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Comparison of arm circumference against standard anthropometric indices using data from a high density town near
1Department of Community Medicine, University of Zimbabwe School of Medicine, Harare.
Insights
Middle upper arm circumference (MUAC) screening for child malnutrition showed moderate accuracy in a Zimbabwean town. While better than some standard indices, its performance was insufficient for reliable identification of healthy or diseased children.
Area of Science:
- Public Health
- Pediatrics
- Anthropometry
Background:
- Child malnutrition remains a significant global health challenge, particularly in resource-limited settings.
- Accurate and accessible screening tools are crucial for early detection and intervention.
- Standard anthropometric indices (weight-for-age, height-for-age, weight-for-height) have limitations in certain contexts.
Purpose of the Study:
- To evaluate the performance of Middle Upper Arm Circumference (MUAC) as a screening tool for malnutrition in children.
- To compare MUAC's effectiveness against standard anthropometric indices in a high-density urban setting.
Main Methods:
- A controlled study involving 90 children aged 1-4 years in a high-density area near Harare, Zimbabwe.
- Comparison of MUAC measurements against standard indices: weight-for-age, height-for-age, and weight-for-height.
- Analysis of sensitivity and specificity using a MUAC cut-off point of 15.5 cm.
Main Results:
- MUAC demonstrated better performance relative to weight-for-age (sensitivity 66.7%, specificity 76.2%) compared to other standard indices.
- However, the overall performance was deemed unsatisfactory, with 28.9% of children inaccurately classified.
- The accuracy of MUAC was insufficient for reliable identification of malnourished children in this specific setting.
Conclusions:
- The study does not support the recommendation of MUAC for identifying malnourished children in similar high-density urban areas.
- MUAC may hold potential utility in regions with a higher prevalence of malnutrition.
- Further research is needed to validate MUAC in diverse epidemiological contexts.
Abstract:
In a limited controlled sample, the performance of the middle upper arm circumference (MUAC) was compared to those of standard indices (weight for age, height for age and weight for height), using 90 children aged one to four years living in a high density town near Harare, Zimbabwe. Using a cut off point of 15,5 cm, the MUAC performed best in relation to the weight for age (sensitivity 66,7 pc (95 pc confidence interval (CI) 53,3-80,0 pc), specificity 76,2 pc (95 pc CI 61,7-80,5 pc)) than to any other standard index. Nevertheless, this performance was unsatisfactory because about 30 in every 100 (28,9 pc) children would have been inaccurately identified as healthy or diseased. Although we do not have evidence from the present study to recommend the use of the MUAC in identifying children who are malnourished and living in similar high density areas, the MUAC may be applicable to children living in areas of higher prevalence of malnutrition.