Mid upper-arm circumference is an effective tool to identify infants and young children with severe acute malnutrition in India

Abstract

Objective To assess the appropriateness of current mid upper-arm circumference (MUAC) cut-offs to identify children with severe acute malnutrition in India. Design The analysis concerned 6307 children admitted to nutrition rehabilitation centres (2009-2011) where they received therapeutic care as per guidelines by WHO and the Indian Academy of Pediatrics. Setting States of Jharkhand, Madhya Pradesh and Uttar Pradesh, India. Subjects Children aged 6-59 months with bilateral pitting oedema or weight-for-height Z-score (WHZ) <115 mm at admission. Results Children aged 6-23 months represented ~80 % of the admissions. Among them, the proportion with WHZ <115 mm (85·7 % v. 81·8 %); the proportion with MUAC<115 mm whose WHZ was <115 mm was 78·8 %. MUAC<115 mm was as effective as WHZ <115 mm were higher than in children with WHZ <115 mm. Conclusions In populations similar to those included in our analysis, MUAC<115 mm appears to be an appropriate criterion to identify children with severe acute malnutrition who are at a greater risk of medical complications and death, particularly among children 6-23 months old.