Mid-upper arm circumference in detection of weight-for-height Z-score below −3 in children aged 6–59 months

To evaluate the predictive ability of mid-upper arm circumference (MUAC) for detecting severe wasting (weight-for-height Z-score (WHZ)

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Veröffentlicht in:	Public health nutrition 2018-07, Vol.21 (10), p.1794-1799
Hauptverfasser:	Kapil, Umesh, Pandey, RM, Bansal, Rahul, Pant, Bhavana, Varshney, Amit Mohan, Yadav, Chander Prakash, Sinha, Shikha, Sareen, Neha, Sachdev, Harshpal Singh
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Schlagworte:	Age Arm - physiology Arm circumference Body composition Body height Body Height - physiology Body Weight - physiology Child, Preschool Children Children & youth Cross-Sectional Studies Data collection Diagnostic systems Edema Families & family life Female Girls Health surveys Humans India - epidemiology Infant Male Malnutrition Nutrition Nutritional Status and Body Composition Reference Values Research Papers ROC Curve Rural areas Sensitivity Studies Weight
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container_title	Public health nutrition
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creator	Kapil, Umesh Pandey, RM Bansal, Rahul Pant, Bhavana Varshney, Amit Mohan Yadav, Chander Prakash Sinha, Shikha Sareen, Neha Sachdev, Harshpal Singh
description	To evaluate the predictive ability of mid-upper arm circumference (MUAC) for detecting severe wasting (weight-for-height Z-score (WHZ)
doi_str_mv	10.1017/S1368980017004165
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Cross-sectional survey. Rural Uttar Pradesh, India. Children (n 18 456) for whom both WHZ (n 18 463) and MUAC were available. The diagnostic test accuracy of MUAC for severe wasting was excellent (area under receiver-operating characteristic curve = 0·933). Across the lower range of MUAC cut-offs (110-120 mm), specificity was excellent (99·1-99·9 %) but sensitivity was poor (13·4-37·2 %); with higher cut-offs (140-150 mm), sensitivity increased substantially (94·9-98·8 %) but at the expense of specificity (37·6-71·9 %). The optimal MUAC cut-off to detect severe wasting was 135 mm. Although the prevalence of severe wasting was constant at 2·2 %, the burden of severe acute malnutrition, defined as either severe wasting or low MUAC, increased from 2·46 to 17·26 % with cut-offs of <115 and <135 mm, respectively. An MUAC cut-off <115 mm preferentially selected children aged ≤12 months (OR=11·8; 95 % CI 8·4, 16·6) or ≤24 months (OR=23·4; 95 % CI 12·7, 43·4) and girls (OR=2·2; 95 % CI 1·6, 3·2). Based on important considerations for screening and case detection in the community, modification of the current WHO definition of severe acute malnutrition may not be warranted, especially in the Indian context.</description><identifier>ISSN: 1368-9800</identifier><identifier>EISSN: 1475-2727</identifier><identifier>DOI: 10.1017/S1368980017004165</identifier><identifier>PMID: 29397809</identifier><language>eng</language><publisher>Cambridge, UK: Cambridge University Press</publisher><subject>Age ; Arm - physiology ; Arm circumference ; Body composition ; Body height ; Body Height - physiology ; Body Weight - physiology ; Child, Preschool ; Children ; Children & youth ; Cross-Sectional Studies ; Data collection ; Diagnostic systems ; Edema ; Families & family life ; Female ; Girls ; Health surveys ; Humans ; India - epidemiology ; Infant ; Male ; Malnutrition ; Nutrition ; Nutritional Status and Body Composition ; Reference Values ; Research Papers ; ROC Curve ; Rural areas ; Sensitivity ; Studies ; Weight</subject><ispartof>Public health nutrition, 2018-07, Vol.21 (10), p.1794-1799</ispartof><rights>Copyright © The Authors 2018</rights><rights>The Authors 2018 2018 The