ArticleNutrition journal2018
Severely malnourished children with a low weight-for-height have a higher mortality than those with a low mid-upper-arm-circumference: I. Empirical data demonstrates Simpson's paradox.
Article in Nutrition journal, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03780348 (A Novel Low-Cost Tool for a More Efficient and Reliable Weight-for-Height/Length Assessment), which is not on this map. Cited by 32 papers, 2 of them syntheses that pooled it.
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The trial behind it
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.
A Novel Low-Cost Tool for a More Efficient and Reliable Weight-for-Height/Length Assessment
Who cites it
32 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Prevalence and risk factors of under-five mortality due to severe acute malnutrition in Africa: a systematic review and meta-analysis.Systematic reviews · 2025Pooled it
- 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.Nutrition journal · 2018Pooled it
- How does baseline anthropometry affect anthropometric outcomes in children receiving treatment for severe acute malnutrition? A secondary analysis of a randomized controlled trial.Maternal & child nutrition · 2022Trial
- Impact of Integration of Severe Acute Malnutrition Treatment in Primary Health Care Provided by Community Health Workers in Rural Niger.Nutrients · 2021Trial
- Trial
- Geographic priorities in the global action plan for wasting: Burkina Faso, Ethiopia, Kenya and Malawi.Bulletin of the World Health Organization · 2026Article
- Article
- Malnutrition and female political representation in India.PloS one · 2026Article
- A Rare Case of Dextrocardia With Atrioventricular Septal Defect and Situs Inversus in an 8-Month-Old Infant Complicated by Severe Acute Malnutrition.Clinical case reports · 2025Article
- Article
- Diagnostic criteria for severe acute malnutrition and fatal outcomes in children aged 6-59 months, Nigeria.Bulletin of the World Health Organization · 2025Observational
- Exploring current barriers and enablers of severe acute malnutrition management among children (6-59 months): perspectives from health professionals in northern Ghana.BMC nutrition · 2025Article
- Addressing dual deficiencies of SAM indicators; gaps and insights from inpatient admission to outpatient discharge, in conflict-affected Yemen; a retrospective study.Conflict and health · 2025Article
- Systematic Screening for Tuberculosis Using Molecular Testing on Stool Samples in Acutely Malnourished Children: A Pilot Implementation Study in a High-Burden Drug-Resistant Tuberculosis Country.Open forum infectious diseases · 2025Article
- Article
- Indian perspective on childhood malnutrition: Prevalence, pathophysiology, risk factors, and prevention.World journal of clinical pediatrics · 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
- Time to recovery from moderate acute malnutrition and its predictors among children aged 6-59 months in Fedis Woreda, East Hararghe Zone, Eastern Ethiopia.Frontiers in nutrition · 2024Article
- Use of collaborative learning approach for increased cure rate among children aged 6-59 months with severe wasting in Karamoja, Uganda.BMJ open quality · 2023Article
- 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
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2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAccording to WHO childhood severe acute malnutrition (SAM) is diagnosed when the weight-for-height Z-score (WHZ) is <-3Z of the WHO
methodsWe examined the mortality experience of 76,887 6-60 month old severely malnourished children admitted for treatment to in-patient, out-patient or supplementary feeding facilities in 18 African countries, of whom 3588 died. They were divided into 7 different diagnostic categories for analysis of mortality rates by comparison of case fatality rates, relative risk of death and meta-analysis of the difference between children admitted using MUAC and WHZ criteria.
resultsThe mortality rate was higher in those children fulfilling the WHO
conclusionsChildren with a low WHZ, but a MUAC above the SAM cut-off point are at high risk of death. Simpson's paradox due to confounding from oedema and mathematical coupling may make previous statistical analyses which failed to distinguish the diagnostic groups an unreliable guide to policy. WHZ needs to be retained as an independent criterion for diagnosis of SAM and methods found to identify those children with a low WHZ, but not a low MUAC, in the community.
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