Use of mid-upper arm circumference to screen for thinness among sub-Saharan African male detainees

2021 ◽  
pp. 1-24
Author(s):  
David CE Philpott ◽  
Valérie Belchior-Bellino ◽  
Mija Ververs
Keyword(s):  
Characteristic Curve ◽  
International Committee ◽  
Red Cross ◽  
African Countries ◽  
Upper Arm ◽  
Arm Circumference ◽  
Group A ◽  
Sub Saharan ◽  
Sensitivity Specificity ◽  
Mid Upper Arm Circumference

Abstract Objective: Body mass index (BMI) is a time-intensive measurement to assess nutritional status. Mid-upper arm circumference (MUAC) has been studied as a proxy for BMI in adults, but there is no consensus on its optimal use. Design: We calculated sensitivity, specificity, and area under receiver operating characteristic curve (AUROCC) of MUAC for BMI <18.5, <17, and <16 kg/m2. We designed a system using two MUAC cutoffs, with a healthy (non-thin) “green” group, a “yellow” group requiring BMI measurement, and a “red” group who could proceed directly to treatment for thinness. Setting: We retrospectively analyzed monitoring data collected by the International Committee of the Red Cross in places of detention. Participants: 11,917 male detainees in eight African countries. Results: MUAC had excellent discriminatory ability with AUROCC: 0.87, 0.90, and 0.92 for BMI<18.5, BMI<17, and BMI<16 kg/m2, respectively. An upper cutoff of MUAC 25.5 cm to exclude healthy detainees would result in 64% fewer detainees requiring BMI screening and had sensitivity 77% (95%CI 69.4,84.7) and specificity 79.6 (95%CI: 72.6,86.5) for BMI<18.5 kg/m2. A lower cutoff of MUAC<21.0 cm had sensitivity 25.4% (95%CI: 11.7,39.1) and specificity 99.0% (97.9,100.0) for BMI<16 kg/m2. An additional 50kg weight requirement improved specificity to 99.6% (95%CI: 99.0,100.0%) with similar sensitivity. Conclusions: A MUAC cutoff of 25.5 cm, above which detainees are classified as healthy and below receive further screening would result in significant time savings. A cutoff of <21.0 cm and weight <50 kg can identify some detainees with BMI <16 kg/m2 who require immediate treatment.

scholarly journals A diagnostic test for malnutrition in adults: mid-upper arm circumference towards body mass index: A literature review

2021 ◽  
Vol 4 (2) ◽  
pp. 94-99
Author(s):  
Fathiyyatul Khaira ◽  
Fiastuti Witjaksono ◽  
Diyah Eka Andayani
Keyword(s):  
Body Mass Index ◽  
Literature Review ◽  
Diagnostic Test ◽  
Body Mass ◽  
Roc Curve ◽  
Upper Arm ◽  
Arm Circumference ◽  
Alternative Measurement ◽  
Sensitivity Specificity ◽  
Mid Upper Arm Circumference

Body mass index is commonly used for detecting malnutrition. At certain conditions, body mass index cannot be measured, so mid-upper arm circumference can be an alternative measurement for detecting malnutrition. Several studies have proposed the cut-off point of mid-upper arm circumference in adults along with its sensitivity, specificity, and area under the ROC curve (AUC). This article aims to describe the diagnostic test for malnutrition using the upper arm circumference in adults and summarize the results of the related studies.

scholarly journals The validity of mid-upper arm circumference as an indicator of low BMI in population screening for undernutrition: a study among adult slum dwellers in eastern India

2018 ◽  
Vol 21 (14) ◽  
pp. 2575-2583 ◽  
Author(s):  
Priyanka Das ◽  
Argina Khatun ◽  
Kaushik Bose ◽  
Raja Chakraborty
Keyword(s):  
Characteristic Curve ◽  
Linear Regression Analysis ◽  
Urban Slum ◽  
Multiple Linear Regression Analysis ◽  
Upper Arm ◽  
Cross Sectional ◽  
Slum Dwellers ◽  
Arm Circumference ◽  
Low Bmi ◽  
Mid Upper Arm Circumference

