3-D Innovations, Algorithms and the Science of Body Measurement

When working in the field, Dr. Karim Bougma is up early—some days rising at 3:00 a.m. to start his day. With a 3-D imaging device in hand, he joins a team each morning as they go house-to-house to collect body measurement data for children under five, which is being used to monitor and evaluate population health and nutrition programs.

Bougma, an anthropometry specialist with the CDC Foundation, is a part of a Centers for Disease Control and Prevention (CDC) team studying the potential of a new technology on anthropometric data collection. Anthropometry is the study of human body measurements. Anthropometric measurements are used to help practitioners, policy makers and program managers understand nutritional status of a population and identify risk factors related to heath.

For example, health care workers use body measurement data to evaluate a patient’s overall health, and weight status, especially to monitor the healthy growth and development of infants and children. This data can also determine risk factors for chronic diseases, like heart disease and diabetes. Anthropometry also plays a central role in a variety of fields such as architecture, industrial design and ergonomics. It informs the development of items like clothing sizes, building structures and safety equipment and provides data for preventive health measures.

Dr. Karim Bougma, an anthropometry specialist with the CDC Foundation.

The goal of this evaluation, which is being carried out in Guatemala and Kenya, is to test the validity, accuracy and acceptability of collecting 3-D scans to then calculate body measurements. The system consists of a tablet or smartphone and a 3-D camera used to take image scans which are integrated into an algorithm to extract measurements of the body.

Traditional anthropometric measurements use a bulky device called a stadiometer to manually measure length or height and tapes to measure circumferences of the head, mid upper arm, waist, hip or other body circumferences. In addition to issues of poor measurement, portable stadiometer equipment regularly used in large-scale surveys is costly, bulky, and can be heavy to transport, which increases the difficulty of collecting length or height in field settings, especially in remote areas. The new body imaging technology is small and portable and has the potential of more accurate data.

The CDC Foundation program is groundbreaking. “This is one of the first times this type of technology has been used for public health purposes targeting young children in low- and middle-income countries,” said Bougma. While this technology has been tested in controlled settings, this is the first time the system is being evaluated in the field.

As an innovation, this is the right way forward. If we have measurement capabilities on the tablets and smartphones, we will have one tool that can do everything.

Dr. Maria Jefferds and Dr. Karim Bougma demonstrate the new technology to prepare for the field work in Guatemala.

Zuguo MEI, MD, MPH, Senior Epidemiologist, CDC

“As an innovation, this is the right way forward,” said Bougma. “Everything is becoming digital and tablets and smartphones are being used for data collection for many of the traditional surveys in low- and middle-income countries,” he said. “If we have measurement capabilities on the tablets and smartphones, we will have one tool that can do everything.”

While in Guatemala, the CDC Foundation and CDC staff trained local teams to use the new evaluation methods. During the household surveys, the teams are collecting data from 600 children and infants using both the manual and automatic methods for comparison. As a part of the evaluation, an additional 600 children will be measured in Kenya later this year.

“We are evaluating whether the results will be conclusive and comparable to the traditional methods,” said Bougma. “We are trying to see if the data from the new system matches the old one.” As a part of the evaluation, the team is also looking at whether the system is acceptable to parents and works for the field staff who are taking the measurements.

Through the evaluation, CDC is providing technical assistance for testing the accuracy and effective use of the technology, which may be the future of anthropometric assessments. The new automated system could have far reaching implications for public health—providing more accurate information will lead to better resource mobilization and preventive measures.

Improvement in measurements could have major public health impacts as the data will be used for program evaluation, policy-making and global reporting.

Without innovations like these to improve the quality of anthropometry data collection, incorrect data could lead to inadequate public health actions. If the anthropometric data is poorly collected and incorrect, the level of resource mobilization will not match the need. For instance, if a survey conducted in a region found malnutrition at 22 percent among children under five years old, this would set off unnecessary alarm bells for funds, resources and implementation of malnutrition programs, explained Bougma.

Dr. Maria Jefferds, CDC, and Dr. Karim Bougma, CDC Foundation, with Bill Gates and participants in the 2018 Goalkeepers event.

Knowing accurate anthropometric measurements of a person and a population can provide important, lifesaving data. “Improvement in measurements could have major public health impacts as the data will be used for program evaluation, policy-making and global reporting,” said Dr. Maria Jefferds, team lead, International Micronutrient Malnutrition Prevention and Control Program, CDC.

In 2019, the CDC team will have the data needed to analyze and then publish the results. As a partner and funder, the Bill & Melinda Gates Foundation will maintain the data collected and analyzed by CDC and make it publically available after publication.

“We believe this device could have a dramatic impact on facilitating the collection and interpretation of data on the prevalence of different forms of malnutrition and the impact of intervention programs,” said Dr. Ken Brown, senior program officer and initiative lead, Bill & Melinda Gates Foundation. “We have sought collaboration with CDC to determine the accuracy of the device and its ease of use and acceptability in low-income field settings because of CDC’s extensive experience and excellent reputation for conducting this type of unbiased, independent evaluation.”

Innovation is key to achieving better health outcomes. This new tool and emerging technologies could revolutionize the way practitioners take body measurements—having accurate and current data will lead to a healthier and safer society.

The initiative is being featured at Goalkeepers 2018 by the Bill & Melinda Gates Foundation as an innovative program driving progress in health. #Goalkeepers18