Abstract
Children malnutrition is a major public health problem in India. Malnutrition has the maximum impact on children living in rural and tribal areas. Various anthropometric indices such as weight–for-age, height-for-age, weight-for- height and Body Mass Index (BMI) are used to assess the nutritional status of the children. Mid-upper-arm circumference (MUAC) is being used as an alternative to traditional measurements like height and weight, particularly in emergency settings. The World Health Organization (WHO) has recommended MUAC to be used as an independent diagnostic criterion for assessing severe acute malnutrition among children. A total of 4502 children between 6-59 months of age were screened over a period of 12 months, in seven Medicins Sans Frontiers (MSF) Project mobile clinic sites located in states of Andhra Pradesh and Chhattisgarh border areas in India. MUAC was measured with MSF-designed fiber optic measuring tapes. In general, the overall prevalence of malnutrition among 6-59 months children was 15.2%. However the prevalence of malnutrition was higher among children of 6-23 months age group (25.8%) as compared to children of 24-59 months (5.4%). Despite various national nutritional intervention programs have been in operation for about four decades, the malnutrition remains very high particularly among the children living in hilly and remote tribal villages.
Highlights
Periodic growth monitoring of children is an important indicator of the health and nutritional well being of the population
Materials and methods Medicins Sans Frontiers (MSF) teams carried out mid-upper-arm circumference (MUAC) screenings at the Maita, Mallampeta, DharmanaPeta, Pusuguppa, Tippapuram, Yampuram and Puttapalli mobile clinics
The yellow part of the tape indicates that the child is at risk of malnutrition, the orange color indicates that the child is moderately malnourished and the red color indicates a severe malnutrition and threat of death [MSF Refugee Handbook] (Table 1)
Summary
Periodic growth monitoring of children is an important indicator of the health and nutritional well being of the population. India registered an impressive growth in term of GDP during last few years, but the malnutrition rates among the Indian children remains high. Nutritional status was evaluated using anthropometric measures like height, weight and indices like body mass index (BMI)[3]. Mid-upper-arm circumference (MUAC) is being used as an alternative index of nutritional status for children during famines or refugee crises and as an additional screening tool in nonemergencies, and is based on a single cut-off value for all the children less than five years of age[4]. A higher cut off point of 115 mm was recommended later by WHO as it allows to identify a more accurate number of infants and children with severe acute malnutrition and has a high specificity of more than 99% over the age range 6–60 months[6]. There is large body of evidence strongly suggesting that MUAC is a better indicator of acute malnutrition than weight/height for use in emergency feeding programs[7]
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