ArticleIndian journal of pediatrics2026
Optimizing Mid-Upper Arm Circumference (MUAC) Thresholds for Screening Wasting and Severe Wasting in Children Aged 6-59 Months in Community Settings in India.
Article in Indian journal of pediatrics, 2026. 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
objectivesTo identify suitable mid-upper arm circumference (MUAC) thresholds for screening wasting and severe wasting among children in India.
methodsCommunity-based cross-sectional studies were conducted in five districts from four Indian states- Jharkhand, Odisha, Uttar Pradesh, and Madhya Pradesh. Anthropometric measurements of 2,335 children aged 6-59 mo were taken.
resultsWasting [Weight-for-height Z-score (WHZ) <-2] and severe wasting (WHZ <-3) prevalence were found to be 30.9% and 5.5%, respectively. A strong correlation [0.72 (95% CI: 0.69, 0.74; P < 0.001)] between MUAC and WHZ was observed. However, Cohen's Kappa coefficients of 0.28 (P < 0.001) and 0.36 (P < 0.001) suggested a lack of strong agreement between the current WHZ and MUAC thresholds for detecting wasting and severe wasting. ROC analyses for identifying severe wasting indicated that MUAC of 12.8 cm was appropriate for children aged 6-59 mo (sensitivity: 0.80, specificity: 0.87, AUC: 0.91; 95% CI: 0.89, 0.93). For children 6-23 mo and 24-59 mo, MUAC of 12.7 cm and 13.3 cm respectively were suitable. For identifying wasting, the appropriate MUAC cut-offs were 13.8 cm for children 6-59 mo (sensitivity: 0.82, specificity: 0.69, AUC: 0.84; 95% CI: 0.82, 0.86), 13.1 cm for children 6-23 mo, and 13.8 cm for children 24-59 mo.
conclusionsMUAC is a reliable indicator of WHZ for children 6-59 mo in India. In under-resourced areas where measuring WHZ may be challenging, MUAC cut-offs of < 14.0 cm for wasting and < 13.0 cm for severe wasting can be used for initial screening. Further assessment using WHZ can follow MUAC screening.
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