Weight-for-Height Z Score and Mid-Upper Arm Circumference as Predictors of Mortality in Children with Severe Acute Malnutrition

Chiabi, Andréas; Mbanga, Clarence; Mah, Evelyn; Dongmo, Félicitée Nguefack; Nguefack, Séraphin; Fru, Florence; Takou, Virginie; Fru, Angwafo

doi:10.1093/tropej/fmw083

Cited by 19 publications

(19 citation statements)

References 14 publications

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“…The results of this study confirm the predictive value of the arm circumference, correlated with weight for height, as an indicator of risk in children with severe acute malnutrition, since it offers greater precision with respect to the estimation of caloric reserves and muscle mass [23]; The present study, in fact, evidences a solid association between low calorie consumption and a small arm circumference [24].…”

Section: Practicessupporting

confidence: 84%

Knowledge, attitudes and food practices in caregivers and nutritional status in infants from Ventaquemada, Boyacá, Colombia

Wilchez

Sánchez

Dı́az

2019

archmed

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Objective: to determine possible association between the nutritional status of children under two years of age and the level of knowledge, attitudes and practices of caregivers of these infants, in relation to nutritional status, including dietary diversity, in accordance with the groups of foods. Materials and methods: there were carried out a observational, analytical, cross-sectional study, which aims to identify the nutritional status according to World Health Organization standards using anthropometric variables, in a sample of 170 infants, simultaneously, was determine the level of knowledge, attitudes and practices of the caregivers, in a rural environment; For this purpose, questionnaires of the United Nations Food and Agriculture Organization, adapted for a rural population of Ventaquemada, Colombia were used. Results: there are no significant differences in malnutrition rates; although most caregivers have good knowledge of infant nutrition, this knowledge is not applied, because caregivers perceive that they are in correct practice. Conclusions: This finding suggests the development of community intervention studies on beliefs, values, individual and collective emotions, around food practices.

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Section: Practicessupporting

confidence: 84%

Knowledge, attitudes and food practices in caregivers and nutritional status in infants from Ventaquemada, Boyacá, Colombia

Wilchez

Sánchez

Dı́az

2019

archmed

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“…The parent trial participants were children aged 2–59 mo who had a negative HIV rapid antibody test and who were admitted to the hospital with SAM, defined as midupper arm circumference (MUAC) <11.0 cm (children aged 2–6 mo) or MUAC <11.5 cm (children aged 6–59 mo) or the presence of kwashiorkor at any age ( 7 ). The more traditional method of assessing childhood malnutrition, weight-for-height or -length z score (WHZ), was not used for trial entry because MUAC predicts mortality better than WHZ ( 11 ). HIV-infected children were excluded from the parent trial because daily cotrimoxazole prophylaxis is already standard of care for this group.…”

Section: Methodsmentioning

confidence: 99%

Changes in susceptibility to life-threatening infections after treatment for complicated severe malnutrition in Kenya

