Mean Mid-upper Arm Circumference Research Articles

What factors are associated with pre-pregnancy nutritional status? Baseline analysis of the KITE cohort: a prospective study in northern Ethiopia

ObjectiveTo assess a broad range of factors associated with pre-pregnancy nutritional status, a key step towards improving maternal and child health outcomes, in Ethiopia.DesignA baseline data analysis of a population-based...

Assessing the role of mid upper arm circumference in identification of low birthweight and wasting in early infancy in India.

We conducted this study to examine the mid upper-arm circumference (MUAC) of full-term infants from birth to 6 months; construct gender-specific MUAC graphs; and assess the role of MUAC as a surrogate marker for low birthweight and wasting in infants younger than 6 months. This is a prospective longitudinal study of 268 (133 female and 135 male) new-borns in a tertiary care centre in Navi Mumbai, India. We measured weight, length, head circumference and MUAC. We drew the MUAC curves for the first 6 months using the mean MUAC and standard deviation (SD) values and assessed the diagnostic test properties of MUAC at birth as a marker of low birthweight. The mean (SD) birthweight of the male and female new-borns was 2756.2g (368.1) and 2803.8g (326.2), respectively (P=0.25). The mean (SD) MUAC at birth was 8.7 (0.3) cm in males and 8.8 (0.2) cm in females, respectively (P=0.14). The plotted mean MUAC curve in infants who were classified with wasting was between the -1SD and -2SD in both genders. The sensitivity and NPV for detecting low birthweight were 100% at cut-off of 8.6cm in females and 8.7cm in males, respectively (area under the curve: 0.92 (females) and 0.96 (males)). MUAC may be a good proxy for low birthweight at birth and the curves from our study show that it may also help in the diagnosis of wasting in infants below 6 months of age in the community, particularly in resource-constrained settings.

Frequency and Outcome of Hypoglycemia in Severely Malnourished Children at Tertiary Care Hospital Larkana

Objective: To determine frequency and outcome of hypoglycemia in severely malnourished children at tertiary care Hospital Larkana.
 Methodology: This descriptive, case series study was carried out at the department of Pediatric Medicine Chandka Medical Hospital Larkana, during 6 months. Severely malnourished children of both gender and age between 6 months to 5 years were enrolled. Severity of malnutrition was evaluated as per standard anthropometric measures i.e. height, body weight, MUAC (mid upper arm circumference) by standard MUAC tape. Hypoglycemia was assessed by checking random blood sugar on glucometer. All the data was recorded via self-made proforma and analyzed by using SPSS version 20.
 Results: Mean age of the patients was 24.27±15.30 months. Mean MUAC was 9.39±1.56. There were 96 (52.20%) females and 88 (47.80%) males. Mean serum glucose level was found to be 86.02±21.58 mg/dL. There were 23(12.50%) patients with hypoglycemia and out of which 16 (69.60%) patients expired and 7 (30.40%) patients survived.
 Conclusion: Hypoglycemia was found to be 12.50% in severely malnourished children and it was significantly associated with adverse outcome.

The Prevalence of Malnutrition in Patients having Chronic Kidney Disease at A Tertiary Care Center in Karachi Pakistan

Background: Chronic kidney disease and associated malnutrition is major health problem in developing countries like Pakistan. CKD patient have been related with body wasting and malnutrition. In this study we assess the prevalence of Malnutrition in chronic kidney disease patients. Objective: To determine the prevalence of malnutrition in patients with chronic kidney disease. Study Design: The type of study is a cross-sectional study. Settings: Dialysis and kidney care center in Karachi-Pakistan. Duration: 6 months from December 2017 to May 2018. Methodology: Patients with chronic kidney disease (CKD) were included and patients with severe comorbid conditions were excluded from the study. Diagnosis of CKD was made via detailed history and clinical examination and relevant laboratory investigations. Patients were classified into 3 SGA grades. Data was collected in a pre-designed proforma. Results: 150 patients were included in the study. The mean age of patients was 58.4 ± 5.86 years. There were n= 93 (62%) males and n= 57 (38%) females. The frequency of malnutrition was n= 63 (42%) were moderately malnourished and n= 32 (21.33%) were severely malnourished. None of the patients under the age of 50 years showed signs of malnutrition. The most common etiology for CKD was diabetes mellitus in n= 75 (50%). The mean BMI of 27.6 ± 5.1 kg/m2, Triceps skin fold thickness was 18.2 ± 7.1 mm and a mean mid upper arm circumference of 23.2 ± 3.9 mm2 respectively. Chi-square test shows a significant association between the incidence of malnutrition and undialysed patients suffering from chronic kidney disease. Having a p-value of <0.001. Conclusion: The frequency of malnutrition in undialyzed patients with CKD was very high, mild to moderate malnutrition was more prevalent than severe malnutrition.

