Mid-upper arm circumference as a screening tool for identifying adolescents with thinness

Area of Science:

• Public Health
• Pediatric Nutrition
• Anthropometry

Background:

• Thinness is a significant public health concern in adolescents.
• Accurate screening tools are crucial for early identification and intervention.
• Mid-upper arm circumference (MUAC) is a simple anthropometric measure with potential for screening nutritional status.

Purpose of the Study:

• To evaluate the effectiveness of MUAC in identifying thinness among Ethiopian adolescents aged 15-19 years.
• To compare the performance of MUAC against Body Mass Index (BMI) Z-score for thinness detection.
• To establish optimal MUAC cut-off points for identifying thinness in this population.

Main Methods:

• A school-based cross-sectional study was conducted in Addis Ababa, Ethiopia.
• Receiver Operating Characteristics (ROC) curve analysis was used to assess the validity of MUAC against BMI Z-score (<-2 SD).
• A total of 851 adolescents (456 males, 395 females) participated in the study.

Main Results:

• The prevalence of thinness and severe thinness was 9.5% among the studied adolescents.
• The Area Under the Curve (AUC) for MUAC versus BMI Z-score <-2 SD was 0.91, indicating high accuracy.
• Optimal MUAC cut-offs were determined as 23.3 cm for males and 22.6 cm for females, demonstrating high sensitivity and specificity.

Conclusions:

• MUAC demonstrates comparable accuracy to BMI Z-score in identifying thinness in adolescents aged 15-19 years.
• MUAC can serve as a practical alternative tool for the surveillance and screening of thinness in this age group.
• The proposed optimal MUAC cut-offs may require adjustment with higher positive predictive values in well-nourished populations to avoid over-identification.