The optimal mid-upper-arm circumference cutoffs to screen severe acute malnutrition in Vietnamese children

Area of Science:

• Pediatrics
• Public Health
• Nutrition Science

Background:

• Severe acute malnutrition (SAM) is a significant cause of mortality in children under five.
• Accurate screening tools are crucial for timely intervention in SAM cases.
• Vietnam requires optimized screening methods for SAM in specific regions.

Purpose of the Study:

• To determine the optimal mid-upper-arm circumference (MUAC) cutoff for screening SAM in children aged 6-59 months in Vietnam.
• To enhance the accuracy of MUAC as a screening indicator for SAM.
• To inform therapeutic feeding programs for SAM children.

Main Methods:

• A survey was conducted across 16 subdistricts in four provinces of Northern Midlands and mountainous areas.
• Data from 4,764 children aged 6-59 months were analyzed.
• Weight-for-height z-scores (WHZ) were used as a reference for diagnosing SAM.

Main Results:

• An optimal MUAC cutoff of 13.5 cm was identified.
• This cutoff would include 65% of children with WHZ below -3SD.
• The 13.5 cm MUAC cutoff demonstrated 65% sensitivity and 72% specificity.

Conclusions:

• A MUAC cutoff of 13.5 cm is recommended for screening SAM in children under 5 in Vietnam's Midlands and mountainous areas.
• Combining MUAC with WHZ may enhance the impact of therapeutic feeding programs.
• Implementing this cutoff can improve SAM prevention and management strategies.