Determining a global mid-upper arm circumference cut-off to assess underweight in adults (men and non-pregnant women).

To determine if a global mid-upper arm circumference (MUAC) cut-off can be established to classify underweight in adults (men and non-pregnant women). We conducted an individual participant data meta-analysis (IPDMA) to explore the sensitivity (SENS) and specificity (SPEC) of various MUAC cut-offs for identifying underweight among adults (defined as BMI < 18·5 kg/m2). Measures of diagnostic accuracy were determined every 0·5 cm across MUAC values from 19·0 to 26·5 cm. A bivariate random effects model was used to jointly estimate SENS and SPEC while accounting for heterogeneity between studies. Various subgroup analyses were performed. Twenty datasets from Africa, South Asia, Southeast Asia, North America and South America were included. All eligible participants from the original datasets were included. The total sample size was 13835. Mean age was 32·6 years and 65 % of participants were female. Mean MUAC was 25·7 cm, and 28 % of all participants had low BMI (<18·5 kg/m2). The area under the receiver operating characteristic curve for the pooled dataset was 0·91 (range across studies 0·61-0·98). Results showed that MUAC cut-offs in the range of ≤23·5 to ≤25·0 cm could serve as an appropriate screening indicator for underweight. MUAC is highly discriminatory in its ability to distinguish adults with BMI above and below 18·5 kg/m2. This IPDMA is the first step towards determining a global MUAC cut-off for adults. Validation studies are needed to determine whether the proposed MUAC cut-off of 24 cm is associated with poor functional outcomes.

KUALITAS DIET, STATUS GIZI DAN STATUS ANEMIA WANITA PRAKONSEPSI ANTARA DESA DAN KOTA

The health status during the preconception period was important to prepare pregnancy. Living patterns that can affect diet quality and nutritional status. This study aimed to analyze the differences in diet quality, nutritional status, and anemia between preconception women in rural and urban areas. This study was conducted using a cross-sectional design that consisted of 68 brides aged 16-35 years selected by consecutive sampling. Diet quality was obtained by diet quality index international (DQI-I) form. Nutritional status based on body mass index (BMI) and mid-upper arm circumference (MUAC). Hemoglobin levels were measured by the cyanmethemoglobin method. Data were analyzed by Independent T-test and Mann Whitney. Subjects in rural and urban areas had low diet quality. The score of variation in the type of protein intake, total fat, and saturated fat was higher in rural areas than urban areas (p=0,001; p=0,013; p=0,002). The mean BMI and MUAC were higher in urban subjects than rural subjects but the hemoglobin levels of rural subjects were higher than urban subjects. The subjects of anemia in urban was 23,5 percent were higher than rural was 14,7 percent but the risk of chronic energy deficiency in rural was 55,9% were higher than urban was 11,8 percent. There were no differences in diet quality and hemoglobin levels between preconception women in rural and urban areas (p=0,990; p=0,116). There were a differences in BMI and MUAC (p=0,026; p=&lt;0,001). There were differences in nutritional status based on BMI and MUAC in both areas. There were no differences in diet quality and hemoglobin levels in rural and urban areas

Relationship between breakfast consumption, BMI status and physical fitness of Ghanaian school-aged children

