Experiences of community caregivers in the assessment of malnutrition using mid-upper arm circumference measurement in children under 5 years old

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

10.26226/morressier.619bdac3be545488cfae50e9 ◽

2021 ◽

Author(s):

Shawn McLaren

Keyword(s):

South African ◽

Upper Arm ◽

Double Burden ◽

African Children ◽

Arm Circumference ◽

Mid Upper Arm Circumference ◽

South African Children

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Mid-upper arm circumference (MUAC) performance versus weight for height in South African children (0–59 months) with acute malnutrition

South African Journal of Clinical Nutrition ◽

10.1080/16070658.2016.1255483 ◽

2017 ◽

Vol 30 (2) ◽

pp. 49-54 ◽

Cited By ~ 3

Author(s):

Natisha Dukhi ◽

Benn Sartorius ◽

Myra Taylor

Keyword(s):

South African ◽

Acute Malnutrition ◽

Upper Arm ◽

African Children ◽

Arm Circumference ◽

Mid Upper Arm Circumference ◽

South African Children

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Mid-upper arm circumference v. weight-for-height Z-score for predicting mortality in hospitalized children under 5 years of age

Public Health Nutrition ◽

10.1017/s1368980016000719 ◽

2016 ◽

Vol 19 (14) ◽

pp. 2513-2520 ◽

Cited By ~ 17

Author(s):

Sakshi Sachdeva ◽

Pooja Dewan ◽

Dheeraj Shah ◽

Rajeev Kumar Malhotra ◽

Piyush Gupta

Keyword(s):

Test Accuracy ◽

Hospitalized Children ◽

Index Test ◽

Care Hospital ◽

Inpatient Mortality ◽

Upper Arm ◽

Risk Of Death ◽

Arm Circumference ◽

Mid Upper Arm Circumference ◽

Children Under 5

AbstractObjectiveTo compare the performance of mid-upper arm circumference (MUAC) against weight-for-height Z-score (WHZ) for predicting inpatient deaths in children under 5 years of age.DesignDiagnostic test accuracy study.SettingPaediatric emergency department of a tertiary care hospital catering to semi-urban and rural population in Delhi, India.SubjectsHospitalized children (n 1663) aged 6 months to 5 years, for whom discharge outcome was available, were consecutively recruited over 14 months. MUAC (cm), weight (kg) height (cm), clinical details and the outcome were recorded. MUAC (index test) was compared with WHZ based on the WHO growth standards (reference test) for predicting the outcome.ResultsOne hundred and twenty-four (7 %) children died during hospital stay. Both MUAC < 11·5 cm (adjusted OR (95 % CI): 3·7 (2·43, 5·60), P<0·001) and WHZ<−3 (2·0 (1·37, 2·99), P<0·001) served as independent predictors of inpatient mortality. However, MUAC was a significantly better predictor of mortality compared with WHZ in terms of area under the receiver-operating characteristic curve (MUAC=0·698, WHZ=0·541, P<0·001). MUAC<11·5 cm had the best trade-off of sensitivity and specificity for predicting inpatient mortality. A combination of WHZ<−3 and/or MUAC<11·5 cm did not significantly improve the predictive value over that of MUAC/WHZ, assessed individually.ConclusionMUAC<11·5 cm is a better predictor of mortality in hospitalized under-5 children, as compared with WHZ<−3. It should be measured in all emergency settings to identify the children at higher risk of death.

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Experiences of community care givers on nutritional assessment of children under 5 years in eThekwini District

10.51415/10321/2572 ◽

2017 ◽

Author(s):

◽

Pretty Gabisile Ndlovu

Keyword(s):

Community Care ◽

Nutritional Assessment ◽

Public Health Problem ◽

Well Being ◽

Major Public Health Problem ◽

Upper Arm ◽

Care Givers ◽

Arm Circumference ◽

Mid Upper Arm Circumference ◽

Children Under 5

Introduction Malnutrition continues to be a major public health problem, especially in children under 5 years of age. Nutritional status is one of the indicators of overall well-being and human resources development of a nation. Aim of the study The aim of the study was to explore and describe experiences of Community Care Givers regarding the assessment of malnutrition in children under 5 years of age in eThekwini District Health Sub-district North area six. Methodology A qualitative, exploratory, descriptive study was used to conduct the study. Semi-structured individual face to face interviews were conducted with 13 participants. The study was guided by Pender’s Model of Health Promotion. Results The findings of the study revealed that participants were dissatisfied with mid upper arm circumference training. They reported lack of support and supervision in their performance such that mid upper arm circumference was non-prioritized. They were dissatisfied with remuneration and they worked under unsafe conditions. Conclusion In order to combat malnutrition in children under 5 years in the community, Community Care Givers need to be vigorously educated on the rationale of malnutrition assessment of children under 5 years in the communities so that they can have insight into what they are doing. Community Care Givers have multiple roles and may need to prioritize their work; this is not easy and requires specific guidance and training from skilled health professionals.

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

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2020.12.059 ◽

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

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The prediction of in-hospital mortality by mid-upper arm circumference: a prospective observational study of the association between mid-upper arm circumference and the outcome of acutely ill medical patients admitted to a resource-poor hospital in sub-Saharan Africa

Clinical Medicine ◽

10.7861/clinmedicine.18-2-123 ◽

2018 ◽

Vol 18 (2) ◽

pp. 123-127 ◽

Cited By ~ 4

Author(s):

Martin Otyek Opio ◽

Teopista Namujwiga ◽

Imaculate Nakitende ◽

John Kellett ◽

Mikkel Brabrand

Keyword(s):

Observational Study ◽

Hospital Mortality ◽

Prospective Observational Study ◽

Sub Saharan Africa ◽

Medical Patients ◽

Upper Arm ◽

Arm Circumference ◽

Resource Poor ◽

Sub Saharan ◽

Mid Upper Arm Circumference

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

Sumatera Medical Journal ◽

10.32734/sumej.v3i3.3309 ◽

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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