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Weight-for-age and mid-upper arm circumference versus weight-for-length as severe acute malnutrition indicators: A
Kumari Pinky1, Rashmi Randa Mahore2, Shiva Saloni Thakur3
1Department of Paediatrics, Government Medical College, Satna, Madhya Pradesh, India.
Insights
Severe acute malnutrition (SAM) affects nearly a quarter of Indian infants under six months, challenging exclusive breastfeeding myths. Combined screening using MUAC and weight-for-length is recommended for early detection in community settings.
Area of Science:
- Pediatric Nutrition
- Public Health
- Infant Health
Background:
- Infants under six months are highly vulnerable to malnutrition.
- National Family Health Survey-4 reported 14.8% severe wasting in Indian infants.
- A study in Central India found 23.8% severe acute malnutrition (SAM) prevalence, questioning exclusive breastfeeding's protective effect.
Purpose of the Study:
- To assess the prevalence of SAM in infants under six months.
- To evaluate screening methods for SAM in infants.
- To identify modifiable risk factors for SAM in this age group.
Main Methods:
- Cross-sectional study involving 600 infants from Central India.
- Evaluation of Mid-Upper Arm Circumference (MUAC) <11 cm for screening.
- Assessment of weight-for-age as a screening indicator.
Main Results:
- MUAC <11 cm showed an area under the curve of 0.936 with 69.23% sensitivity and 73.09% specificity.
- Weight-for-age had higher sensitivity (88.81%) but lower specificity (61.1%).
- Low birth weight and adverse feeding practices were identified as key modifiable risk factors.
Conclusions:
- Combined MUAC and weight-for-length screening strategies are effective for detecting SAM in infants.
- These combined strategies are particularly relevant for low-resource, community-based settings.
- Early detection and intervention are crucial for managing SAM in infants under six months.
Abstract:
Infants are more susceptible to malnutrition than older children. The prevalence of severe wasting among Indian infants under-6 months of age is 14.8% according to the National Family Health Survey-4. The myth of complete protection by exclusive breastfeeding is debated when the prevalence of severe acute malnutrition (SAM) sprang up as high as 23.8% in a cross sectional study from Central India among 600 infants. Area under the curve for MUAC <11 cm was 0.936 (95% confidence interval); its sensitivity and specificity were 69.23% and 73.09%, respectively; area under the curve for weight-for-age had higher sensitivity at (88.81%), but lower specificity (61.1%). The highlighted modifiable risk factors were low birth weight and adverse feeding practices. Combined MUAC and weight-for-length screening strategies should be used specifically in low-resource, community-based contexts for SAM in infants aged under six months.