BackgroundGood nutrition and physical activity of school-aged children are important for ensuring optimum growth and reducing obesity. This present study assessed associations between breakfast consumption, BMI-for-Age (BMI) and physical fitness in a cross-section of school-aged children attending government-owned primary schools in Kumasi, Ghana.MethodThe sample consisted of 438 pupils (boys = 213; girls = 225; mean age 11.1 ± 1.1), attending 10 randomly selected schools. Weight (kg), height (cm) and Mid Upper Arm Circumference (MUAC) were measured for each participant, and BMI-for-age z-scores determined using the World Health Organisation (WHO) anthroplus software. Participants were stratified into thinness, normal weight, overweight/obese using WHO cut offs. Physical fitness was assessed using forward jump, left and right handgrips, flexibility, sit-ups and 50 metre run following standard procedures and converted to scores of 1 to 10 following Japanese standards, based on which percentiles were derived. Total fitness score for each pupil was computed by adding all scores. A questionnaire was used to assess meal intake patterns.ResultsThe mean BMI-for-age z-score for participants was − 0.24 ± 0.99. Thinness, normal weight and overweight/obesity were 2.7, 86.5, and 10.5% respectively among the pupils. Overweight was higher in girls (14.2%) compared to boys (4.2%), p = 0.003. Similarly, mean MUAC was significantly (p = 0.021) higher in the girls (22.0 ± 3.2 cm) than the boys (20.7 ± 7.3 cm). For physical fitness, the girls scored higher in forward jump (p < 0.0001), 50-m run (p = 0.002) and overall fitness score than the boys (21.0 ± 6.2 versus 19.2 ± 8.3, p = 0.012). However, a larger proportion of boys performed excellently and poorly than girls (p = 0.019). A positive correlation was observed between BMI z-score and hand grip (r = 0.21, p < 0.001), while sit up (r = − 0.11, p = 0.018) showed a negative correlation with BMI z-score. No other fitness test varied by BMI. Overweight children performed best in handgrip. Majority of children said they engaged in exercise (89.9%) and consumed breakfast (78.9%). Breakfast consumption was not associated with BMI z-score (x2 0.0359, p = 0.549) but non-breakfast consumers performed better in 50 m run compared to consumers (7.0 seconds ± 2.3 vrs 6.3 seconds ± 2.5, p = 0.022). Children who reported to exercise were physically fitter than those who did not.ConclusionUnderweight levels were low while overweight was over 10% in these children. Girls were more than 3 times affected by overweight than boys, and were also physically fitter than boys. Breakfast consumption was not related to weight or fitness.

Cash and voucher assistance and children's nutrition status in Somalia.

To address ongoing food insecurity and acute malnutrition in Somalia, a broad range of assistance modalities are used, including in‐kind food, food vouchers, and cash transfers. Evidence of the impact of cash and voucher assistance (CVA) on prevention of acute malnutrition is limited in humanitarian and development settings. This study examined the impact of CVA on prevention of child acute malnutrition in 2017/2018 in the context of the Somalia food crisis. Changes in diet and acute malnutrition were measured over a 4‐month period among children age 6–59 months from households receiving household transfers of approximately US$450 delivered either as food vouchers or a mix of in‐kind food, vouchers, and cash. Baseline to endline change in children's dietary diversity, meal frequency, minimum acceptable diet (MAD), mid‐upper arm circumference (MUAC), and acute malnutrition (MUAC < 12.5 cm) were compared using difference‐in‐difference analysis with inverse probability weighting. There were no statistically significant changes in dietary diversity, meal frequency, or the proportion of children with MAD for either intervention group. Adjusted change in mean MUAC showed increases of 0.5 cm (confidence interval [CI; 0.0, 0.7 cm]) in the food voucher group and 0.1 cm (CI [−0.1, 0.4]) in the mixed transfer group. In adjusted analysis, prevalence of acute malnutrition among children under 5 years increased by 0.7% (CI [−13.4, 14.4%]) among food voucher recipients and decreased by 4.8% (CI [−9.9, 8.1%]) in mixed transfer recipients. The change over time in both mean MUAC and acute malnutrition prevalence was similar for both interventions, suggesting that cash and vouchers had similar effects on child nutrition status.

Neonatal mid upper arm circumference as surrogate of birth weight

Background: Recording an accurate birth weight by primary health worker has been a problem in rural areas, leading to search for an alternative, inexpensive, age independent and noninvasive method to predict newborn birth weight and wellbeing. With this background I aimed to found out whether the neonatal-MUAC is associated with birth weight or not?Methods: This hospital based prospective observational study was conducted in SNCU and postnatal ward, Kamla Raja Hospital, G.R. Medical College, and Gwalior (M.P). A total of 1303 newborns were included in the study. The Mid upper arm circumference (MUAC) of newborns were taken and Birth weight recorded were filled in a proforma.Results: Total 1303 neonates were evaluated. The mean MUAC and birth weight in preterm was found to be 1854.80±387.3 and 7.47±0.9 as compared to full term newborn having mean birth weight(2818.95±328.1) and mean MUAC (9.58+0.7).The Pearson coefficient of correlation between neonatal MUAC (N-MUAC) and birth weight was found to be r= 0.987 and p&lt;0.01. Birth weight can be predicted from regression equation: Birth weight (gms)=422.99 (N-MUAC) + (-1272.66). Cut-off value of neonatal mid upper arm circumference (N-MUAC) was found to be 8.85cm to predict low birth weight newborn.Conclusions: Birth weight of newborn can be predicted from neonatal mid upper arm circumference (N-MUAC) in areas where the conventional scale are not easily available for measuring the birth weight of newborn.

