Evaluation of Five Formulae for Estimating Body Surface Area of Nigerian Children

BACKGROUND: Physiological functions are often assessed by standardizing for body surface area (BSA) to avoid excessive variation in calculations in pediatric practice. AIM: To explore the suitability of existing formulae for estimating the BSA of Nigerian children. SUBJECTS AND METHODS: This cross-sectional study involved healthy children in a Local Government Area, Oyo State, Nigeria. The BSAs of 2745 children were calculated using the formulae by Boyd, Mosteller, Gehan and George, Haycock, and Dubois-DuBois, and the sixth arithmetic mean of these five formulae (mean-BSA) was performed. The outcome of interest was agreement between estimated BSA and mean-BSA for each method. The performance of each BSA estimation method was compared using bias, root mean square error and Bland-Altman plots of agreement. RESULTS: The study participants comprised of 1229 males and 1246 females with mean (standard deviation) ages of 6.3 (3.0) years and 6.6 (3.1) years respectively (P = 0.01). Reference values for BSA estimates by gender were proposed each age group. Furthermore, BSA estimates from Boyd's and Mosteller's formulae were most similar to the mean-BSA with mathematically perfect correlations. The degree of deviation of BSA estimates from DuBois was largest with a remarkable increase at ages <6 years. CONCLUSION: Formulae by Boyd and Mosteller are the best BSA estimate for Nigerian children among the existing formulae.