Authors</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c472t-174a9dcb2caf91d7d12818d0cb5a0f950d8b146ceb6944d002e52f9d508c9dc3</citedby><cites>FETCH-LOGICAL-c472t-174a9dcb2caf91d7d12818d0cb5a0f950d8b146ceb6944d002e52f9d508c9dc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10260960/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10260960/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27923,27924,53790,53792</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29397809$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kapil, Umesh</creatorcontrib><creatorcontrib>Pandey, RM</creatorcontrib><creatorcontrib>Bansal, Rahul</creatorcontrib><creatorcontrib>Pant, Bhavana</creatorcontrib><creatorcontrib>Varshney, Amit Mohan</creatorcontrib><creatorcontrib>Yadav, Chander Prakash</creatorcontrib><creatorcontrib>Sinha, Shikha</creatorcontrib><creatorcontrib>Sareen, Neha</creatorcontrib><creatorcontrib>Sachdev, Harshpal Singh</creatorcontrib><title>Mid-upper arm circumference in detection of weight-for-height Z-score below −3 in children aged 6–59 months</title><title>Public health nutrition</title><addtitle>Public Health Nutr</addtitle><description>To evaluate the predictive ability of mid-upper arm circumference (MUAC) for detecting severe wasting (weight-for-height Z-score (WHZ) <-3) among children aged 6-59 months. Cross-sectional survey. Rural Uttar Pradesh, India. Children (n 18 456) for whom both WHZ (n 18 463) and MUAC were available. The diagnostic test accuracy of MUAC for severe wasting was excellent (area under receiver-operating characteristic curve = 0·933). Across the lower range of MUAC cut-offs (110-120 mm), specificity was excellent (99·1-99·9 %) but sensitivity was poor (13·4-37·2 %); with higher cut-offs (140-150 mm), sensitivity increased substantially (94·9-98·8 %) but at the expense of specificity (37·6-71·9 %). The optimal MUAC cut-off to detect severe wasting was 135 mm. Although the prevalence of severe wasting was constant at 2·2 %, the burden of severe acute malnutrition, defined as either severe wasting or low MUAC, increased from 2·46 to 17·26 % with cut-offs of <115 and <135 mm, respectively. An MUAC cut-off <115 mm preferentially selected children aged ≤12 months (OR=11·8; 95 % CI 8·4, 16·6) or ≤24 months (OR=23·4; 95 % CI 12·7, 43·4) and girls (OR=2·2; 95 % CI 1·6, 3·2). Based on important considerations for screening and case detection in the community, modification of the current WHO definition of severe acute malnutrition may not be warranted, especially in the Indian context.</description><subject>Age</subject><subject>Arm - physiology</subject><subject>Arm circumference</subject><subject>Body composition</subject><subject>Body height</subject><subject>Body Height - physiology</subject><subject>Body Weight - physiology</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Children & youth</subject><subject>Cross-Sectional Studies</subject><subject>Data collection</subject><subject>Diagnostic systems</subject><subject>Edema</subject><subject>Families & family life</subject><subject>Female</subject><subject>Girls</subject><subject>Health surveys</subject><subject>Humans</subject><subject>India - epidemiology</subject><subject>Infant</subject><subject>Male</subject><subject>Malnutrition</subject><subject>Nutrition</subject><subject>Nutritional Status and Body Composition</subject><subject>Reference Values</subject><subject>Research Papers</subject><subject>ROC Curve</subject><subject>Rural areas</subject><subject>Sensitivity</subject><subject>Studies</subject><subject>Weight</subject><issn>1368-9800</issn><issn>1475-2727</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNp1kc1u1TAQhSMEoqXwAGyQJTZsDGPHjuMVQhV_UhELumJjOfbkxlUSX-yEil2XXcMb9knwpZfyJ1Y-0pzzeUanqh4yeMqAqWcfWN20uoWiAQRr5K3qkAklKVdc3S66jOluflDdy_kMAKRS6m51wHWtVQv6sIrvgqfrdouJ2DQRF5Jbpx4Tzg5JmInHBd0S4kxiT84xbIaF9jHR4YckH2l2MSHpcIzn5Orya70LuSGMviCI3aAnzdXFN6nJFOdlyPerO70dMz7Yv0fV6auXp8dv6Mn712-PX5xQJxRfKFPCau867myvmVee8Za1HlwnLfRagm87JhqHXaOF8AAcJe-1l9C6kquPqufX2O3aTegdzkuyo9mmMNn0xUQbzJ-TOQxmEz8bBrwB3UAhPNkTUvy0Yl7MFLLDcbQzxjUbprWopS5rFevjv6xncU1zOc9wJlqhawWyuNi1y6WYc8L-ZhsGZlen-afOknn0-xk3iZ_9FUO9h9qpS8Fv8Nff_8d-B6HirCY</recordid><startdate>20180701</startdate><enddate>20180701</enddate><creator>Kapil, Umesh</creator><creator>Pandey, RM</creator><creator>Bansal, Rahul</creator><creator>Pant, Bhavana</creator><creator>Varshney, Amit