IS MID UPPER ARM CIRCUMFERENCE (MUAC) CUT-OFFS BY WHO ALONE A SUFFICIENT CRITERION FOR DETECTING ACUTE MALNOURISHED PAKISTANI CHILDREN, AGED 6-59 MONTHS?
Background and objectives: Weight for height Z score (WHZ) is a gold standard for identifying malnutrition in children
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| Veröffentlicht in: | Annals of nutrition and metabolism 2017-10, Vol.71 (Suppl. 2), p.492 |
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| container_issue | Suppl. 2 |
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| container_title | Annals of nutrition and metabolism |
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| creator | Safdar, Nilofer Fatimi Kumar, Ratan Amir, Mehreen Zaheer, Sidra |
| description | Background and objectives: Weight for height Z score (WHZ) is a gold standard for identifying malnutrition in children |
| doi_str_mv | 10.1159/000480486 |
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Whereas, mid upper arm circumference (MUAC) is a proxy for WHZ and is mostly used in Pakistan to identify malnutrition in children. Current WHO guide lines for community screening for malnutrition recommend MUAC < 11.5 cm for severe acute malnutrition (SAM), however it is abstruse how MUAC relates to WHZ to define acute malnutrition. Our aim was to estimate the cut-off values of MUAC and its sensitivity and appropriateness with WHZ scale for screening SAM in children from Sindh, Pakistan. Methods: A cross-sectional study of 491 children < 5 years old from rural area of Adilpur village, Sind Pakistan was undertaken. Demographic information was taken from the parent/caretaker and anthropometric data was assessed according to WHO protocol. Receiver operator characteristics (ROC) curves and Youden index was constructed to present the relationship between MUAC and WHZ score for different cut-off values of MUAC for moderate acute malnutrition (MAM) and SAM. Sensitivity and specificity of MUAC < 11.5 cm was calculated in comparison with WHZ-score <-3 standard deviation (SD). Results: The sensitivity and specificity of MUAC <11.5 cm was 25.5% and 98.6 % respectively. Using the current WHO cut-off <11.5 cm for MUAC to screen SAM, more than 74 % of children with WHZ-score < -3 were missed. The best and optimal cut-off for screening SAM was obtained at MUAC <12.8 cm with sensitivity 63.8 % and specificity 88.1 %. Conclusions: Using the current WHO cut-off of MUAC can only capture a smaller proportion of children < 5 years of age with SAM. There is an urgent need to revise cut-off value of MUAC from <11.5 cm to 12.8 cm in the community for treatment of malnutrition in children < 5 years old or we need to apply both tools MUAC <11.5 cm and WHZ-score < -3 SD simultaneously to detect all SAM children in the community.]]></description><identifier>ISSN: 0250-6807</identifier><identifier>EISSN: 1421-9697</identifier><identifier>DOI: 10.1159/000480486</identifier><language>eng</language><publisher>Basel: S. Karger AG</publisher><subject>Anthropometry ; Arm circumference ; Arms ; Body height ; Body measurements ; Children ; Children & youth ; Childrens health ; Communities ; Demographics ; Malnutrition ; Rural areas ; Screening ; Sensitivity</subject><ispartof>Annals of nutrition and metabolism, 2017-10, Vol.71 (Suppl. 2), p.492</ispartof><rights>Copyright S. Karger AG Oct 2017</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids></links><search><creatorcontrib>Safdar, Nilofer Fatimi</creatorcontrib><creatorcontrib>Kumar, Ratan</creatorcontrib><creatorcontrib>Amir, Mehreen</creatorcontrib><creatorcontrib>Zaheer, Sidra</creatorcontrib><title>IS MID UPPER ARM CIRCUMFERENCE (MUAC) CUT-OFFS BY WHO ALONE A SUFFICIENT CRITERION FOR DETECTING ACUTE MALNOURISHED PAKISTANI CHILDREN, AGED 6-59 MONTHS?