Measuring severe acute malnutrition (SAM): Need to redefine cut off for mid upper arm circumference (MUAC)
Journal Title: Medpulse International Journal of Pediatrics - Year 2018, Vol 6, Issue 3
Abstract
Background: Mid upper arm circumference (MUAC) is used to screen and diagnose severe acute malnutrition(SAM). The performance of world health organization (WHO) MUAC cut off of 11.5 cm was evaluated in terms of sensitivity and specificity. Objectives: To assess sensitivity, specificity and youden index of MUAC cut off value of 11.5 cm and to find suitable MUAC cutoff values with better sensitivity, specificity, predictive value and youden index to predict wasting in Indian children. Methodology: The descriptive hospital based cross sectional study of 700 children between 6to 60 months attending Belgaum Institute Of Medical Sciences, pediatric OPD were assessed by anthropometric measurements. Sensitivity, specificity, predictive value and youden index of WHO suggested MUAC cutoff of <11.5 cm was calculated. Receiver operating curve (ROC) and youden index were calculated to find out the best possible cutoff value of MUAC for diagnosing SAM in these children. Results: The sensitivity and specificity of MUAC <11.5 cm was 12.3% and 98.6% respectively. The best cut off for screening SAM was obtained at MUAC < 13.5 cm where the sensitivity and specificity was 84.5% and 76.2% respectively. Conclusion: The present cutoff of MUAC <11.5 cm capturesonly a small proportion of all children with SAM cases. There is an urgent need to revise cutoff value of MUAC to higher values to improve its sensitivity for detecting children with SAM.
Authors and Affiliations
Jyothi S Doshetty, Vijaykumar Murteli, Arunkumar Desai
Keywords
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