ArticleGlobal health, science and practice2021
Accuracy of Using Mid-Upper Arm Circumference to Detect Wasting Among Children Aged 6-59 Months in Nepal.
Article in Global health, science and practice, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 20 citations in OpenAlex.
- Three-arm clinical trial of improved flour targeting intestinal microbiota (MALINEA).Maternal & child nutrition · 2024Trial
- Improving case-detection of wasting among under-five-year-old children in Ethiopia: A secondary analysis of community-based surveys in humanitarian settings.PLOS global public health · 2026Article
- Burden of anthropometric failures and concordance of mid-upper arm circumference with weight for length z score in identifying malnutrition among under 2-year-old children in Southern India.Public health nutrition · 2025Article
- Diagnostic performance of MUAC and MUACZ in screening acute malnutrition among children aged 6-23 months in Amhara Region, Ethiopia.Scientific reports · 2025Article
- Diagnostic accuracy of MUAC for assessment of acute malnutrition among children aged 6-59 months in Africa: systematic review and meta-analysis.Frontiers in nutrition · 2025Review
- Diagnostic Accuracy of Mid-Upper Arm Circumference for the Detection of Acute Malnutrition Among Children Aged 6-60 Months: A Diagnostic Accuracy Study.Journal of research in health sciences · 2024Article
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- Utilization of mid-upper arm circumference as discharge tool for children in outpatient therapeutic program, Ethiopia.Journal of nutritional science · 2022Article
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Authors and funding
7 authors at 2 institutions in 2 countries.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundIn countries with a high prevalence of undernutrition, timely, accurate screening at the community level is essential to identify children with wasting. The World Health Organization recommends using either weight-for-height z-scores (WHZ) and mid-upper arm circumference (MUAC) or both measures and signs of edema to be used to identify children with severe acute malnutrition for treatment. We compared WHZ and MUAC cutoffs to identify wasting among children aged 6-59 months in Nepal, using WHZ as the reference standard.
methodsWe used cross-sectional anthropometric data for 3,169 children aged 6-59 months from a 2017 cross-sectional dataset, representative of 42 of Nepal's 77 districts. We used descriptive statistics, receiver operating characteristic (ROC) curves, and kappa statistics to compare the use of MUAC and WHZ to identify wasting. The Youden index was calculated to determine the optimum MUAC cutoffs.
resultsThe prevalence of wasting was 3.1% and 10.5% using MUAC and WHZ, respectively. We found 13.6% sensitivity for severe acute malnutrition (SAM) (MUAC <115 mm) and 21.0% sensitivity for moderate acute malnutrition (MAM) (MUAC ≥115 to <125 mm), with specificity of 99.7% and 91.2%, respectively. The sensitivity of MUAC for children aged 6-23 months was higher than for children aged 24-59 months. The total area of the ROC curve was 0.53 for the MUAC cutoff for SAM and 0.56 for MAM. The optimum MUAC cutoffs for SAM and MAM were 125 mm and 132 mm, respectively.
conclusionsAlthough MUAC can be used as a rapid screening tool to detect wasting in children aged 6-59 months, using the recommended MUAC cutoffs captures only a small proportion of the total number of wasted children. The poor sensitivity and specificity of MUAC compared to WHZ suggests a need to refine admission and discharge criteria for acute malnutrition management programs to ensure that wasting among infants and children in Nepal is consistently and accurately diagnosed and treated.
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