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Mid upper-arm circumference is an effective tool to identify infants and young children with severe acute malnutrition in India

  • Victor M Aguayo (a1), Satinder Aneja (a2), Nina Badgaiyan (a1) and Karanveer Singh (a3)

Abstract

Objective

To assess the appropriateness of current mid upper-arm circumference (MUAC) cut-offs to identify children with severe acute malnutrition in India.

Design

The analysis concerned 6307 children admitted to nutrition rehabilitation centres (2009–2011) where they received therapeutic care as per guidelines by WHO and the Indian Academy of Pediatrics.

Setting

States of Jharkhand, Madhya Pradesh and Uttar Pradesh, India.

Subjects

Children aged 6–59 months with bilateral pitting oedema or weight-for-height Z-score (WHZ)<−3 or MUAC<115 mm at admission.

Results

Children aged 6–23 months represented ~80 % of the admissions. Among them, the proportion with WHZ<−3 was similar to that with MUAC<115 mm (85·7 % v. 81·8 %); the proportion with MUAC<115 mm whose WHZ was <−3 was 82·6 %; and the proportion with WHZ<−3 whose MUAC<115 mm was 78·8 %. MUAC<115 mm was as effective as WHZ<−3 in identifying 6–59-month-old children with medical complications (32·2 % v. 31·6 %, respectively), the most important risk factor of death among oedema-free children. Furthermore, death rates in children with MUAC<115 mm were higher than in children with WHZ<−3 (0·61 % v. 0·58 %, respectively) and 91 % of the deaths among oedema-free children were deaths of children with MUAC<115 mm.

Conclusions

In populations similar to those included in our analysis, MUAC<115 mm appears to be an appropriate criterion to identify children with severe acute malnutrition who are at a greater risk of medical complications and death, particularly among children 6–23 months old.

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Copyright

Corresponding author

* Corresponding author: Email vaguayo@unicef.org

References

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1. Black, RE, Allen, LH, Bhutta, ZA et al. (2008) Maternal and child undernutrition: global and regional exposures and health consequences. Lancet 371, 243260.
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14. World Health Organization (2013) Guideline: Updates on the Management of Severe Acute Malnutrition in Infants and Children. Geneva: WHO.

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Mid upper-arm circumference is an effective tool to identify infants and young children with severe acute malnutrition in India

  • Victor M Aguayo (a1), Satinder Aneja (a2), Nina Badgaiyan (a1) and Karanveer Singh (a3)

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