Nutr Res Pract.  2015 Jun;9(3):268-277. 10.4162/nrp.2015.9.3.268.

Efficacy of mid-upper arm circumference in identification, follow-up and discharge of malnourished children during nutrition rehabilitation

• Mogendi JB
• De Steur H
• Gellynck X
• Saeed HA
• Makokha A

• KMID: 2313840
• DOI: http://doi.org/10.4162/nrp.2015.9.3.268

Abstract

BACKGROUND/OBJECTIVES
Although it is crucial to identify those children likely to be treated in an appropriate nutrition rehabilitation programme and discharge them at the appropriate time, there is no golden standard for such identification. The current study examined the appropriateness of using Mid-Upper Arm Circumference for the identification, follow-up and discharge of malnourished children. We also assessed its discrepancy with the Weight-for-Height based diagnosis, the rate of recovery, and the discharge criteria of the children during nutrition rehabilitation.
SUBJECTS/METHODS
The study present findings from 156 children (aged 6-59 months) attending a supplementary feeding programme at Makadara and Jericho Health Centres, Eastern District of Nairobi, Kenya. Records of age, weight, height and mid-upper arm circumference were selected at three stages of nutrition rehabilitation: admission, follow-up and discharge. The values obtained were then used to calculate z-scores as defined by WHO Anthro while estimating different diagnostic indices.
RESULTS
Mid-upper arm circumference single cut-off (< 12.5 cm) was found to exhibit high values of sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio at both admission and discharge. Besides, children recorded higher rate of recovery at 86 days, an average increment of 0.98 cm at the rate of 0.14mm/day, and a weight gain of 13.49gm/day, albeit higher in female than their male counterparts. Nevertheless, children admitted on basis of low MUAC had a significantly higher MUAC gain than WH at 0.19mm/day and 0.13mm/day respectively.
CONCLUSIONS
Mid-upper arm circumference can be an appropriate tool for identifying malnourished children for admission to nutrition rehabilitation programs. Our results confirm the appropriateness of this tool for monitoring recovery trends and discharging the children thereafter. In principle the tool has potential to minimize nutrition rehabilitation costs, particularly in community therapeutic centres in developing countries.

Keyword

Malnutrition; nutrition rehabilitation; MUAC; weight-for-height; recovery

MeSH Terms

Arm*
Child*
Developing Countries
Diagnosis
Female
Follow-Up Studies*
Humans
Infant
Infant Nutritional Physiological Phenomena
Kenya
Male
Malnutrition
Rehabilitation*
Sensitivity and Specificity
Weight Gain

Figure

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  Fig. 1 Study profile of the study and sample selection

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  Fig. 2 Polynomial graphs showing evolution of MUAC, weight and height, WHZ, MUACZ and WAZ during rehabilitation

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