SynthesisNutrition journal2018
Severely malnourished children with a low weight-for-height have similar mortality to those with a low mid-upper-arm-circumference: II. Systematic literature review and meta-analysis.
Synthesis in Nutrition journal, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Impact of Integration of Severe Acute Malnutrition Treatment in Primary Health Care Provided by Community Health Workers in Rural Niger.Nutrients · 2021Trial
- Outcomes of community-based nutrition support groups in Dioila Health District, Mali.Frontiers in nutrition · 2026Article
- Article
- Diagnostic criteria for severe acute malnutrition and fatal outcomes in children aged 6-59 months, Nigeria.Bulletin of the World Health Organization · 2025Observational
- The performance of upper arm circumference for age in diagnosing severe acute malnutrition in children aged 6 to 59 months in South Kivu, Eastern Democratic Republic of Congo: Lwiro Cohort.BMC public health · 2025Article
- Contribution of malnutrition to infant and child deaths in Sub-Saharan Africa and South Asia.BMJ global health · 2024Article
- Arm circumference for age, arm circumference and weight-for-height z-score for the evaluation of severe acute malnutrition: a retrospective cohort study in eastern Democratic Republic of Congo.BMC public health · 2024Article
- Mid-upper arm circumference only protocol in Pakistan: missed opportunities for children suffering from severe acute malnutrition? A mixed-methods observational study.Public health nutrition · 2024Article
- Association between diagnostic criteria for severe acute malnutrition and hospital mortality in children aged 6-59 months in the eastern Democratic Republic of Congo: the Lwiro cohort study.Frontiers in nutrition · 2023Article
- Programmatic adaptations to acute malnutrition screening and treatment during the COVID-19 pandemic.Maternal & child nutrition · 2022Article
- Severe acute malnutrition morphological patterns in children under five.Scientific reports · 2021Article
- Article
- Comparison of Mid-Upper-Arm Circumference and Weight-For-HeightJournal of nutrition and metabolism · 2021Article
- Article
- Article
- The optimal mid-upper-arm circumference cutoffs to screen severe acute malnutrition in Vietnamese children.AIMS public health · 2020Article
- Article
- Severe acute malnutrition and mortality in children in the community: Comparison of indicators in a multi-country pooled analysis.PloS one · 2019Article
- Identifying children at risk of malnutrition.Nutrition journal · 2018Article
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe WHO recommended criteria for diagnosis of sever acute malnutrition (SAM) are weight-for-height/length Z-score (WHZ) of <- 3Z of the WHO
methodsWe conducted a systematic search for reports which examined the relationship of WHZ and MUAC to mortality for children less than 60 months. The WHZ, MUAC, outcome and programmatic variables were abstracted from the reports and examined. Individual study's case fatality rates were compared by chi-squared analysis and random effects meta-analyses for combined data.
resultsTwenty-one datasets were reviewed. All the patient studies had an ascertainment bias. Most were inadequate because they had insufficient deaths, used obsolete standards, combined oedematous and non-oedematous subjects, did not report the proportion of children with both deficits or the deaths occurred remotely after anthropometry. The meta-analyses showed that the mortality risks for children who have SAM by MUAC < 115 mm only and those with SAM by WHZ < -3Z only are not different.
conclusionsAs the diagnostic criteria identify different children, this analysis does not support the abandonment of WHZ as an important independent diagnostic criterion for the diagnosis of SAM. Failure to identify such children will result in their being denied treatment and unnecessary deaths from SAM.
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