AbstractObjectiveTo explore the possibility for a statistically appropriate value of mid-upper arm circumference (MUAC) to identify the state of severe undernutrition, based on very low BMI, among adult Indian slum dwellers.DesignCross-sectional study on adults. Height and MUAC were recorded and BMI was computed. Chronic energy deficiency (CED) was determined using the WHO international guidelines as BMI<18·5 kg/m2and normal as BMI≥18·5 kg/m2. Besides calculating mean,sdand 25th, 50th and 75th percentile values, multiple linear regression analysis was undertaken to assess the associations between age, MUAC and BMI. Receiver-operating characteristic curve analysis was performed to determine the best MUAC cut-off to identify CED status. Theχ2test was used to assess significance of the difference in CED prevalence across MUAC categories.SettingAn urban slum in Midnapore town, West Bengal State, India.SubjectsMale (n467) and female (n488) Indian slum dwellers.ResultsMUAC of 22·7 and 21·9 cm, respectively, in males and females were the best cut-off points to differentiate CED from non-CED.ConclusionsResults supported the validity of the WHO-recommended MUAC cut-offs for adults. There is still a need to establish statistically appropriate MUAC cut-offs to predict undernutrition and morbidity.

Utility of Arm Circumference as a Screening Instrument to Identify Women at Nutritional Risk

1994 ◽  
Vol 24 (4) ◽  
pp. 164-166 ◽  
Author(s):  
V C Rodrigues ◽  
R S Phaneendra Rao ◽  
A Lena
Keyword(s):  
Pregnant Women ◽  
Screening Test ◽  
Anthropometric Measurements ◽  
Nutritional Risk ◽  
Upper Arm ◽  
Predictive Values ◽  
Arm Circumference ◽  
Sensitivity Specificity ◽  
Mid Upper Arm Circumference ◽  
Study Setting

Anthropometric measurements of 567 healthy non-pregnant women aged 20–40 years were studied to assess the utility of mid-upper-arm-circumference as a screening test to detect malnutrition. The prevalence of malnutrition in the study sample was 38.4%. A cut-off point of 24 cm was found to be most appropriate in the study setting as at that level the sensitivity, specificity and positive predictive values were 71.1%, 69.6% and 59.4%, respectively.

scholarly journals Determining a global mid-upper arm circumference cut-off to assess underweight in adults (men and non-pregnant women)

2020 ◽  
Vol 23 (17) ◽  
pp. 3104-3113 ◽  
Author(s):  
Alice M Tang ◽  
Mei Chung ◽  
Kimberly R Dong ◽  
Paluku Bahwere ◽  
Kaushik Bose ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Operating Characteristic ◽  
Meta Analysis ◽  
Characteristic Curve ◽  
Total Sample ◽  
Upper Arm ◽  
Arm Circumference ◽  
Individual Participant ◽  
Low Bmi ◽  
Mid Upper Arm Circumference

AbstractObjective:To determine if a global mid-upper arm circumference (MUAC) cut-off can be established to classify underweight in adults (men and non-pregnant women).Design:We conducted an individual participant data meta-analysis (IPDMA) to explore the sensitivity (SENS) and specificity (SPEC) of various MUAC cut-offs for identifying underweight among adults (defined as BMI < 18·5 kg/m2). Measures of diagnostic accuracy were determined every 0·5 cm across MUAC values from 19·0 to 26·5 cm. A bivariate random effects model was used to jointly estimate SENS and SPEC while accounting for heterogeneity between studies. Various subgroup analyses were performed.Setting:Twenty datasets from Africa, South Asia, Southeast Asia, North America and South America were included.Participants:All eligible participants from the original datasets were included.Results:The total sample size was 13 835. Mean age was 32·6 years and 65 % of participants were female. Mean MUAC was 25·7 cm, and 28 % of all participants had low BMI (<18·5 kg/m2). The area under the receiver operating characteristic curve for the pooled dataset was 0·91 (range across studies 0·61–0·98). Results showed that MUAC cut-offs in the range of ≤23·5 to ≤25·0 cm could serve as an appropriate screening indicator for underweight.Conclusions:MUAC is highly discriminatory in its ability to distinguish adults with BMI above and below 18·5 kg/m2. This IPDMA is the first step towards determining a global MUAC cut-off for adults. Validation studies are needed to determine whether the proposed MUAC cut-off of 24 cm is associated with poor functional outcomes.

