Mid-upper arm circumference measurement for severe malnutrition screening in underfives

Background Severe malnutrition in Indonesia remains abundant. Severe malnutrition has been assessed by several methods, including mid–upper arm circumference (MUAC) and weight-for-height z-score (WHZ). As a screening method, MUAC is expected to be useful for identifying malnutrition in communities. Objective To determine whether MUAC measurements can be used for screening severe malnutrition at the community level in Indonesia. Method A cross-sectional study was conducted in 853 children aged 6 – 59 months who came to an integrated health service post (Posyandu) in Semarang, Central Java. Anthropometric measurements were performed by cadres and researchers and included MUAC and WHZ. Statistical analysis was done by McNemar test; results with P values >0.05 indicated no significant difference. Sensitivity and specificity were determined by 2 x 2 tables. The MUAC cut-off values were determined by receiver-operating characteristic (ROC) curve. Results Eight hundred fifty-three out of 1,115 children met the inclusion criteria, consisting of 419 (49.1%) boys, with most over the age of 2 years (57.2%). Kappa test revealed good inter-rater reliability in measurements between the cadre and researchers (Kappa=0.726). There were significant differences between MUAC (by cadres) and below red line status as well as WHZ, between MUAC (by researchers) and WHZ, as well as MUAC (by cadre and researchers) with WHZ and height-for-age z-score/HAZ . Sensitivity, specificity, PPV, and NPV of MUAC (by cadre) were 12.5%, 99.9%, 75%, and 97.5%, respectively, while those by the researchers were 16.7%, 99.6%, 57%, and 97.6%, respectively. In this study, MUAC of 14 cm was the best cut-off for severe malnutrition. Conclusion The MUAC measurement of 14 cm can be used for screening severe malnutrition in underfives at community.

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Assessing Malnutrition in Pregnant Women Using the Dietary Diversity Score and the Mid-Upper Arm Circumference: A Cross-Sectional Study, Zambia

Food and Nutrition Sciences ◽

10.4236/fns.2020.117051 ◽

2020 ◽

Vol 11 (07) ◽

pp. 912-925

Author(s):

Sebean Mayimbo ◽

Clara Maphosa Haruzivishe ◽

Concepta Kwaleyela ◽

Bwembya Phoebe ◽

Ellen Chirwa ◽

...

Keyword(s):

Pregnant Women ◽

Dietary Diversity ◽

Cross Sectional Study ◽

Sectional Study ◽

Upper Arm ◽

Cross Sectional ◽

Dietary Diversity Score ◽

Arm Circumference ◽

Mid Upper Arm Circumference

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Mid-upper arm circumference as a screening tool for identifying adolescents with thinness

Public Health Nutrition ◽

10.1017/s1368980020003869 ◽

2020 ◽

pp. 1-10

Author(s):

Binyam Girma Sisay ◽

Demewoz Haile ◽

Hamid Yimam Hassen ◽

Seifu Hagos Gebreyesus

Keyword(s):

Addis Ababa ◽

High Sensitivity ◽

Cross Sectional Study ◽

Operating Characteristics ◽

Upper Arm ◽

Cross Sectional ◽

Arm Circumference ◽

Receiver Operating Characteristics Curve ◽

Adolescence Period ◽

Mid Upper Arm Circumference

Abstract Objective: To evaluate the performance of mid-upper arm circumference (MUAC) to identify thinness in the late adolescence period (aged 15–19 years) in Ethiopia. Design: We conducted a school-based cross-sectional study. The receiver operating characteristics curve was used to examine the validity of MUAC compared with BMI Z-score to identify adolescents with thinness (BMI Z-score <−2 sd). Settings: Fifteen high schools (grade 9–12) located in Addis Ababa, Ethiopia. Participants: A total of 851 adolescent (456 males and 395 females) were included in the study. Results: The prevalence of thinness and severe thinness among high-school adolescents in Addis Ababa was 9·5 % (95 % CI 7·7, 11·7 %). The overall AUC for MUAC against BMI Z-score <−2 SD was 0·91 (95 % CI 0·88, 0·93). The optimal MUAC cut-offs to identify thinness were 23·3 cm for males and 22·6 cm for females. These cut-off points give high sensitivity and specificity for both males (a sensitivity of 87·9 % and a specificity of 75·9 %) and females (a sensitivity of 100 % and a specificity 88·2 %). Conclusions: MUAC has a comparable level of accuracy with BMI Z-score to identify thinness in adolescents aged 15–19 years. Hence, MUAC could be used as an alternative tool for surveillance and screening of thinness among adolescents aged 15–19 years. The optimum cut-off proposed by this study may incorrectly include a large number of adolescents when used in a relatively well-nourished population. In this situation, it would be necessary to choose a cut-off with greater positive predictive value.