Newborn mid-upper arm circumference as valid proxy measure of gestational age

Background: Prematurity is a significant contributor to neonatal mortality in India. Conventionally, gestational age (GA) of newborn is estimated using Naegele’s formula and New Ballard scoring (NBS), a physical and neurological maturity scoring method of newborn. Objective: The current study was aimed to find out an estimation of GA using neonatal mid-upper arm circumference (MUAC). Materials and Methods: This hospital-based prospective observational study was conducted in the sick newborn care unit and postnatal ward of a tertiary hospital of Central India. A total of 1303 newborns were included in the study. The MUAC was taken and the GA assessed by NBS and Naegele’s formula was filled in a pro forma. Results: A total of 1303 neonates were evaluated. The mean MUAC varied from 6.20±0.5 cm among the preterm newborns to 10.27±0.5 cm among newborns born after the 40th week of gestation. The mean MUAC was 8.04±0.6 cm irrespective of GA. MUAC was found to be significantly correlated with GA (r=0.903, p&lt;0.01). Conclusion: MUAC in newborns can be used as surrogate of GA and can be used for its estimation.

Relationship Between Maternal Nutritional Status and Birth Outcome Among Pregnant Women Attending Antenatal Clinic at Yusuf Dantsoho Memorial Hospital Kaduna

This study was undertaken to find out the relationship between maternal dietary pattern, anthropometric indices with birth outcome among pregnant women in their 3^rd trimester attending antenatal clinic at Yusuf Dantsoho Memorial Hospital, Tudun Wada, Kaduna. Sixty-seven mothers – baby pair participated in the study. Weight, height, and Mid Upper Arm Circumference (MUAC) of mothers were measured with unclothed newborn length, weight, head and chest circumference also taken. Results obtained shows mean maternal age, weight, height, and MUAC of 31.20±8.40 years, 70.37±12.73 kg, 1.620±0.07 m, 26.65±4.08 cm, and 26.63±3.80 kg/m² respectively. Majority of the pregnant women (77.60%) had good nutritional status while 16.40%, 6.00% are moderately and severely malnourished respectively. Maternal dietary pattern showed daily to weekly intake of all the food groups with less than 50% except for bread and cereals which is more than 50%. Maternal mean intake of total protein and total calories was close to the recommended daily intake of 60- 75 kg/day, and 2500 – 3000 kcal respectively. Newborn anthropometric measurements indicated that 61.20% were mildly stunted, 70.10% mildly underweight, and 62.70% moderately wasted neonates. Head and chest circumference are within the normal range. Maternal anthropometry and dietary pattern showed a positive correlation with birth outcome.

Integrated multisectoral strategy to improve girls’ and women’s nutrition before conception, during pregnancy and after birth in India (Swabhimaan): protocol for a prospective, non-randomised controlled evaluation

IntroductionSwabhimaan is a community-based programme to improve adolescent girls’ and women’s nutrition in the rural areas of three Indian states—Bihar, Chhattisgarh and Odisha with high prevalence of undernutrition.Methods and analysisSwabhimaan...

Exploring Differences Between Adolescents and Adults With Perinatal Depression-Data From the Expanding Care for Perinatal Women With Depression Trial in Nigeria.

