title: Weight-for-Height Z Score and Mid-Upper Arm Circumference as Predictors of Mortality in Children with Severe Acute Malnutrition.
abstract: Mortality associated with severe acute malnutrition (SAM) could be reduced by screening malnourished children for those most vulnerable to death. We compared the weight-for-height Z score (WHZ) and mid-upper arm circumference (MUAC) as predictors of mortality in children with SAM.
  
  
  
  We conducted a retrospective study spanning over 8 years, using records of children aged 6-59 months, hospitalized for SAM and discharged alive or who died during hospitalization.
  
  
  
  Area under the curve was greater for MUAC [0.809 (95% CI, 0.709-0.911, p = 0.001)] than WHZ [0.649 (95% CI, 0.524-0.774, p = 0.032)]. MUAC predicted death better [sensitivity: 95.5%, specificity: 25.0%, positive likelihood ratio (PLR): 1.27, negative likelihood ratio (NLR): 0.18] than WHZ (sensitivity: 86.4%, specificity: 21.4%, PLR: 1.10, NLR: 0.64). Best MUAC and WHZ cut-offs for predicting death (10.3 cm and -4, respectively) were most accurate in infants aged <12 months, the former being more accurate.
  
  
  
  MUAC predicts death better than WHZ in children with SAM.
authors.affiliation: Yaounde Gynaeco-Obstetric and Pediatric hospital/Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaoundé, Cameroon.
authors.forename: Andreas
authors.initials: A
authors.lastname: Chiabi
authors.affiliation: Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaoundé, Cameroon.
authors.forename: Clarence
authors.initials: C
authors.lastname: Mbanga
authors.affiliation: Yaounde Gynaeco-Obstetric and Pediatric hospital/Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaoundé, Cameroon.
authors.forename: Evelyn
authors.initials: E
authors.lastname: Mah
authors.affiliation: Yaounde Gynaeco-Obstetric and Pediatric hospital/Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaoundé, Cameroon.
authors.forename: Felicitee
authors.initials: F
authors.lastname: Nguefack Dongmo
authors.affiliation: Yaounde Gynaeco-Obstetric and Pediatric hospital/Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaoundé, Cameroon.
authors.forename: Seraphin
authors.initials: S
authors.lastname: Nguefack
authors.affiliation: Yaounde Gynaeco-Obstetric and Pediatric hospital, Yaoundé, Cameroon.
authors.forename: Florence
authors.initials: F
authors.lastname: Fru
authors.affiliation: Yaounde Gynaeco-Obstetric and Pediatric hospital, Yaoundé, Cameroon.
authors.forename: Virginie
authors.initials: V
authors.lastname: Takou
authors.affiliation: Yaounde Gynaeco-Obstetric and Pediatric hospital/Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaoundé, Cameroon.
authors.forename: Angwafo
authors.initials: A
authors.lastname: Fru
mesh_terms: D000886:Anthropometry; D001132:Arm / Q000033:anatomy & histology*; D001827:Body Height; D001835:Body Weight; D002163:Cameroon / Q000453:epidemiology; D015362:Child Nutrition Disorders / Q000401:mortality; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D007223:Infant; D008297:Male; D008403:Mass Screening; D009752:Nutritional Status; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D000067011:Severe Acute Malnutrition / Q000175:diagnosis / Q000401:mortality*; D012720:Severity of Illness Index
keywords: mid-upper arm circumference; severe acute malnutrition; weight-for-height Z score