Diagnostic accuracy of mid-upper arm circumference (MUAC) for detection of severe and moderate acute malnutrition among tribal children in central India
Manoj Rajanna Talapalliwar, Bishan S Garg.
Abstract
Background: Mid-upper arm circumference (MUAC) is used to diagnose severe acute malnutrition (SAM) and moderate acute malnutrition. The performance of MUAC measurements in terms of sensitivity and specificity was varied.
Objective: To evaluate the cutoff values of MUAC for screening SAM among tribal children of Melghat.
Materials and Methods: The cross-sectional study was carried out in the villages of Melghat block of Amravati district, Maharashtra, India. A total of 446 children in the age group 660 months from the study area were assessed by anthropometric measurements using newly developed WHO growth standard. Data were analyzed by using ANTHRO, EPI_INFO 2007, and R software. Sensitivity and specificity of WHO/UNICEF suggested cutoff of MUAC were calculated. Receiver-operating curve (ROC) and Youden Index was calculated to find out the best possible cutoff value of MUAC for diagnosing SAM in these tribal children.
Result: The sensitivity and specificity of MUAC < 11.5 cm was 13.6% and 99.3%, respectively. The best cutoff for screening SAM was obtained at MUAC < 12.8 cm where the sensitivity and specificity was 50% and 90.8%, respectively.
Conclusion: The present cutoff of MUAC < 11.5 cm captures only a small proportion of all children with SAM cases. There is an urgent need to revise cutoff value of MUAC to higher value to improve its sensitivity for detecting children with SAM.
Key words: Severe acute malnutrition (SAM), children, diagnosis, mid-upper arm circumference (MUAC), tribal
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