title: Comparison of Mid-Upper Arm Circumference and Weight-for-Height to Diagnose Severe Acute Malnutrition: A Study in Southern Ethiopia.
abstract: Weight-for-heightZ-score (WHZ) and mid-upper arm circumference (MUAC) are two independent anthropometric indicators for diagnosing and admitting children with severe acute malnutrition (SAM) for treatment. While severely wasted children are at high risk of mortality, MUAC and WHZ do not always identify the same population of children as having SAM. Understanding how this discrepancy relates to age and sex may provide valuable information for care programmes for children with SAM. Age and sex distribution for differences between children identified as SAM by MUAC and WHZ were examined and the degree of agreement calculated. Children (n= 4297) aged 6-59 months with validated anthropometric measures were recruited from a population-based survey conducted in rural southern Ethiopia. MUAC < 115 mm and WHZ < -3 were used to define severe wasting as per the World Health Organization (WHO) classification. The kappa coefficient (κ) was calculated. There was fair agreement between the MUAC and WHZ definitions of severe wasting in boys (κ = 0.37) and children younger than 24 months (κ = 0.32) but poor agreement in girls (κ = 0.15) and children aged 24 months and above (κ = 0.13). More research is needed on response to treatment and prediction of mortality using different anthropometric measurements in relation to ages and sex of children.
authors.affiliation: Department of Women's and Children's Health, International Maternal and Child Health Uppsala University, SE-75185 Uppsala, Sweden. amare.tadesse@kbh.uu.se.|Department of Public Health Sciences, Addis Continental Institute of Public Health, P.O. Box 26751/1000 Addis Ababa, Ethiopia. amare.tadesse@kbh.uu.se.
authors.forename: Amare Worku
authors.initials: AW
authors.lastname: Tadesse
authors.affiliation: Department of Women's and Children's Health, International Maternal and Child Health Uppsala University, SE-75185 Uppsala, Sweden. elazar.balla@kbh.uu.se.|Department of Public Health Sciences, Addis Continental Institute of Public Health, P.O. Box 26751/1000 Addis Ababa, Ethiopia. elazar.balla@kbh.uu.se.
authors.forename: Elazar
authors.initials: E
authors.lastname: Tadesse
authors.affiliation: Department of Public Health Sciences, Addis Continental Institute of Public Health, P.O. Box 26751/1000 Addis Ababa, Ethiopia. yemaneberhane@gmail.com.
authors.forename: Yemane
authors.initials: Y
authors.lastname: Berhane
authors.affiliation: Department of Women's and Children's Health, International Maternal and Child Health Uppsala University, SE-75185 Uppsala, Sweden. Lotta.Ekstrom@kbh.uu.se.
authors.forename: Eva-Charlotte
authors.initials: EC
authors.lastname: Ekström
mesh_terms: D001132:Arm; D049628:Body Size / Q000208:ethnology; D002675:Child, Preschool; D003906:Developing Countries; D005002:Ethiopia / Q000453:epidemiology; D005191:Family Characteristics / Q000208:ethnology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D015596:Nutrition Assessment; D009749:Nutrition Surveys; D015995:Prevalence; D011379:Prognosis; D012306:Risk; D012423:Rural Health / Q000208:ethnology; D000067011:Severe Acute Malnutrition / Q000175:diagnosis* / Q000453:epidemiology / Q000208:ethnology / Q000401:mortality; D012737:Sex Factors; D012959:Socioeconomic Factors; D065927:Waist-Height Ratio; D019282:Wasting Syndrome / Q000175:diagnosis* / Q000453:epidemiology / Q000208:ethnology / Q000401:mortality; D014944:World Health Organization
keywords: MUAC; WHZ; age; agreement; severe acute malnutrition; sex and children