Background: Depression is common among women in the perinatal period. Although pregnancy and motherhood among adolescents are global public health issues, little is known about how adolescents differ from adults in the occurrence and correlates of perinatal depression.Methods: Data were derived from a cluster randomized controlled trial of psychosocial interventions for perinatal depression in primary maternal care in Nigeria (the Expanding Care for Perinatal Women with Depression trial). Adolescents and adult participants recruited during pregnancy and followed up till 6-month postpartum were compared: proportions with depression [screening positive to depression on the Edinburgh Postnatal Depression Scale (score ≥ 12) and meeting the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria using the short form of the Composite International Diagnostic Interview]; adjustment and attitude to pregnancy and motherhood (using the Maternal Adjustment and Maternal Attitudes scale); and parenting skills (measured on Infant–Toddler version of the Home Inventory for Measurement of the Environment). Infant and fetal growth were assessed by measures of weight and head circumference at birth and upper mid-upper arm circumference (MUAC) at 6 months.Results: Of 8,580 adults screened, 6.9% had major depression compared with 17.7% of 772 screened adolescents (p < 0.001). Adolescents had significantly poorer adjustment and attitudes to pregnancy, lower mean fetal gestational age at birth, and a smaller mean baby’s birth weight. At 6-month postpartum, there were no significant differences in the rates of remission from depression between adolescent and adult women (Edinburgh Postnatal Depression Scale score <6). Adolescent mothers continued to have poorer maternal attitudes and parenting skills indicated by significantly lower scores on the Infant–Toddler version of the Home Inventory for Measurement of the Environment responsivity and involvement subscales. Infants of adolescent mothers had a higher rate of undernutrition (defined as MUAC < 12.5 cm) compared with those of adult mothers: 14.8 and 6.3%, respectively (p = 0.008), with the mean MUAC remaining significantly lower for infants of adolescent mothers after adjusting for their lower birth weight (p = 0.04).Conclusion: Perinatal depression is more common and is associated with poorer maternal attitudes and parenting skills in adolescents compared with those in adults. Evidence from this exploratory study suggests that in improving outcomes in infants of adolescent mothers with perinatal depression, depression treatment may need to be supplemented with specific approaches to improve parenting skills.

Assessment of dietary diversity, antenatal care, food taboos, meal frequency, and nutritional status of pregnant adolescents in rural Malawi: a cross-sectional study

High rates of pregnancy during adolescence in Malawi compromise the nutritional status of adolescent mothers and their infants. When a pregnant adolescent is malnourished, she is at risk for health complications. Research focusing on the nutritional status of pregnant adolescents in Malawi is minimal. The purpose of this study was to assess dietary diversity, antenatal care, food taboos, meal frequency, and nutritional status of pregnant adolescents in rural Malawi. The study included sixty-two pregnant adolescents between 15-19 years old. Data collection included the use of a pre-tested questionnaire, standardized dietary diversity survey and measurements of mid-upper arm circumference (MUAC), height, and hemoglobin. Statistical analysis included descriptive analysis, linear and logistic regression. Mean (SD) age was 17.7 (1.2) years. Mean MUAC was 25.9 (2.0) cm; 31% had MUAC <25 cm. The occurrence of stunting was 19% and 21% were ≤150 cm tall. The mean hemoglobin was 10.37 (1.93) g/dL and 66% were anemic. The mean dietary diversity score was 4.06 (1.18) and 69% did not achieve minimum dietary diversity (score ≥ five.) No participants consumed dairy and only 7% consumed eggs. Eating meat and poultry or dark green leafy vegetables predicted a 1.31g/dL (pvalue = 0.0306) or 1.08 g/dL (p-value =0.0331) increase in hemoglobin levels, respectively (R 2 =0.15). Food taboos during pregnancy were common (35%). Compared to the Malawi National Nutrition Guidelines, 87% were not eating daily from each of the six food groups and 74% were not meeting the recommended meal frequency during pregnancy (three meals and at least one snack/day). Less than 50% consumed foods from legumes/nuts and animal food groups. The majority (63%) did not take antenatal supplements and only 37% consumed ferrous sulfate. Only 52% received advice about nutrition during pregnancy and few (8%) received advice about infant and young child feeding. Girls who received nutrition advice were more likely to take an iron supplement [OR=4.19 (1.82-9.68), p =0.0008] compared to those who did not. As the number of antenatal visits increased, the participants were more likely to take a supplement [OR=11.88 (3.40-41.49) p =0.001]. Interventions for pregnant adolescents in rural Malawi should occur early in pregnancy and include education on dietary diversity, increasing hemoglobin levels, meal frequency, food taboos, antenatal supplements and infant and young child feeding. Keywords: Adolescent nutrition, Pregnant adolescents, Dietary diversity, Food taboos, Hemoglobin Afr. J. Food Agric. Nutr. Dev . 2019; 19(3): 14555-14570

Mid-upper arm circumference cut-offs for screening thinness and severe thinness in Indian adolescent girls aged 10-19 years in field settings.

