Mid-arm circumference for detecting malnutrition during infancy

Abstract

Mid-arm circumference (MAC) has been extensively used at 1-5 years of age as an age-independent indicator of protein-energy malnutrition (PEM). Its role below 12 months of age has not been studied adequately and a search for a clinically reliable cut-off point has not been systematically done. This study was planned to establish the age-independent character of MAC within the 6-12 month age group and identify a cut-off point demonstrating the maximum sensitivity and specificity in detection of PEM. Two hundred and forty malnourished infants [< 80% weight for age (W/A) of 50th percentile of NCHS standard] were included with even distribution into 6 subgroups; 240 healthy infants were taken as controls. MAC within the age of 6-12 months was found to be age independent with an overall increase of 5.1%. By using various cut-off points a value of < or = 12.5 cm of MAC proved to be having maximum sensitivity (92.1%) and specificity (88.3%). MAC is, therefore, a simple, age independent, informative measurement for early assessment of PEM by using single cut-off point < or = 12.5 cm, and can serve as a screening test for targeting infants for meaningful utilization of nutritional programmes. Since nearly all MAC tapes in current use already have < or = 12.5 cm colour coded cut-off, no new tapes are necessary.

Serum Albumin and Selected Antioxidants Status in Children with Protein Energy Malnutrition in Sokoto, Nigeria

“…Our finding of a significantly decreased MUAC is in agreement with Alatrouni [17], who attributed this to muscle atrophy which is found in all types of PEM. Bhatia et al [20] also reported that the decrease in MUAC may be due to loss of subcutaneous fat which is observed in marasmus and marasmic-kwashiorkor. The mean MUAC was significantly (p<0.001) lower in the malnourished children and the differences were more marked with the increasing severity of malnutrition, though the mean weight, and BMI were similar among the different classes of PEM.…”

Prevalence of overweight and obesity in urban and semi‐urban Jordanian children aged 3–6 years

“…Prevalence of under‐weight, estimated by BMI cutt‐off points only, was higher compared with the CDC reference values. According to the classification of Waterlow and colleagues (1977) and Bhatia and colleagues (1999) for malnutrition, the non‐significant difference existed between children with underweight and children with healthy weight suggested no stunting in the underweight group. Based on the work of Collins (1996) and Ojo and colleagues (2002), we should advise, in future work, the combination of anthropometric variables (MUAC and BMI cutt‐off points) and clinical variables in the determination of prevalence of malnutrition and in the formulation of intervention strategies for nutrition rehabilitation.…”

Introduction

“…Approximately 9% of children below 5 years of age suffer from wasting indicating malnutrition (weight-forheight below -2 standard deviations (<-2 SD) of the NCHS/WHO reference values) and are at risk of death or severe impairment of growth and psychological development. Alternatively simple anthropometric measures can be usedcommonly the mid upper arm circumference (MUAC) [7][8][9].…”