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Mid-upper-arm-circumference and mid-upper-arm circumference z-score: the best predictor of mortality?

J Rasmussen1, A Andersen, A B Fisker

  • 1Bandim Health Project, Indepth Network, Apartado 861, Bissau, Guinea-Bissau. jurasmussen@gmail.com

European Journal of Clinical Nutrition
|July 19, 2012
PubMed

Insights

Mid-upper-arm circumference (MUAC) effectively identifies children at high risk of mortality, similar to the MUAC z-score. Given its simplicity, MUAC is recommended for field use in assessing child malnutrition and mortality risk.

Area of Science:

  • Pediatric Nutrition
  • Global Health
  • Child Mortality Studies

Background:

  • Mid-upper-arm circumference (MUAC) is a standard anthropometric measure for assessing nutritional status in children over six months.
  • The World Health Organization (WHO) introduced the MUAC z-score in 2007 for children over three months.

Purpose of the Study:

  • To compare the effectiveness of MUAC and MUAC z-score in identifying children at high risk of short-term mortality.
  • To evaluate these indicators in Guinea-Bissau.

Main Methods:

  • The Bandim Health Project collected data on MUAC measurements and mortality in children from birth up to three years.
  • Two cohorts (1995-96 and 2005-06) were studied to assess prognostic abilities using receiver operating characteristic curves, sensitivity, and positive predictive value.

Main Results:

  • MUAC identified more girls and younger children (6-11 months) as malnourished compared to the MUAC z-score.
  • Both MUAC and MUAC z-score demonstrated comparable prognostic ability for predicting mortality in children aged 6-35 months.
  • Prognostic ability was higher in settings with lower mortality rates, and MUAC showed good performance in the youngest infants.

Conclusions:

  • MUAC and MUAC z-score have equivalent prognostic abilities for predicting short-term mortality in children aged 6-35 months.
  • Due to its ease of use in field settings, MUAC is sufficient for identifying children at high risk of mortality, negating the need for the MUAC z-score.
Abstract

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