Mohan</creator><creator>Yadav, Chander Prakash</creator><creator>Sinha, Shikha</creator><creator>Sareen, Neha</creator><creator>Sachdev, Harshpal Singh</creator><general>Cambridge University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7RQ</scope><scope>7RV</scope><scope>7T2</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ATCPS</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20180701</creationdate><title>Mid-upper arm circumference in detection of weight-for-height Z-score below −3 in children aged 6–59 months</title><author>Kapil, Umesh ; Pandey, RM ; Bansal, Rahul ; Pant, Bhavana ; Varshney, Amit Mohan ; Yadav, Chander Prakash ; Sinha, Shikha ; Sareen, Neha ; Sachdev, Harshpal Singh</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c472t-174a9dcb2caf91d7d12818d0cb5a0f950d8b146ceb6944d002e52f9d508c9dc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Age</topic><topic>Arm - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Public health nutrition</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kapil, Umesh</au><au>Pandey, RM</au><au>Bansal, Rahul</au><au>Pant, Bhavana</au><au>Varshney, Amit Mohan</au><au>Yadav, Chander Prakash</au><au>Sinha, Shikha</au><au>Sareen, Neha</au><au>Sachdev, Harshpal Singh</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Mid-upper arm circumference in detection of weight-for-height Z-score below −3 in children aged 6–59 months</atitle><jtitle>Public health nutrition</jtitle><addtitle>Public Health Nutr</addtitle><date>2018-07-01</date><risdate>2018</risdate><volume>21</volume><issue>10</issue><spage>1794</spage><epage>1799</epage><pages>1794-1799</pages><issn>1368-9800</issn><eissn>1475-2727</eissn><abstract>To evaluate the predictive ability of mid-upper arm circumference (MUAC) for detecting severe wasting (weight-for-height Z-score (WHZ) <-3) among children aged 6-59 months. Cross-sectional survey. Rural Uttar Pradesh, India. Children (n 18 456) for whom both WHZ (n 18 463) and MUAC were available. The diagnostic test accuracy of MUAC for severe wasting was excellent (area under receiver-operating characteristic curve = 0·933). Across the lower range of MUAC cut-offs (110-120 mm), specificity was excellent (99·1-99·9 %) but sensitivity was poor (13·4-37·2 %); with higher cut-offs (140-150 mm), sensitivity increased substantially (94·9-98·8 %) but at the expense of specificity (37·6-71·9 %). The optimal MUAC cut-off to detect severe wasting was 135 mm. Although the prevalence of severe wasting was constant at 2·2 %, the burden of severe acute malnutrition, defined as either severe wasting or low MUAC, increased from 2·46 to 17·26 % with cut-offs of <115 and <135 mm, respectively. An MUAC cut-off <115 mm preferentially selected children aged ≤12 months (OR=11·8; 95 % CI 8·4, 16·6) or ≤24 months (OR=23·4; 95 % CI 12·7, 43·4) and girls (OR=2·2; 95 % CI 1·6, 3·2). Based on important considerations for screening and case detection in the community, modification of the current WHO definition of severe acute malnutrition may not be warranted, especially in the Indian context.</abstract><cop>Cambridge, UK</cop><pub>Cambridge University Press</pub><pmid>29397809</pmid><doi>10.1017/S1368980017004165</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record>
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subjects	Age Arm - physiology Arm circumference Body composition Body height Body Height - physiology Body Weight - physiology Child, Preschool Children Children & youth Cross-Sectional Studies Data collection Diagnostic systems Edema Families & family life Female Girls Health surveys Humans India - epidemiology Infant Male Malnutrition Nutrition Nutritional Status and Body Composition Reference Values Research Papers ROC Curve Rural areas Sensitivity Studies Weight
title	Mid-upper arm circumference in detection of weight-for-height Z-score below −3 in children aged 6–59 months
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