Evaluation of Calf Circumference, Mid-upper-arm Circumference and Ishii Test for the Assessment of Sarcopenia with Schizophrenia in a Mental Health Center

2021 ◽  
Author(s):  
Ming Chen ◽  
Xiuping Lei ◽  
Tian Zhu ◽  
Qiuxia Li ◽  
Xiaoyan Chen
Keyword(s):  
Mental Health ◽  
Screening Tools ◽  
Calf Circumference ◽  
Upper Arm ◽  
Predictive Values ◽  
Arm Circumference ◽  
Schizophrenic Patients ◽  
Males And Females ◽  
Sensitivity Specificity ◽  
Mid Upper Arm Circumference

Abstract ObjectiveOur objective was to understand the prevalence of sarcopenia in schizophrenic patients and to evaluate if calf circumference (CC), mid-upper-arm circumference (MUAC) and Ishii tests can be used to accurately screen for sarcopenia in schizophrenic patients.MethodWe enrolled schizophrenic patients aged 50 or older, who were regularly taking antipsychotic medications, at two mental health centres. Bioimpedance-based muscle-mass was analysed with an InBody 770 instrument, while muscle strength was measured with a digital grip-strength dynamometer. The physical performance of the patients was gauged from their gait speed over 6 m. Standard AWGS2019 diagnostic criteria were used, and the accuracies of the three screening methods were indicated by the sensitivity, specificity, receiver operating characteristic curve, positive predictive values and negative predictive values.ResultsA total of 339 stable schizophrenic patients were enrolled. The overall prevalence of sarcopenia was 53.1%, and the prevalence was, respectively, 55.6% and 47.66% for males and females. The prevalence of sarcopenia obesity in the total population was 16.22%, and that of males and females was 18.97% and 10.28%, respectively.The CC, MUAC and Ishii test sensitivity/specificity in screening for sarcopenia were 78.3%/67%, 76.74%/68.93%, 89.92%/67%, respectively, in males and 92.16 %/69.64%, 74.51%/78.57%, 96.08%/55.36%, respectively, in females. In males, the AUCs of the CC, MUAC and Ishii test were 0.8 (95%CI, 0.744-0.856), 0.78 (95%CI, 0.721-0.84) and 0.88 (95%CI, 0.837-0.922), respectively, and in females, they were 0.893 (95%CI, 0.833-0.953), 0.843 (95%CI, 0.772-0.915) and 0.855 (95%CI, 0.784-0.926), respectively.ConclusionThe incidence of sarcopenia in schizophrenia patients is high. Clinical doctors should screen for sarcopenia in patients with schizophrenia and provide timely interventions to reduce the occurrence of adverse events. The CC, MUAC and Ishii tests are simple and easy-to-use screening tools for sarcopenia in both males and females with schizophrenia.

scholarly journals Mid-upper arm circumference in detection of weight-for-height Z-score below −3 in children aged 6–59 months

2018 ◽  
Vol 21 (10) ◽  
pp. 1794-1799 ◽  
Author(s):  
Umesh Kapil ◽  
RM Pandey ◽  
Rahul Bansal ◽  
Bhavana Pant ◽  
Amit Mohan Varshney ◽  
...  
Keyword(s):  
Severe Acute Malnutrition ◽  
Characteristic Curve ◽  
Predictive Ability ◽  
Acute Malnutrition ◽  
Test Accuracy ◽  
Cross Sectional Survey ◽  
Upper Arm ◽  
Cross Sectional ◽  
Arm Circumference ◽  
Mid Upper Arm Circumference

AbstractObjectiveTo evaluate the predictive ability of mid-upper arm circumference (MUAC) for detecting severe wasting (weight-for-height Z-score (WHZ) <−3) among children aged 6–59 months.DesignCross-sectional survey.SettingRural Uttar Pradesh, India.SubjectsChildren (n 18 456) for whom both WHZ (n 18 463) and MUAC were available.ResultsThe 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 <115 and <135 mm, respectively. An MUAC cut-off <115 mm preferentially selected children aged ≤12 months (OR=11·8; 95 % CI 8·4, 16·6) or ≤24 months (OR=23·4; 95 % CI 12·7, 43·4) and girls (OR=2·2; 95 % CI 1·6, 3·2).ConclusionsBased 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.

