Journal article
Low mid-upper arm circumference identifies children with a high risk of death who should be the priority target for treatment
- Abstract:
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Background:
Severe acute malnutrition (SAM) is currently defined by the WHO as either a low mid-upper arm circumference (i.e. MUAC <115 mm), a low weight-for-height z-score (i.e. WHZ <- 3), or bilateral pitting oedema. MUAC and WHZ do not always identify the same children as having SAM. This has generated broad debate, as illustrated by the recent article by Grellety & Golden (BMC Nutr. 2016;2:10).
Discussion:
Regional variations in the proportion of children selected by each index seem mostly related to differences in body shape, including stuntedness. However, the practical implications of these variations in relation to nutritional status and also to outcome are not clear. All studies that have examined the relationship between anthropometry and mortality in representative population samples in Africa and in Asia have consistently showed that MUAC is more sensitive at high specificity levels than WHZ for identifying children at high risk of death. Children identified as SAM cases by low MUAC gain both weight and MUAC in response to treatment. The widespread use of MUAC has brought enormous benefits in terms of the coverage and efficiency of programs. As a large high-risk group responding to treatment, children with low MUAC should be regarded as a public health priority independently of their WHZ.
Conclusion:
While a better understanding of the mechanism behind the discrepancy between MUAC and WHZ is desirable, research in this area should not delay the implementation of programs aiming at effectively reducing malnutrition-related deaths by prioritising the detection and treatment of children with low MUAC.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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- Files:
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(Preview, Version of record, 472.0KB, Terms of use)
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- Publisher copy:
- 10.1186/s40795-016-0101-7
Authors
- Publisher:
- BioMed Central
- Journal:
- BMC Nutrition More from this journal
- Volume:
- 2
- Issue:
- 1
- Article number:
- 63
- Publication date:
- 2016-10-21
- Acceptance date:
- 2020-10-07
- DOI:
- EISSN:
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2055-0928
- Language:
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English
- Keywords:
- Pubs id:
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1125839
- Local pid:
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pubs:1125839
- Deposit date:
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2020-09-16
Terms of use
- Copyright holder:
- Briend et al.
- Copyright date:
- 2016
- Rights statement:
- ©2020 The Author(s).
- Notes:
- Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
- Licence:
- CC Attribution (CC BY)
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