Upper arm length along with mid-upper arm circumference to enhance wasting prevalence estimation and diagnosis: sensitivity and specificity in 6–59-months-old children. Issue 2 (4th June 2021)

• Record Type: Journal Article
• Authors: Barro, Mouhamed; Baro, Mohamed Daouda; Cisse, Djibril; Zagre, Noel; Ba, Thierno; Neff Baro, Shanti; Diagana, Yacouba
• Is Part Of: Family medicine and community health. Volume 9:Issue 2(2021)
• Publication Date: 2021-06-04
• Subjects: malnutrition -- child health -- community medicine -- global health -- nutritional status; Family medicine -- Periodicals; Public health -- Periodicals; Family medicine; Public health; Family Practice; Community Health Services; General Practice; Electronic journals; Periodicals; Periodical; 610.5
• DOI: 10.1136/fmch-2020-000748
• Languages: English
• ISSNs: 2305-6983

Abstract

Abstract : Objective: To evaluate the added value of the use of upper arm length (UAL) along with mid-upper arm circumference (MUAC) to diagnose and estimate the prevalence of wasting in comparison to current WHO standard and other MUAC-based methods. Design: UAL and usual anthropometric measurements were collected during a national cross-sectional nutritional survey. Children were classified into three upper arm length groups (UALGs): UALG1, UALG2 and UALG3 according to the following UAL limits: ≤150, 151–180 and ≥181 mm, respectively. Receiver operating characteristic curves were used to determine the best MUAC cut-off for each group using weight-for-height Z-score (WHZ) as a reference standard. Wasting prevalence, sensitivity and specificity of all diagnostic methods were compared. Setting: This study was conducted in Mauritania. Participants: National representative sample of children from 6 to 59 months old. Results: In total, 12 590 children were included in the study. Wasting prevalence was 16.1%, 5.0% and 12.5% when diagnosed by WHZ <−2, MUAC <125 mm and MUAC–UALG methods, respectively. Using the MUAC–UALG method increased the sensitivity for wasting diagnosis from 17.98% with MUAC <125 mm to 39.43% with MUAC–UALG. The specificity decreased from 97.49% with MUAC <125 mm to 92.71% with MUAC–UALG. With MUAC–height Z score and MUAC <138 mm, sensitivity was 26.04% and 69.76% and specificity were 97.40% and 75.64% respectively. Conclusion: This alternative method using MUAC tape to measure UAL increases the wasting diagnosis accuracy and allows for a better estimation of wasting prevalence. This method could be used as a potential alternative method for quick surveys in emergency settings such as Corona virus disease 2019 context.