</title><title>Annals of nutrition and metabolism</title><description><![CDATA[Background and objectives: Weight for height Z score (WHZ) is a gold standard for identifying malnutrition in children <5 years of age. Whereas, mid upper arm circumference (MUAC) is a proxy for WHZ and is mostly used in Pakistan to identify malnutrition in children. Current WHO guide lines for community screening for malnutrition recommend MUAC < 11.5 cm for severe acute malnutrition (SAM), however it is abstruse how MUAC relates to WHZ to define acute malnutrition. Our aim was to estimate the cut-off values of MUAC and its sensitivity and appropriateness with WHZ scale for screening SAM in children from Sindh, Pakistan. Methods: A cross-sectional study of 491 children < 5 years old from rural area of Adilpur village, Sind Pakistan was undertaken. Demographic information was taken from the parent/caretaker and anthropometric data was assessed according to WHO protocol. Receiver operator characteristics (ROC) curves and Youden index was constructed to present the relationship between MUAC and WHZ score for different cut-off values of MUAC for moderate acute malnutrition (MAM) and SAM. Sensitivity and specificity of MUAC < 11.5 cm was calculated in comparison with WHZ-score <-3 standard deviation (SD). Results: The sensitivity and specificity of MUAC <11.5 cm was 25.5% and 98.6 % respectively. Using the current WHO cut-off <11.5 cm for MUAC to screen SAM, more than 74 % of children with WHZ-score < -3 were missed. The best and optimal cut-off for screening SAM was obtained at MUAC <12.8 cm with sensitivity 63.8 % and specificity 88.1 %. Conclusions: Using the current WHO cut-off of MUAC can only capture a smaller proportion of children < 5 years of age with SAM. There is an urgent need to revise cut-off value of MUAC from <11.5 cm to 12.8 cm in the community for treatment of malnutrition in children < 5 years old or we need to apply both tools MUAC <11.5 cm and WHZ-score < -3 SD simultaneously to detect all SAM children in the community.]]></description><subject>Anthropometry</subject><subject>Arm circumference</subject><subject>Arms</subject><subject>Body height</subject><subject>Body measurements</subject><subject>Children</subject><subject>Children & youth</subject><subject>Childrens health</subject><subject>Communities</subject><subject>Demographics</subject><subject>Malnutrition</subject><subject>Rural areas</subject><subject>Screening</subject><subject>Sensitivity</subject><issn>0250-6807</issn><issn>1421-9697</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><recordid>eNqNjUtKBDEURYMo2H4G7uCBEwVLk7K-I4mpl66HlaTIB3HUOGgHjdjaZS_G3VoDFyBcuINzLpexC8FvhSjbO8550cypDthCFLnI2qqtD9mC5yXPqobXx-xkmjaci7wpygX7oQCGOkjjiB6kN6DIq2Q0erQK4cokqa5BpZg5rQM8vsBz70AOziJICElrUoQ2gvIU0ZOzoJ2HDiOqSHYJct4iGDlYlzyFHjsY5ROFKC2B6mno5qcbkMsZVFnZgnE29uHhjB29vb5P6_O_PmWXGqPqs8_d9mu_nr5Xm-1-9zGjVc4r0YqKF_X9_6xf0kpOew</recordid><startdate>20171001</startdate><enddate>20171001</enddate><creator>Safdar, Nilofer Fatimi</creator><creator>Kumar, Ratan</creator><creator>Amir, Mehreen</creator><creator>Zaheer, Sidra</creator><general>S. Karger AG</general><scope>7QP</scope><scope>K9.</scope><scope>NAPCQ</scope></search><sort><creationdate>20171001</creationdate><title>IS MID UPPER ARM CIRCUMFERENCE (MUAC) CUT-OFFS BY WHO ALONE A SUFFICIENT CRITERION FOR DETECTING ACUTE MALNOURISHED PAKISTANI CHILDREN, AGED 6-59 MONTHS?