(i) To assess diagnostic accuracy of mid-upper arm circumference (MUAC) for screening thinness and severe thinness in Indian adolescent girls aged 10-14 and 15-19 years compared with BMI-for-age Z-score (BAZ) &lt;-2 and &lt;-3 as the gold standard and (ii) to identify appropriate MUAC cut-offs for screening thinness and severe thinness in Indian girls aged 10-14 and 15-19 years. Cross-sectional, conducted October 2016-April 2017. Four tribal blocks of two eastern India states, Chhattisgarh and Odisha. Girls (n 4628) aged 10-19 years. Measurements included height, weight and MUAC to calculate BAZ. Standard diagnostic accuracy tests, receiver-operating characteristic curves and Youden index helped arrive at MUAC cut-offs at BAZ &lt; -2 and &lt;-3, as gold standard. Mean MUAC and BMI correlation was positive (0·78, P = 0·001 and r 2 = 0·61). Among 10-14 years, MUAC cut-off corresponding to BAZ &lt; -2 and BAZ &lt; -3 was ≤19·4 and ≤18·9 cm. Among 15-19 years, corresponding values were ≤21·6 and ≤20·7 cm. For both BAZ &lt; -2 and BAZ &lt; -3, specificity was higher in 15-19 v. 10-14 years. State-wise variations existed. MUAC cut-offs ranged from 17·7 cm (10 years) to 22·5 cm (19 years) for BAZ &lt; -2, and from 17·0 cm (10 years) to 21·5 cm (19 years) for BAZ &lt; -3. Single-age area under the curve range was 0·82-0·97. Study provides a case for use of year-wise and sex-wise context-specific MUAC-cut-offs for screening thinness/severe thinness in adolescents, rather than one MUAC cut-off across 10-19 years, depending on purpose and logistic constraints.

The impact of maternal antenatal treatment with two doses of azithromycin and monthly sulphadoxine-pyrimethamine on child weight, mid-upper arm circumference and head circumference: A randomized controlled trial.

AimIntermittent preventive treatment in pregnancy (IPTp) with azithromycin and monthly sulfadoxine-pyrimethamine increased the mean child weight, mid-upper arm and head circumference at four weeks of age in a rural low-income setting. Now we assess for how long these gains were sustained during 0–5 years of age.MethodsWe enrolled 1320 pregnant Malawian women in a randomized trial and treated them with two doses of sulfadoxine-pyrimethamine (control) or monthly sulfadoxine-pyrimethamine as IPTp against malaria, or monthly sulfadoxine-pyrimethamine and two doses of azithromycin (AZI-SP) as IPTp against malaria and reproductive tract infections. Child weight, mid-upper arm circumference, head circumference and weight-for-height Z-score were recorded at one, six, 12, 24, 36, 48, and 60 months.ResultsThroughout follow-up, the mean child weight was approximately 100 g higher (difference in means 0.12 kg, 95% CI 0.04–0.20, P = 0.003 at one month; 0.19 kg, 95% CI 0.05–0.33, P = 0.007, at six months), mean head circumference 2 mm larger (0.3 cm, 95% CI 0.1 to 0.5, P = 0.004 at one month) and the cumulative incidence of underweight by five years of age was lower (hazard ratio 0.74, 95% CI 0.60 to 0.90, P = 0.002) in the AZI-SP group than in the control group. The 2 mm difference in the mean mid-upper arm circumference at one month (0.2 cm, 95% CI 0.0 to 0.3, P = 0.007) disappeared after three years of age. There was no difference in mean weight-for-height Z-score at any time point.ConclusionIn Malawi, IPTp with azithromycin and monthly sulfadoxine-pyrimethamine has a modest, 3-5-year positive impact on child weight, mid-upper arm circumference and head circumference, but not on weight-for-height Z-score.