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Mid upper arm circumference in pregnant women and its relationship with birth weight

Panacea Journal of Medical Sciences ◽

10.18231/j.pjms.2021.067 ◽

2021 ◽

Vol 11 (2) ◽

pp. 331-335

Author(s):

Surendra Nath Soren ◽

Partha Sarathi Sahu

Keyword(s):

Birth Weight ◽

Pregnant Women ◽

Linear Regression Analysis ◽

Care Facility ◽

Health Care Facility ◽

Cross Sectional Study ◽

Upper Arm ◽

Cross Sectional ◽

Arm Circumference ◽

Mid Upper Arm Circumference

: Mid upper arm circumference (MUAC) is considered as a good indicator of maternal nutritional status in pregnant women. Very few studies have been done to establish a relationship between MUAC and birth weight of newborn. This study was carried out to analyze the relationship between MUAC and birth weight of newborn in a tertiary health care facility.This cross sectional study was conducted in 240term pregnant women. MUAC was measured to the nearest millimeters using a non-stretchable tape at the midpoint between acromian process and olecranon process. Newborn baby weight was measured within 24 hrs of birth. The association between MUAC and birth weight was established by linear regression analysis.The mean of MUAC among pregnant women delivering LBW was 21.68±2.27 cm which was significantly low (p<0.001) compared to women delivering normal babies (23.47±2.56 cm). There wasa positive correlation(r=0.32;p<0.05)between MUAC and birth weight of newborn.The cut off value of MUAC for the prediction of LBW in our study was found to be 22.59 cm with 62.77% sensitivity and 71.55% specificity.Among the various maternal factors for the prediction of LBW, mid-upper arm circumference (MUAC) can be correlated with birth weight outcome effectively.

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Diagnostic Concordance between Random Upper Arm Circumference and Mid Upper Arm Circumference Measurements among Children Aged 6–59 Months in South Ethiopia: A Community-Based Cross-Sectional Study

Journal of Nutrition and Metabolism ◽

10.1155/2021/6654817 ◽

2021 ◽

Vol 2021 ◽

pp. 1-10

Author(s):

Juhar Admama Bamud ◽

Afework Mulugeta Bezabih ◽

Fentaw Wassie Feleke ◽

Getahun Fentaw Mulaw

Keyword(s):

Sensitivity And Specificity ◽

Cross Sectional Study ◽

Receiver Operating Curve ◽

Sectional Study ◽

Upper Arm ◽

Cross Sectional ◽

Arm Circumference ◽

Diagnostic Concordance ◽

Mid Upper Arm Circumference ◽

Kappa Agreement

Random upper arm circumference (RUAC) is frequently used for malnutrition screening among children aged 6–59 months. However, inadequate evidence exists regarding its agreement with mid upper arm circumference (MUAC). This study examined diagnostic concordance between RUAC and standard MUAC measurements and tested RUAC’s ability for screening malnutrition among children aged 6–59 months. A cross-sectional study was conducted from April 30 to May 30/2015 in Ethiopia. Data were taken from a sample of 819 children aged 6–59 months with a simple random sampling technique. The data were analyzed using SPSS version 22 software. The kappa agreement level, sensitivity, and specificity were calculated. The receiver operating curve was prepared to determine the optimal cutoff RUAC for the sensitivity and specificity. With National Center for Health Statistics (NCHS) cutoff (12 cm), the performance of RUAC measurements in terms of sensitivity was low (44%). The kappa agreement level between the two measurements was 0.551 ( p value < 0.001). With the new WHO cutoff (12.5 cm), however, RUAC was improved in validity (sensitivity 81%), specificity 96.9%, and kappa agreement level (K = 0.807; p < 0.001 ).

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Derivation of MUAC cut-off to identify undernourished 1-6 months old infants

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20184283 ◽

2018 ◽

Vol 5 (6) ◽

pp. 2217 ◽

Cited By ~ 1

Author(s):

Ramamani D. ◽

Suganya E.