</title><author>Safdar, Nilofer Fatimi ; Kumar, Ratan ; Amir, Mehreen ; Zaheer, Sidra</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-proquest_journals_20619160473</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Anthropometry</topic><topic>Arm circumference</topic><topic>Arms</topic><topic>Body height</topic><topic>Body measurements</topic><topic>Children</topic><topic>Children & youth</topic><topic>Childrens health</topic><topic>Communities</topic><topic>Demographics</topic><topic>Malnutrition</topic><topic>Rural areas</topic><topic>Screening</topic><topic>Sensitivity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Safdar, Nilofer Fatimi</creatorcontrib><creatorcontrib>Kumar, Ratan</creatorcontrib><creatorcontrib>Amir, Mehreen</creatorcontrib><creatorcontrib>Zaheer, Sidra</creatorcontrib><collection>Calcium & Calcified Tissue Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><jtitle>Annals of nutrition and metabolism</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Safdar, Nilofer Fatimi</au><au>Kumar, Ratan</au><au>Amir, Mehreen</au><au>Zaheer, Sidra</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>IS MID UPPER ARM CIRCUMFERENCE (MUAC) CUT-OFFS BY WHO ALONE A SUFFICIENT CRITERION FOR DETECTING ACUTE MALNOURISHED PAKISTANI CHILDREN, AGED 6-59 MONTHS?</atitle><jtitle>Annals of nutrition and metabolism</jtitle><date>2017-10-01</date><risdate>2017</risdate><volume>71</volume><issue>Suppl. 2</issue><spage>492</spage><pages>492-</pages><issn>0250-6807</issn><eissn>1421-9697</eissn><abstract><![CDATA[Background and objectives: Weight for height Z score (WHZ) is a gold standard for identifying malnutrition in children <5 years of age. Whereas, mid upper arm circumference (MUAC) is a proxy for WHZ and is mostly used in Pakistan to identify malnutrition in children. Current WHO guide lines for community screening for malnutrition recommend MUAC < 11.5 cm for severe acute malnutrition (SAM), however it is abstruse how MUAC relates to WHZ to define acute malnutrition. Our aim was to estimate the cut-off values of MUAC and its sensitivity and appropriateness with WHZ scale for screening SAM in children from Sindh, Pakistan. Methods: A cross-sectional study of 491 children < 5 years old from rural area of Adilpur village, Sind Pakistan was undertaken. Demographic information was taken from the parent/caretaker and anthropometric data was assessed according to WHO protocol. Receiver operator characteristics (ROC) curves and Youden index was constructed to present the relationship between MUAC and WHZ score for different cut-off values of MUAC for moderate acute malnutrition (MAM) and SAM. Sensitivity and specificity of MUAC < 11.5 cm was calculated in comparison with WHZ-score <-3 standard deviation (SD). Results: The sensitivity and specificity of MUAC <11.5 cm was 25.5% and 98.6 % respectively. Using the current WHO cut-off <11.5 cm for MUAC to screen SAM, more than 74 % of children with WHZ-score < -3 were missed. The best and optimal cut-off for screening SAM was obtained at MUAC <12.8 cm with sensitivity 63.8 % and specificity 88.1 %. Conclusions: Using the current WHO cut-off of MUAC can only capture a smaller proportion of children < 5 years of age with SAM. There is an urgent need to revise cut-off value of MUAC from <11.5 cm to 12.8 cm in the community for treatment of malnutrition in children < 5 years old or we need to apply both tools MUAC <11.5 cm and WHZ-score < -3 SD simultaneously to detect all SAM children in the community.]]></abstract><cop>Basel</cop><pub>S. Karger AG</pub><doi>10.1159/000480486</doi></addata></record> |
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| ispartof | Annals of nutrition and metabolism, 2017-10, Vol.71 (Suppl. 2), p.492 |
| issn | 0250-6807 1421-9697 |
| language | eng |
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| source | JSTOR Archive Collection A-Z Listing; Karger Journals; Alma/SFX Local Collection |
| subjects | Anthropometry Arm circumference Arms Body height Body measurements Children Children & youth Childrens health Communities Demographics Malnutrition Rural areas Screening Sensitivity |
| title | IS MID UPPER ARM CIRCUMFERENCE (MUAC) CUT-OFFS BY WHO ALONE A SUFFICIENT CRITERION FOR DETECTING ACUTE MALNOURISHED PAKISTANI CHILDREN, AGED 6-59 MONTHS? |
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