Mid upper arm circumference as an alternative measure to assess the nutritional status of adolescents: a study in India based on NFHS-4 data

2021 ◽  
pp. 1-12
Author(s):  
Aparna Roy ◽  
T. V. Sekher
Keyword(s):  
Nutritional Status ◽  
Sensitivity And Specificity ◽  
Measurement Data ◽  
Anthropometric Measurement ◽  
Alternative Measure ◽  
Upper Arm ◽  
Male Adolescents ◽  
Arm Circumference ◽  
Mid Upper Arm Circumference ◽  
The Relationship

Abstract Use of body mass index (BMI) to assess the nutritional status of adolescents requires many resources, especially for country-level assessment. This study aimed to determine the relationship between BMI and mid upper arm circumference (MUAC) among adolescent males and females in India and to examine whether MUAC effectively represents the nutritional status of adolescents. The study utilized anthropometric measurement data collected by India’s National Family Health Survey-4 (2015–16). The weighted sample for analysis included 91,315 female and 14,893 male adolescents. The BMI and MUAC measurements showed a positive correlation in both female and male adolescents. Using BMI-for-age Z-score classifications, 12.7% of the adolescents were undernourished. Using MUAC (in cm) as per NACS (Nutrition Assessment, Counselling, and Support) guidelines and Mramba et al. (2017) classified 22.9% and 3.7% of the adolescents as undernourished respectively. Finally, using the MUAC-for-age Z-score classification, 98.4% of adolescents were determined to be normal and 1.7% undernourished. Sensitivity and specificity tests of the MUAC cut-offs, in comparison with BMI cut-offs, showed that all three MUAC cut-off classifications had high specificity (NACS cut-off: 81.3%; Mramba et al. cut-off (cm): 97.7%; Mramba et al. cut-off (Z-score): 99.1%). The NACS cut-off had moderately high sensitivity (52.2%) but the Mramba et al. cut-offs had low sensitivity (13.3% for the centimetre cut-off and 6.6% for the Z-score cut-off). Sensitivity and specificity tests proved the relationship between BMI and MUAC, and that MUAC represents adolescent nutritional status with considerable efficiency. With further research, it may be established that MUAC is a better and promising measure of adolescent nutrition, having the advantage of needing fewer resources for data collection. The MUAC has the potential to offer a simple and low-resource alternative to BMI to assess nutritional status among adolescents in poor countries.

scholarly journals 61 Maternal mid-upper arm circumference is associated with small for gestational age in a Zambian cohort

2021 ◽  
Vol 224 (2) ◽  
pp. S43
Author(s):  
Ashley A. Appiagyei ◽  
Bellington Vwalika ◽  
Anne West Honart ◽  
Andrew Kumwenda ◽  
Chileshe Mabula ◽  
...  
Keyword(s):  
Gestational Age ◽  
Small For Gestational Age ◽  
Upper Arm ◽  
Arm Circumference ◽  
Mid Upper Arm Circumference

Description of Pregnant Women's Nutritional Status Based on The Mid-Upper Arm Circumference in Sundari Medan General Hospital In 2019

2019 ◽  
Vol 3 (3) ◽  
Author(s):  
David Franli ◽  
Makmur Sitepu ◽  
Hotma Partogi Pasaribu ◽  
Sake Juli Martina
Keyword(s):  
Nutritional Status ◽  
Pregnant Women ◽  
General Hospital ◽  
Upper Arm ◽  
Cross Sectional ◽  
Arm Circumference ◽  
Energy Stores ◽  
Cross Sectional Design ◽  
Mid Upper Arm Circumference ◽  
Observational Descriptive Study

Introduction. Chronic energy deficieny (CED) is a condition of a body characterized by low body weight and low energy stores, possibly limited physical capacity due to deprivation of food over a long period time. Ministry of Health ( Kemenkes) showed that in 2015, 305 out of 100.000 death of pregnant women is realated to malnutriotion and CED. Objective. The aim of this study is to determine the overview of pregnant women nutritional status based on mid-upper arm circumference (MUAC) in Sundari Medan General Hospital. Method. The study was an observational descriptive study with a cross sectional design. The samples of this study consists of pregnant women from Sundari Medan Genaral Hospital, who had fulilled the inclusion and esclusion criteria by total sampling. Results.. Among 60 samples, the prevalance of Non-CED woman (85%) was found higher than the mild malnutrition (15%). Conclusion. Prevalance of CED pregnant women was found higher in risky age, middle educated and high income family.  

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