Keyword(s):

Nutritional Status ◽

Public Health Problem ◽

Cross Sectional Study ◽

Youden Index ◽

Major Public Health Problem ◽

Upper Arm ◽

Cross Sectional ◽

Under Nutrition ◽

Arm Circumference ◽

Mid Upper Arm Circumference

Background: Under nutrition is the major public health problem in our country. There are numerous anthropometric methods, one of which is mid upper arm circumference (MUAC). MUAC cut-off classify the nutritional status of the children aged between 6-60 months. However, there is no specific cut-off for MUAC to identify the undernourished infants aged between 1-6 months. With the above background study was planned with the following objectives. Objectives of this study were to classify the nutritional status of 1-6 months aged infants using WLZ classification and to derive a cut off value for Mid upper arm circumference, to define under nutrition/wasting among 1-6 months aged infantsMethods: The cross-sectional study was carried out among 706 infants aged between 1-6 months. Nutritional status was assessed using WLZ. Various MUAC was tested against WLZ of <-2, in order to identify the cut-off below which, the infant will be considered undernourished.Results: Mean age of the participants was 96±55 days. Mean weight, length and mid upper arm circumference was 4.75±1.02 kg, 58.51±4.47 cm and 12.15±3.01cm respectively. MUAC cut-off <13.5 cm has yielded highest youden index, accuracy and sensitivity of 0.36, 0.79,99% respectively. The total area under ROC curve is 0.707 [95% CI: 0.66, 0.74; p<0.0001], having a good diagnostic accuracy and it is statistically significant.Conclusions: A MUAC cut-off value below 13.5 cm, among 1-6 months aged infants will be considered to be undernourished.

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Anthropometric surrogates to identify low birth weight babies: hospital based cross-sectional study

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20193732 ◽

2019 ◽

Vol 6 (5) ◽

pp. 2098

Author(s):

Jyothi S. D. ◽

Raghavendra Doddamani

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Cross Sectional Study ◽

Anthropometric Measurements ◽

Upper Arm ◽

Thigh Circumference ◽

Cross Sectional ◽

Arm Circumference ◽

Low Birth Weight Babies ◽

Mid Upper Arm Circumference

Background: Birth weight acts as a crucial sensitive and reliable tool to prevent infant and child morbidity and mortality. There has been a considerable interest in recent years for using simple anthropometric measures as an alternative to birth weight. Objective of the study is to determine the cut off values of the anthropometric measurements and to assess the accuracy of the anthropometric surrogates to identify low birth weight babiesMethods: This is a cross sectional study conducted for a period of one year from 1st Dec 2011 to 31st Nov 2012 at Christian fellowship hospital, Oddanchatram, Dindigal, Tamilnadu. Study population included all the live newborns of term gestation at the hospital. A total of 500 newborns were included in the study during the period. Birth weight of the newborn was measured using spring scale to the nearest 25 grams. Head circumference, Chest circumference, Mid Upper Arm Circumference, Foot Length, Thigh circumference, Calf circumference, Crown-hell length were measured using proper guidelines to the nearest 0.1 cm.Results: In the present study, low birth weight was present in 262 (52.4%) of the newborns. Thigh circumference with cut off value of 15 cm had higher sensitivity and specificity of 97.5% and 80.9% respectively. It was followed by Mid upper arm circumference with cut off value of 10 cm, sensitivity of 81.5% and specificity of 93.9%. Thigh circumference and mid upper arm circumference had high area under curve of 0.949 and 0.855 respectively. All the anthropometric measurements were statistically significant at 5% level of significance.Conclusions: Thigh circumference with a cut off of 15 cm, followed by mid upper arm circumference of 10 cm were the better surrogate anthropometric measurements with better sensitivity, specificity to identify low birth weight babies.

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Correlation of Mid Upper Arm Circumference, Mid Upper Arm Area, Tricep Skin Fold Thickness with Hand Grip Strength in Cricket Players: A Cross-Sectional Study

International Physiology ◽

10.21088/ip.2347.1506.5217.5 ◽

2017 ◽

Vol 5 (2) ◽

pp. 69-75

Author(s):

Kumbhar Amruta Nitin ◽

◽

Rukadikar Charushila A. ◽

Rukadikar Atul R ◽

Mundewadi S.A ◽

...

