Concordance between estimates of acute malnutrition measured by weight-for-height and by mid-upper arm circumference after age adjustment: population-representative surveys from humanitarian settings

BMC Nutrition
Eva LeidmanOleg Bilukha

Abstract

Mid-upper arm circumference (MUAC) and weight-for-height (WHZ) are commonly used indicators to identify acute malnutrition. However, MUAC and WHZ diagnose different children, and produce prevalence estimates that are meaningfully different. Previous research in Somalia has suggested improved concordance using MUAC-for-age (MUACZ) rather than MUAC. We further evaluate the relationship between MUACZ, MUAC, and WHZ using surveys conducted globally. We analyzed 882 population representative surveys from 41 countries. Children ages 6-59 months were classified as acutely malnourished using three independent criteria: WHZ < - 2 (WHZ2), MUAC< 125 mm (MUAC125), MUACZ < - 2 (MUACZ2). Population prevalence using each of the three criteria are presented by country and region. Correlations of survey prevalence for each indicator pair were assessed. Multivariable regression models of MUACZ and MUAC125 adjusted for WHZ2, stunting prevalence, age, and sex. To evaluate individual level diagnostic concordance, we compared the proportion of children identified by each of the three criteria. Median prevalence of acute malnutrition overall was highest for MUACZ2 (14.0%) followed by WHZ2 (10.6%), and lowest for MUAC125 (7.3%). The absolute differenc...Continue Reading

References

Jul 19, 2012·European Journal of Clinical Nutrition·J RasmussenP Aaby

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Software Mentioned

ggplot2
MUACZ
RStudio
SAS

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