Low mid-upper arm circumference identifies children with a high risk of death who should be the priority target for treatment
Background: <br>Severe acute malnutrition (SAM) is currently defined by the WHO as either a low mid-upper arm circumference (i.e. MUAC <115 mm), a low weight-for-height z-score (i.e. WHZ <- 3), or bilateral pitting oedema. MUAC and WHZ do not always identify the same children as...
| Những tác giả chính: | , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Định dạng: | Journal article |
| Ngôn ngữ: | English |
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BioMed Central
2016
|
| _version_ | 1826275382950625280 |
|---|---|
| author | A Briend JL Alvarez N Avril P Bahwere J Bailey JA Berkley P Binns N Blackwell N Dale H Deconinck P Delchevalerie N Dent M Gallagher S Guerrero K Hanson M Kerac M Manary MK Mwangome M Myatt KPQ Phelan S Pietzsch NS Ubach S Shepherd S Van Der Kam A Vargas S Whitney |
| author_facet | A Briend JL Alvarez N Avril P Bahwere J Bailey JA Berkley P Binns N Blackwell N Dale H Deconinck P Delchevalerie N Dent M Gallagher S Guerrero K Hanson M Kerac M Manary MK Mwangome M Myatt KPQ Phelan S Pietzsch NS Ubach S Shepherd S Van Der Kam A Vargas S Whitney |
| author_sort | A Briend |
| collection | OXFORD |
| description | Background: <br>Severe acute malnutrition (SAM) is currently defined by the WHO as either a low mid-upper arm circumference (i.e. MUAC <115 mm), a low weight-for-height z-score (i.e. WHZ <- 3), or bilateral pitting oedema. MUAC and WHZ do not always identify the same children as having SAM. This has generated broad debate, as illustrated by the recent article by Grellety & Golden (BMC Nutr. 2016;2:10). <br><br>Discussion: <br>Regional variations in the proportion of children selected by each index seem mostly related to differences in body shape, including stuntedness. However, the practical implications of these variations in relation to nutritional status and also to outcome are not clear. All studies that have examined the relationship between anthropometry and mortality in representative population samples in Africa and in Asia have consistently showed that MUAC is more sensitive at high specificity levels than WHZ for identifying children at high risk of death. Children identified as SAM cases by low MUAC gain both weight and MUAC in response to treatment. The widespread use of MUAC has brought enormous benefits in terms of the coverage and efficiency of programs. As a large high-risk group responding to treatment, children with low MUAC should be regarded as a public health priority independently of their WHZ. <br><br>Conclusion:<br> While a better understanding of the mechanism behind the discrepancy between MUAC and WHZ is desirable, research in this area should not delay the implementation of programs aiming at effectively reducing malnutrition-related deaths by prioritising the detection and treatment of children with low MUAC. |
| first_indexed | 2024-03-06T22:57:52Z |
| format | Journal article |
| id | oxford-uuid:610ccf3f-8e1d-4bd7-a8d7-0c55107a363d |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T22:57:52Z |
| publishDate | 2016 |
| publisher | BioMed Central |
| record_format | dspace |
| spelling | oxford-uuid:610ccf3f-8e1d-4bd7-a8d7-0c55107a363d2022-03-26T17:57:18ZLow mid-upper arm circumference identifies children with a high risk of death who should be the priority target for treatmentJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:610ccf3f-8e1d-4bd7-a8d7-0c55107a363dEnglishSymplectic ElementsBioMed Central2016A BriendJL AlvarezN AvrilP BahwereJ BaileyJA BerkleyP BinnsN BlackwellN DaleH DeconinckP DelchevalerieN DentM GallagherS GuerreroK HansonM KeracM ManaryMK MwangomeM MyattKPQ PhelanS PietzschNS UbachS ShepherdS Van Der KamA VargasS WhitneyBackground: <br>Severe acute malnutrition (SAM) is currently defined by the WHO as either a low mid-upper arm circumference (i.e. MUAC <115 mm), a low weight-for-height z-score (i.e. WHZ <- 3), or bilateral pitting oedema. MUAC and WHZ do not always identify the same children as having SAM. This has generated broad debate, as illustrated by the recent article by Grellety & Golden (BMC Nutr. 2016;2:10). <br><br>Discussion: <br>Regional variations in the proportion of children selected by each index seem mostly related to differences in body shape, including stuntedness. However, the practical implications of these variations in relation to nutritional status and also to outcome are not clear. All studies that have examined the relationship between anthropometry and mortality in representative population samples in Africa and in Asia have consistently showed that MUAC is more sensitive at high specificity levels than WHZ for identifying children at high risk of death. Children identified as SAM cases by low MUAC gain both weight and MUAC in response to treatment. The widespread use of MUAC has brought enormous benefits in terms of the coverage and efficiency of programs. As a large high-risk group responding to treatment, children with low MUAC should be regarded as a public health priority independently of their WHZ. <br><br>Conclusion:<br> While a better understanding of the mechanism behind the discrepancy between MUAC and WHZ is desirable, research in this area should not delay the implementation of programs aiming at effectively reducing malnutrition-related deaths by prioritising the detection and treatment of children with low MUAC. |
| spellingShingle | A Briend JL Alvarez N Avril P Bahwere J Bailey JA Berkley P Binns N Blackwell N Dale H Deconinck P Delchevalerie N Dent M Gallagher S Guerrero K Hanson M Kerac M Manary MK Mwangome M Myatt KPQ Phelan S Pietzsch NS Ubach S Shepherd S Van Der Kam A Vargas S Whitney Low mid-upper arm circumference identifies children with a high risk of death who should be the priority target for treatment |
| title | Low mid-upper arm circumference identifies children with a high risk of death who should be the priority target for treatment |
| title_full | Low mid-upper arm circumference identifies children with a high risk of death who should be the priority target for treatment |
| title_fullStr | Low mid-upper arm circumference identifies children with a high risk of death who should be the priority target for treatment |
| title_full_unstemmed | Low mid-upper arm circumference identifies children with a high risk of death who should be the priority target for treatment |
| title_short | Low mid-upper arm circumference identifies children with a high risk of death who should be the priority target for treatment |
| title_sort | low mid upper arm circumference identifies children with a high risk of death who should be the priority target for treatment |
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