Keyword(s):

Grip Strength ◽

Cross Sectional Study ◽

Sectional Study ◽

Upper Arm ◽

Cross Sectional ◽

Skin Fold Thickness ◽

Hand Grip ◽

Skin Fold ◽

Arm Circumference ◽

Mid Upper Arm Circumference

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Mid-upper arm circumference versus weight for height Z-score for detecting malnutrition in children aged 06-59 months in rural and urban areas of Jabalpur district, Madhya Pradesh, India

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20201983 ◽

2020 ◽

Vol 7 (5) ◽

pp. 1794

Author(s):

Nandini Shukla ◽

Neelam Anupama Toppo ◽

Pradeep Kumar Kasar ◽

Brajesh Sharma

Keyword(s):

Urban Areas ◽

Sampling Technique ◽

Cross Sectional Study ◽

Upper Arm ◽

Cross Sectional ◽

Rural And Urban Areas ◽

Number Of Children ◽

Rural And Urban ◽

Arm Circumference ◽

Mid Upper Arm Circumference

Background: WHO and UNICEF propose two independent criteria for diagnosing malnutrition in children aged 6-60 months, viz. mid upper arm circumference and weight-for-height. However, both these criteria do not identify same set of children as having malnutrition, and using only one of the diagnostic criteria proposed by WHO may potentially leave some high-risk children untreated. Therefore, the purpose of this study was to determine the prevalence of malnutrition by using both mid-upper arm circumference (MUAC) and weight for height (W/H) and their differences among children.Methods: Cross sectional study carried out in rural and urban areas of Jabalpur district among 1237 children of age group 06-59 months in randomly selected eight ward and two blocks of Jabalpur district. Where 720 children were from urban wards and 517 from rural villages. Multistage random sampling technique was used for the selection of study subjects. Pre-designed and pretested questionnaire was used for interview, Salter’s Scale for weighing, non-stretchable Measuring Tape for measuring height and Shakir’s tape for mid upper arm circumference.Results: In rural area, prevalence of malnutrition according to MUAC is 74 (14.3%) while according to w/h is 102 (19.7%). While in urban, prevalence according to MUAC is 104 (14.4%) while according to w/h is 136 (18.9%).Conclusions: The findings are clear that, prevalence of wasting by W/H is more than by MUAC. With the use of the currently recommended WHO cut-off for MUAC, a significant number of children would not have been identified. A higher cut off value, therefore recommended for screening.

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Validating mid-upper arm circumference (MUAC) cut off points as an indicator of nutritional status among nine tribal populations of India

Anthropological Review ◽

10.2478/anre-2021-0018 ◽

2021 ◽

Vol 84 (3) ◽

pp. 301-315

Author(s):

Gautam K. Kshatriya ◽

Raja Chakraborty ◽

Nitish Mondal ◽

Kaushik Bose

Keyword(s):

Cross Sectional Study ◽

Anthropometric Measurement ◽

Sectional Study ◽

Upper Arm ◽

Cross Sectional ◽

Energy Deficiency ◽

Chronic Energy Deficiency ◽

Arm Circumference ◽

Tribal Populations ◽

Mid Upper Arm Circumference

Abstract Mid-upper arm circumference (MUAC) is an alternative anthropometric measurement to assess undernutrition but a universally accepted cut-off is yet to be established. The objectives of the present study are to determine whether the proposed sex-specific global cut-offs are suitable across several tribes in India. This cross-sectional study was conducted among nine tribal populations in India (1046 males, 1087 females). Weight, height and MUAC values were obtained, and body mass index (BMI) was calculated. The BMI cut-off (<18.5 kg/m2) was used to determine chronic energy deficiency (CED). The ROC Curve analyses of binomial logistic regression for MUAC versus CED revealed optimal cut-off point of MUAC as 23.8 cm (in males) and 21.8 cm (in females). MUAC cut-offs were similar in females, relative to males, in all tribes. Males with MUAC<24cm and females with MUAC<22 encompassed significantly higher numbers of CED than those with MUAC≥24 and ≥22 cm, respectively (χ2-value males: 254.9, p<0.001; females: 493.60, p<0.01). A single cut off point of MUAC may not be universally applicable for diverse populations and both sexes as well. It seemed that there is no alternative than to undertake further validation studies in various populations before using the MUAC cut off to identify undernourished or CED condition.

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