Design and validation of a double-burden mid-upper arm circumference (MUAC) tape for South African children aged six to 24 months

Background: Malnutrition is a major public health challenge in developing countries. It has been identified as an important cause of child mortality and morbidity and leads to inadequate physical and cognitive development in children. The South African government implemented a strategy for malnutrition assessment in children under 5 years by community caregivers (CCGs), who would then refer children at risk or those having developed malnutrition to primary health care clinics. Irrespective of this strategy, children still present at clinics with severe malnutrition.Aim: The aim of the study was to explore and describe the experiences of community caregivers with the assessment of malnutrition in children under 5 years old.Setting: The study was conducted in North Area six of eThekwini district in the province of KwaZulu-Natal.Methods: A qualitative, exploratory descriptive approach was used to collect data from 13 purposively selected CCGs. Content analysis was used to analyse data.Results: The majority of participants were dissatisfied with the training, as it was conducted in a language in which they were not proficient. They reported a lack of support and supervision in their performance such that mid-upper arm circumference was non-prioritised. They were dissatisfied with work overload not matched by remuneration and they worked under unsafe conditions.Conclusion: Effective training of CCGs needs to be conducted in the language that they understand to combat malnutrition in children under 5 years. CCGs have multiple roles and may need to prioritise their work; this is not easy and requires specific guidance from skilled health professionals.

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Use of Mid-Upper Arm Circumference (MUAC) to Predict Malnutrition among Sri Lankan Schoolchildren

Nutrients ◽

10.3390/nu12010168 ◽

2020 ◽

Vol 12 (1) ◽

pp. 168

Author(s):

Chisa Shinsugi ◽

Deepa Gunasekara ◽

Hidemi Takimoto

Keyword(s):

Birth Weight ◽

Rank Correlation ◽

Overweight And Obesity ◽

Public Health Issue ◽

Sri Lankan ◽

Z Score ◽

Upper Arm ◽

Double Burden ◽

Arm Circumference ◽

Mid Upper Arm Circumference

The double burden of malnutrition (under- and overnutrition) is a serious public health issue in childhood. The mid-upper arm circumference (MUAC) is a simple tool for screening nutritional status, but studies of the optimal cutoff to define malnutrition are limited. This study aimed to explore the prediction of malnutrition by MUAC in Sri Lankan schoolchildren. The participants were 538 students (202 boys, 336 girls) aged 5–10 years. Spearman’s rank correlation was calculated for MUAC and both body-mass-index-for-age z-score (BAZ) and height-for-age z-score (HAZ). Receiver operating characteristic (ROC) analysis was conducted to assess the ability of MUAC to correctly classify malnutrition, after stratifying for age and birth weight. MUAC correlated significantly with BAZ (r = 0.84) and HAZ (r = 0.35). The areas under the ROC curve for thinness, overweight, obesity, and stunting were 0.88, 0.97, 0.97, and 0.77, respectively. The optimal MUAC cutoff values for predicting thinness and stunting were 167.5 mm and 162.5 mm, respectively; the optimal cutoffs for predicting overweight and obesity were 190.5 mm and 218.0 mm, respectively. These cutoffs differed after stratification by age group and birth weight. Our results confirm MUAC to be a useful tool for monitoring growth in schoolchildren.

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Maternal and early life nutrition and physical activity: setting the research and intervention agenda for addressing the double burden of malnutrition in South African children

Global Health Action ◽

10.1080/16549716.2017.1301085 ◽

2017 ◽

Vol 10 (1) ◽

pp. 1301085 ◽

Cited By ~ 5

Author(s):

A. Prioreschi ◽

S. Wrottesley ◽

C. E. Draper ◽

S. A. Tomaz ◽

C. J. Cook ◽

...

Keyword(s):

Physical Activity ◽

South African ◽

Early Life ◽

Double Burden ◽

African Children ◽

Activity Setting ◽

Double Burden Of Malnutrition ◽

Nutrition And Physical Activity ◽

South African Children

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Exposure to lead and vaccine-specific IgG titers in South African children participating in the Venda Health Examination of Mothers, Babies and their Environment (VHEMBE): A longitudinal study

Environmental Research ◽

10.1016/j.envres.2019.108794 ◽

2020 ◽

Vol 180 ◽

pp. 108794 ◽

Cited By ~ 1

Author(s):

Thomas Z. Di Lenardo ◽

Brian J. Ward ◽

Stéphane Pillet ◽

Koren Mann ◽

Riana Bornman ◽

...

Keyword(s):

Longitudinal Study ◽

South African ◽

Health Examination ◽

African Children ◽

Specific Igg ◽

South African Children

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The impact of the school feeding programme on the education and health outcomes of South African children

Children and Youth Services Review ◽

10.1016/j.childyouth.2021.106029 ◽

2021 ◽

Vol 126 ◽

pp. 106029

Author(s):

Cyprian M. Mostert

Keyword(s):

Health Outcomes ◽

South African ◽

African Children ◽

School Feeding ◽

Education And Health ◽

The Impact ◽

South African Children

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

Journal of Biosocial Science ◽

10.1017/s0021932021000298 ◽

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.

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