Arriving at Age Specific MUAC Cutoffs for Screening of Moderate Acute Malnutrition and Severe Acute Malnutrition in Children (7–36 Months) From the Tribal Population of Dahod

Abstract

Abstract Objectives To identify SAM and MAM children using WHZ and MUAC. To derive age-appropriate MUAC cut offs for identifying SAM and MAM in children. Assess the sensitivity of MUAC for screening of SAM and MAM in children 7–36 mos. Arriving at age specific MUAC cut offs for identification of acute malnutrition can facilitate early identification of SAM to bring about reduction in under nutrition related morbidity and mortality and promote effective community based management. Methods The study was conducted in Antela and Piplod villages. Limkheda-I was included in the study because of the lesser amount of children found in the above mentioned villages. The prevalence of various forms of undernutrition- stunting, wasting and underweight was found using WHZ, WAZ, HAZ and MUAC. The Prevalence of MAM by MUAC was mapped using the cut-off between the range of 11.5 cm to 12.5 cm and SAM using the cut-off of <11.5 cm. Prevalence of MAM and SAM was mapped by WHZ. The age appropriate MUAC cut offs for identifying SAM and assessing Sensitivity and Specificity of MUAC vis-à-vis the gold standard WHZ were arrived at. Results The highest prevalence of undernutrition was in the form of stunting in the children, followed by underweight and wasting. Correlation between various anthropometric indices and factors likely to affect the same were established and WAZ and WHZ (0.62) were found to be highly correlated. The correlation of present body weight was highest with MUAC indicating that a little change in child's weight would cause change in MUAC thus making it an appropriate indicator of acute malnutrition. Sensitivity and Specificity of various MUAC cut offs were arrived at and Youden index was calculated by plotting ROC curves. MUAC cut off of <11.1 cm had the highest Youden index and the optimal cut off for identifying SAM was <11.1 cm (sen. of 99.9%, sp. 99.7%). Conclusions MUAC is age dependent and therefore age specific MUAC cut offs need to be derived for early detection of SAM. A single cut-off is not adequate to detect SAM. A higher prevalence of stunting, wasting and underweight was seen in males and hence MUAC and WHZ is affected by gender in the present study. Funding Sources The study was funded was UGC DSA SAP III.