Ngari

Mwalekwa

Timbwa

et al. 2018

The American Journal of Clinical Nutrition

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BackgroundGoals of treating childhood severe acute malnutrition (SAM), in addition to anthropometric recovery and preventing short-term mortality, include reducing the risks of subsequent serious infections. How quickly and how much the risk of serious illness changes during rehabilitation are unknown but could inform improving the design and scope of interventions.ObjectiveThe aim of this study was to investigate changes in the risk of life-threatening events (LTEs) in relation to anthropometric recovery from SAM.DesignThis was a secondary analysis of a clinical trial including 1778 HIV-uninfected Kenyan children aged 2–59 mo with complicated SAM, enrolled after the inpatient stabilization phase of treatment, and followed for 12 mo. The main outcome was LTEs, defined as infections requiring rehospitalization or causing death. We examined anthropometric variables measured at months 1, 3, and 6 after enrollment in relation to LTEs occurring during the 6 mo after each of these time points.ResultsOver 12 mo, there were 823 LTEs (257 fatal), predominantly severe pneumonia and diarrhea. At months 1, 3, and 6, 557 (34%), 764 (49%), and 842 (56%) children had a weight-for-height or -length z score (WHZ) ≥−2, respectively, which, compared with a WHZ <−3, was associated with lower risks of subsequent LTEs [adjusted HRs (95% CIs): 0.50 (0.40, 0.64), 0.30 (0.23, 0.39), and 0.23 (0.16, 0.32), respectively]. However, children with a WHZ ≥−2 at 1, 3, and 6 mo still had 39 (95% CI: 32, 47), 26 (95% CI: 22, 32), and 15 (95% CI: 12, 20) LTEs/100 child-years of observation during the following 6 mo. WHZ at study enrollment predicted subsequent WHZ but not the risk of LTEs. Changes in height-for-age z score did not predict LTEs.ConclusionsAnthropometric response was associated with a rapid and substantial reduction in risk of LTEs. However, reduction in susceptibility lagged behind anthropometric improvement. Disease events, together with anthropometric assessment, may provide a clearer picture of the effectiveness of interventions. Robust protocols for detecting and treating poor anthropometric recovery and addressing broader vulnerabilities that complicated SAM indicates may save lives. This trial was registered at www.clinicaltrials.gov as NCT00934492.

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“…The most retrieved studies (32 studies) were from Ethiopia [4,5,17,18,, followed by Malawi (n = 6 studies) [56][57][58][59][60][61], and Nigeria (n = 3 studies) [62][63][64]. Cameroon [65,66], Kenya [67,68], Sudan [69,70], and Ghana [71,72] were represented by two studies, whereas South Africa [73], Uganda [74], Niger [75], Zambia [76], and Democratic Republic of Congo (DRC) [77] were represented by one study. The highest (n = 35 studies) number of reported studies were undertaken at inpatient treatment centers and the rest (n = 18 studies) were at an outpatient treatment program.…”

Section: Study Characteristicsmentioning

confidence: 99%

The recovery rate from severe acute malnutrition among under-five years of children remains low in sub-Saharan Africa. A systematic review and meta-analysis of observational studies

et al. 2020

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Background Globally, Severe Acute Malnutrition (SAM) has been reduced by only 11% over the past 20 years and continues to be a significant cause of morbidity and mortality. So far, in Sub-Saharan Africa, several primary studies have been conducted on recovery rate and determinants of recovery from SAM in under-five children. However, comprehensive reviews that would have a shred of strong evidence for designing interventions are lacking. So, this review and meta-analysis was conducted to bridge this gap. Methods A systematic review of observational studies published in the years between 1/1/2000 to 12/31/2018 was conducted following the Meta-analysis of Observational Studies in Epidemiology (MOOSE) statement. Two reviewers have been searched and extracted data from CINAHL (EBSCO), MEDLINE (via Ovid), Emcare, PubMed databases, and Google scholar. Articles' quality was assessed using the Newcastle-Ottawa Scale by two independent reviewers, and only studies with fair to good quality were included in the final analysis. The review presented the pooled recovery rate from SAM and an odds ratio of risk factors affecting recovery rate after checking for heterogeneity and publication bias. The review has been registered in PROSPERO with protocol number CRD42019122085. Result Children with SAM from 54 primary studies (n = 140,148) were included. A pooled rate of recovery was 71.2% (95% CI: 68.5-73.8; I 2 = 98.9%). Children who received routine medication (Pooled Odds ratio (POR):1.85;95% CI: 1.49-2.29; I 2 = 0.0%), older age (POR:

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Weight-for-Height Z Score and Mid-Upper Arm Circumference as Predictors of Mortality in Children with Severe Acute Malnutrition

Abstract: MUAC predicts death better than WHZ in children with SAM.

Cited by 19 publications

References 14 publications

Knowledge, attitudes and food practices in caregivers and nutritional status in infants from Ventaquemada, Boyacá, Colombia

Knowledge, attitudes and food practices in caregivers and nutritional status in infants from Ventaquemada, Boyacá, Colombia

Changes in susceptibility to life-threatening infections after treatment for complicated severe malnutrition in Kenya

The recovery rate from severe acute malnutrition among under-five years of children remains low in sub-Saharan Africa. A systematic review and meta-analysis of observational studies

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