIFICATION_MIN_MONTHS = 6;
+export declare const MUAC_CLASSIFICATION_MAX_MONTHS = 59;
 export declare function mapWhoNutritionalStatus(indicatorKind: WhoIndicatorKind, zScore: number, ageInDays: number): WhoNutritionalStatusResult;
+/** Table 1 MUAC cutoffs (115 mm / 125 mm), input in cm. */
+export declare function mapWhoMuacNutritionalStatus(muacCm: number, ageMonthsCompleted: number): WhoNutritionalStatusResult | null;
+/** Table 1: bilateral pitting oedema → severe acute malnutrition. */
+export declare function mapWhoEdemaNutritionalStatus(bilateralPittingEdema: boolean): WhoNutritionalStatusResult | null;
+export declare function indicatorResultFromWhoStatus(indicator: string, ns: WhoNutritionalStatusResult, zScore?: number | null, percentile?: number | null): IndicatorResult;
 //# sourceMappingURL=nutritional-status.d.ts.map

package/dist/who/nutritional-status.d.ts.map

@@ -1 +1 @@
-{"version":3,"file":"nutritional-status.d.ts","sourceRoot":"","sources":["../../src/who/nutritional-status.ts"],"names":[],"mappings":"AACA,OAAO,KAAK,EAAiC,0BAA0B,EAAE,MAAM,aAAa,CAAC;AAE7F,MAAM,MAAM,gBAAgB,GAAG,KAAK,GAAG,KAAK,GAAG,MAAM,GAAG,KAAK,GAAG,KAAK,GAAG,KAAK,GAAG,MAAM,CAAC;AAiLvF,wBAAgB,uBAAuB,CACrC,aAAa,EAAE,gBAAgB,EAC/B,MAAM,EAAE,MAAM,EACd,SAAS,EAAE,MAAM,GAChB,0BAA0B,CAkC5B"}
+{"version":3,"file":"nutritional-status.d.ts","sourceRoot":"","sources":["../../src/who/nutritional-status.ts"],"names":[],"mappings":"AAEA,OAAO,KAAK,EACV,eAAe,EAEf,0BAA0B,EAC3B,MAAM,aAAa,CAAC;AAErB,MAAM,MAAM,gBAAgB,GAAG,KAAK,GAAG,KAAK,GAAG,MAAM,GAAG,KAAK,GAAG,KAAK,GAAG,KAAK,GAAG,MAAM,CAAC;AAUvF,2EAA2E;AAC3E,eAAO,MAAM,8BAA8B,IAAI,CAAC;AAChD,eAAO,MAAM,8BAA8B,KAAK,CAAC;AAuLjD,wBAAgB,uBAAuB,CACrC,aAAa,EAAE,gBAAgB,EAC/B,MAAM,EAAE,MAAM,EACd,SAAS,EAAE,MAAM,GAChB,0BAA0B,CAkC5B;AAED,2DAA2D;AAC3D,wBAAgB,2BAA2B,CACzC,MAAM,EAAE,MAAM,EACd,kBAAkB,EAAE,MAAM,GACzB,0BAA0B,GAAG,IAAI,CA8BnC;AAED,qEAAqE;AACrE,wBAAgB,4BAA4B,CAC1C,qBAAqB,EAAE,OAAO,GAC7B,0BAA0B,GAAG,IAAI,CAUnC;AAED,wBAAgB,4BAA4B,CAC1C,SAAS,EAAE,MAAM,EACjB,EAAE,EAAE,0BAA0B,EAC9B,MAAM,GAAE,MAAM,GAAG,IAAW,EAC5B,UAAU,GAAE,MAAM,GAAG,IAAW,GAC/B,eAAe,CAejB"}

