Infants are more vulnerable to malnutrition as compared with older children. Prevalence of severe wasting in Indian infants under 6 months of age (U6M) is 14.8% (National Family Health Survey 4, 2015-2016). Weight for length z-score (WLZ) and mid-upper arm circumference (MUAC) are 2 anthropometric parameters for detecting severe acute malnutrition (SAM) in children aged 6 months to 5 years. But in infants U6M, currently no accepted MUAC criteria are present for SAM. Calculating WLZ is practically difficult and cumbersome as compared with measuring MUAC. We tried to find out whether MUAC can be used in detecting SAM in infants aged 1 to 6 months also. The area under ROC curve was computed to evaluate the accuracy of MUAC in detecting SAM (taking WLZ as reference test). Level of accuracy was found out to be “good.” Optimal MUAC cut-off with best diagnostic accuracy was identified as ≤11.5 cm, using the highest Youden index of 0.55.
AgbeilleMFNoudamadjoAKpanidjaG, et al. Severe acute malnutrition among infants under 6 months of age in the teaching hospital of Borgou / Alibori in Northen Benin. J Pediatr Neonatal Care. 2023;13(2):151154. doi:10.15406/jpnc.2023.13.00507.
KeracMBlencoweHGrijalva-EternodC, et al. Prevalence of wasting among under 6-month-old infants in developing countries and implications of new case definitions using WHO growth standards: a secondary data analyses. Arch Dis Child. 2011;96(11):1008-1013.
4.
ChoudharyTSSrivastavaAChowdhuryR, et al. Severe wasting among Indian infants<6 months: findings from the National Family Health Survey 4. Matern Child Nutr. 2019;15:e12866.
5.
National Family Health Survey-5 (NFHS-5) Compendium Of Fact Sheets, Key Indicators, India and 14 states/UTs (Phase-2). Ministry of Health & Family Welfare, Government of India. 2019-2021:5.
6.
TessemaMLaillouATeferaATekluYBergerJWieringaFT.Routinely MUAC screening for severe acute malnutrition should consider the gender and age group bias in the Ethiopian non-emergency context. PLoS ONE. 2020;15(4):e0230502.
7.
KeracMMwangomeMMcGrathMHaiderRBerkleyJA.Management of acute malnutrition in infants aged under 6 months (MAMI): current issues and future directions in policy and research. Food Nutr Bull. 2015;36(1 suppl):S30-S34.
8.
MwangomeMNgariMFeganG, et al. Diagnostic criteria for severe acute malnutrition among infants aged under 6 mo. Am J Clin Nutr. 2017;105(6):1415-1423.
9.
ShekharSShahD.Validation of mid upper arm circumference cut offs to diagnose severe wasting in Indian children. Indian Pediatr. 2012;49(6):496-497.
10.
ChandSShahD.Mid-upper arm circumference for detection of severe acute malnutrition in infants aged between one and six months. Indian Pediatr. 2015;52(6):528-529.
11.
World Health Organization. United Nations International Children’s Emergency Fund. WHO Child Growth Standards and the Identification of severe Acute Malnutrition in Infants and Children. A Joint Statement by the World Health Organization and the United Nations Children’s Fund. Geneva, Switzerland: World Health Organization Press; 2009.
12.
ShapiroDE.The interpretation of diagnostic tests. Stat Methods Med Res. 1999;8(2):113-134.
13.
JimaBRHassenHYGetnetYBahwerePGebreyesusSH.Diagnostic performance of mid upper arm circumference for detecting severe wasting among infants aged1-6 months in Ethiopia. Am J Clin Nutr. 2021;113(1):55-62.
14.
GhimireUAryalBKGuptaAKSapkotaS.Severe acute malnutrition and its associated factors among children under 5 years: a facility-based cross-sectional study. BMC Pediatr. 2020;20(1):249.
15.
RanaRBarthorpHMurphyMTBeriA.Implementing the family-MUAC approach for infants under 6 months in context of COVID-19 in Ethiopia. Field Exchange. 2021;64:64.
16.
ZehraMSaleemAKaziZParkarS.Mid-upper arm circumference assessment and comparison with weight for length Z score in infants≤ 6 months as an indicator of severe acute malnutrition. Cureus. 2021;13(9):e18167.
17.
JyothiSDSpoorthiLArunkumarS.Mid-upper arm circumference cut-off for detection of severe acute malnutrition in infants aged between one and six months. Int J Pediatr Res. 2020;7:430-436.
18.
DasguptaRSinhaDJainSKPrasadV.Screening for SAM in the community: is MUAC a “Simple Tool”?Indian J Pediatr. 2013;50:154-155.
19.
DairoMDFatokunMEKutiM.Reliability of themed upper arm circumference for the assessment of wasting among children aged 12-59 months in urban Ibadan, Nigeria. Int J Biomed Sci. 2012;8(2):140-143.
20.
ur RehmanMBibiSImranIAnwarHAlamTMohammedK. Mid upper arm circumference and weight for height z-score as screening tools for acute malnutrition in underweight children<5 years of age. J Physiol. 2020;16(1):6-9.
