Mid-upper arm circumference in detection of weight-for-height Z -score below −3 in children aged 6–59 months
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Objective To evaluate the predictive ability of mid-upper arm circumference (MUAC) for detecting severe wasting (weight-for-height Z -score (WHZ) Design Cross-sectional survey. Setting Rural Uttar Pradesh, India. Subjects Children ( n 18 456) for whom both WHZ ( n 18 463) and MUAC were available. Results 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 Conclusions 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
Anthropometry · Circumference · Malnutrition · Malnutrition in children · Receiver operating characteristic · Severe Acute Malnutrition · Wasting · Wasting Syndrome · Child Nutrition and Water Access · Food Security and Health in Diverse Populations · Medicine · Obesity, Physical Activity, Diet · Internal Medicine · Pediatrics
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