Usefulness and reliability of tanner pubertal self-rating to urban Black adolescents in South Africa

Self-rating of pubertal development is the recommended method to assess puberty in large community-based surveys of adolescent development and behavior. The aim of this study was to validate for the first time pubertal self-assessment using the sexual maturation scale developed by Tanner among Black South African adolescents (n=182) aged between 10 and 18 years who were recruited and assessed at public schools in Soweto-Johannesburg. There was significant concordance between adolescents' and same sex health professional's assessment of pubic hair growth and breast development in females (kappa coefficients .71 and .76, respectively; p <.0005), and pubic hair growth and genital development in males (kappa coefficients .63 and .60, respectively; p <.0005). We conclude that the Tanner pubertal self-rating appears to be a reasonably valid instrument to use among black South African youth. The tool can be administered in school or other community-based settings with moderate confidence provided the procedure is thoroughly explained to the participant through the developed tutorial in the language of choice, and privacy and confidentiality are assured.