package/dist/who/nutritional-status.js

@@ -1,3 +1,4 @@
+import { ACUTE_MAM, ACUTE_SAM } from "../acute-malnutrition.js";
 import { FIVE_YEARS_DAYS } from "../age.js";
 function normalizeKind(kind) {
     if (kind === "wfh")
@@ -6,8 +7,24 @@ function normalizeKind(kind) {
         return "hfa";
     return kind;
 }
-function result(nutritionalStatus, nutritionalStatusCode, sdBand, reference) {
-    return { nutritionalStatus, nutritionalStatusCode, sdBand, reference };
+const MUAC_SAM_MAX_CM = 11.5;
+const MUAC_MAM_MAX_CM = 12.5;
+/** IMCI MUAC classification typically applies at 6–59 completed months. */
+export const MUAC_CLASSIFICATION_MIN_MONTHS = 6;
+export const MUAC_CLASSIFICATION_MAX_MONTHS = 59;
+function result(nutritionalStatus, nutritionalStatusCode, sdBand, reference, acute) {
+    return {
+        nutritionalStatus,
+        nutritionalStatusCode,
+        sdBand,
+        reference,
+        ...(acute
+            ? {
+                acuteMalnutritionStatus: acute.status,
+                acuteMalnutritionStatusCode: acute.code,
+            }
+            : {}),
+    };
 }
 function whoSdBand(z, kind, underFive) {
     if (kind === "hcfa") {
@@ -114,10 +131,10 @@ function mapHfaFiveToNineteen(z) {
 function mapWflUnderFive(z) {
     const ref = "who-imci-table1-0-5";
     if (z < -3) {
-        return result("Severely wasted", "SEV_W", "< −3 SD", ref);
+        return result("Severely wasted", "SEV_W", "< −3 SD", ref, ACUTE_SAM);
     }
     if (z <= -2) {
-        return result("Moderately wasted", "MOD_W", "−3 SD to −2 SD", ref);
+        return result("Moderately wasted", "MOD_W", "−3 SD to −2 SD", ref, ACUTE_MAM);
     }
     if (z <= 1) {
         return result("Normal", "N", "−2 SD to +1 SD", ref);
@@ -187,3 +204,44 @@ export function mapWhoNutritionalStatus(indicatorKind, zScore, ageInDays) {
     }
     return result("", "", "", underFive ? "who-imci-table1-0-5" : "who-growth-ref-5-19");
 }
+/** Table 1 MUAC cutoffs (115 mm / 125 mm), input in cm. */
+export function mapWhoMuacNutritionalStatus(muacCm, ageMonthsCompleted) {
+    const muac = Number(muacCm);
+    if (!Number.isFinite(muac) || muac <= 0)
+        return null;
+    if (ageMonthsCompleted < MUAC_CLASSIFICATION_MIN_MONTHS ||
+        ageMonthsCompleted > MUAC_CLASSIFICATION_MAX_MONTHS) {
+        return null;
+    }
+    const ref = "who-imci-table1-0-5";
+    if (muac < MUAC_SAM_MAX_CM) {
+        return result("Severe acute malnutrition (MUAC)", "SAM", "< 11.5 cm", ref, ACUTE_SAM);
+    }
+    if (muac < MUAC_MAM_MAX_CM) {
+        return result("Moderate acute malnutrition (MUAC)", "MAM", "11.5 cm to < 12.5 cm", ref, ACUTE_MAM);
+    }
+    return result("Normal (MUAC)", "N", "≥ 12.5 cm", ref);
+}
+/** Table 1: bilateral pitting oedema → severe acute malnutrition. */
+export function mapWhoEdemaNutritionalStatus(bilateralPittingEdema) {
+    if (!bilateralPittingEdema)
+        return null;
+    const ref = "who-imci-table1-0-5";
+    return result("Severe acute malnutrition (bilateral pitting oedema)", "SAM", "Clinical", ref, ACUTE_SAM);
+}
+export function indicatorResultFromWhoStatus(indicator, ns, zScore = null, percentile = null) {
+    return {
+        indicator,
+        zScore,
+        nutritionalStatus: ns.nutritionalStatus,
+        nutritionalStatusCode: ns.nutritionalStatusCode,
+        sdBand: ns.sdBand,
+        ...(ns.acuteMalnutritionStatus
+            ? {
+                acuteMalnutritionStatus: ns.acuteMalnutritionStatus,
+                acuteMalnutritionStatusCode: ns.acuteMalnutritionStatusCode,
+            }
+            : {}),
+        ...(percentile != null ? { percentile } : {}),
+    };
+}

package/package.json

@@ -1,6 +1,6 @@
 {
   "name": "child-growth-standards",
-  "version": "0.2.0",
+  "version": "0.2.3",
   "description": "Pediatric growth — NNC (eOPT) cutoff classification and WHO LMS z-scores with nutritional status",
   "type": "module",
   "license": "MIT",