ArticlePublic health nutrition2025
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.
Article in Public health nutrition, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo assess anthropometric failure prevalence using a composite index of anthropometric failure and evaluate the concordance of mid-upper arm circumference (MUAC) with weight for length z score (WLZ) in identifying acute malnutrition in children.
designWe used data from a pre-proof-of-concept (pre-POC) study conducted in 2022-2023.
settingThe study was conducted in the Vellore district in Tamil Nadu, South India.
participantsWe included all children aged 5-19 months who were pre-screened for the pre-POC study and had available data on weight, length, MUAC, date of birth and child sex.
resultsA total of 663 children were available for analysis, with a mean age of 11·4 months. The prevalence of underweight, stunting and wasting was 23·8 %, 24·3 % and 16·6 %, respectively. 36·7 % of the children had at least one form of anthropometric deficit, and 8·2 % showed severe deficits. We found a fair agreement between MUAC and WLZ values (kappa = 0·32) and a poor agreement of kappa = 0·19 and 0·10 with weight for age z score (WAZ) and length for age z score (LAZ), respectively.
conclusionsThe prevalence of malnutrition remains a significant public health concern in South India, with rates consistent with previous literature. MUAC and WLZ cutoffs by the WHO identify different groups with acute malnutrition. Community-based studies using WLZ criteria can adopt screening with higher MUAC cutoffs, followed by WLZ or, alternatively, WAZ alone, as low WAZ covers most participants with low MUAC and WLZ, providing better feasibility. However, the optimal measurement for risk identification requires further exploration.
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