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确定一个最佳的案例定义,使用中高臂周长与或没有体重的年龄来确定儿童浪费在菲律宾
Lyle Daryll Dimaano Casas1,2, Jhanna Uy1,3, Eldridge Ferrer4
1Research Department, Philippine Institute for Development Studies, Quezon City, Metro Manila, Philippines.
PloS one
|December 27, 2024
概括
仅仅是中上臂周长 (MUAC) 不足以识别被浪费的菲律宾儿童. 将MUAC与体重对年龄z-score (WAZ) 结合起来,可显著提高中度和严重衰减的检测准确度,有助于及时干预.
科学领域:
- 公共卫生 营养 公共卫生 营养
- 儿童营养不良问题
- 诊断准确性研究 诊断准确性研究
背景情况:
- 准确的人类测量,如体重与身高的z-score (WHZ) 对于识别儿童消耗至关重要,但在资源有限的环境中具有挑战性.
- 中上臂周长 (MUAC) 是一个更简单的选工具,但仅仅在识别浪费时的有效性需要进一步评估.
- 现有的MUAC切断可能导致低诊断和延迟治疗浪费的儿童,影响健康结果.
研究的目的:
- 用WHZ作为标准标准,确定在6-59个月的菲律宾儿童中检测儿童消耗的最佳案例定义.
- 为了评估各种MUAC截止值和联合MUAC-weight-for-age z-score (WAZ) 定义的诊断性能.
主要方法:
- 来自菲律宾的2018-2019年扩展国家营养调查数据的分析 (N=30,522).
- 评估不同MUAC截止值和联合MUAC-WAZ标准对WHZ的诊断准确性 (灵敏度,特异性,AUROC).
- 根据接收器运行特征曲线 (AUROC) 下的最高面积,确定表现最佳的案例定义.
主要成果:
- 目前的MUAC切断在识别严重的 (AUROC:0.558) 和中度的 (AUROC:0.586) 消耗方面表现不佳.
- 最佳的MUAC切线被确定为<13.6cm的严重消耗 (AUROC:0.690) 和14.0cm的中度消耗 (AUROC:0.737).
- 结合WAZ<-2与MUAC切断值 (严重的<11.7厘米,中度的<12.7厘米) 显著改善了诊断准确性 (AUROC:分别为0.800和0.810).
结论:
- 仅仅依靠扩展的MUAC截止值,对于在菲律宾儿童中根据WHZ标准检测浪费,没有足够的改善.
- 将WAZ与MUAC相结合,提供了一种更准确,更灵敏的方法来识别中度和重度丧的儿童.
- 拟议的WAZ和MUAC联合病例定义需要进一步调查,以便在菲律宾急性营养不良综合管理计划中切实实施.
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