SOCIO-DEMOGRAPHIC CHARACTERISTICS AND PREVALENCE OF UNDER NUTRITION AMONG ADULT SABARS OF BANKURA DISTRICT, WEST BENGAL, INDIA

Nutritional status is an important index of economic growth and development. The status of nutrition of a given population has positively or negatively influenced nation’s economic growth. Our study was designed to find out the relationship between socio-demographic characteristics and nutritional status among adult Sabars. The present cross-sectional study was conducted at six villages under Ranibandh block of Bankura District, West Bengal. A total 226 adults (males = 111 and females = 115) Sabars, aged above 18 years in these village were included in the study. The mean (SD) values of age, family members, family income per month, and per-capita income were 37.32 (16.62) years, 4.63 (1.85) members, 2725.2 (1424.3) Rupees, 691.58 (545.32) Rupees, respectively. The prevalence of illiteracy was 45.0% and 82.6%, respectively among males and females. There was a statistically significant (Chi-square = 39.67, p < 0.001) difference between two sexes. Among males more than 65.8% were daily wage laborers. Among females collection of products was the main occupation (28.7%). The frequency of use of drinking water from tube well, tap and well were 79.2%, 11.1% and 4.4%, respectively. The mean (SD) height, weight, mid-upper arm circumference (MUAC) and (body mass index (BMI) of the subjects were 159.88 (5.93) cm, 49.6 (7.42) kg, 28.38 (7.83) cm and 19.4 (2.59) kg/m2, respectively, among males. The mean (SD) height, weight, MUAC and BMI among females were 1148.9 (5.04) cm, 40.1 (5.88) kg, 22.9 (2.34) cm and 18.0 (2.30) kg/m2, respectively. All mean values were higher among men. The rates of under nutrition were higher (60.0%) among the illiterate group than the literate group (37.0%) based on BMI. Likewise, based on MUAC, the rates of under nutrition were higher (41.4%) among illiterates compared to literates. The prevalence of under nutrition based on BMI and MUAC was high according to the World Health Organization (WHO) guideline, indicating critical nutritional situation. To reduce the nutritional stress among this ethnic group, immediate appropriate nutritional intervention programes should be initiated. Serious efforts are needed to increase their educational status and per-capita income.

Comparison of Weight-for-Height Z-score and Mid-Upper Arm Circumference to Diagnose Moderate and Severe Acute Malnutrition in children aged 6-59 months.

Objective:To compare weight for height (WHZ) and mid upper arm circumference (MUAC) to diagnose malnutrition in children aged 6–59 months and to determine the association of various risk factors with the nutritional status of the children.Methods:Descriptive study conducted at the Department of Paediatric Medicine of The Children’s Hospital Lahore from May 2017 to April 2018. A total of 257 children 6 to 59 months of age having MUAC of <125mm were included. WHZ scoring was done and compared with MUAC.Results:There was slight male predominance 135 (52.5%). Mean age of children was 13.43 + 8.81 months (95% CI: 12.34-14.51). Mean MUAC was 103±13.5 mm (95%CI: 101-105mm). Exclusive breast feeding was present in 82 (32%). Maternal illiteracy was common in SAM (p = was 0.001). More children (73.2%) were identified as SAM by MUAC of <115 mm as compared to WHZ of <-3SD (70%). The ROC curve analysis for MUAC (cut-off value:103, 95%CI; AUC: 101-107 mm) showed it as an excellent predictor (p=<0.001) for children having SAM and WHZ <-3SD, with (AUC= 0.786 [95%CI; 0.725-0.848]).Conclusion:Both MUAC and WHZ showed fair degree of agreement to diagnose moderate and severe acute malnutrition among children aged 6–59 months. At the community level of resource limited countries, MUAC can be used as an appropriate rapid diagnostic method to identify malnourished children to be managed in nutritional rehabilitation programs.

ACUTE MALNUTRITION

Objective: To determine the frequency of low mid upper arm circumference(MUAC) of children with acute malnutrition. Patients and methods: This study was conducted inthe department of paediatrics at Liaquat University Hospital Hyderabad from 01-06-2012 to 30-11-2012. All the children with features of malnutrition, of either gender were recruited andevaluated for their mid upper arm circumference which was measured through plastic measuringtape. Result: During six month study period, total 135 children with acute malnutrition werestudied for their mid upper arm circumference (MUAC), of which 95(70%) were males and40(30%) were females. The mean age ±SD of overall population was 30.24±10.57 month whilethe mean age of male children was 32.88±11.76 and the female child was 31.62±10.97 months.Regarding the MUAC, was low in 93(68.9%) children with acute malnutrition. The mean age ±SDof child with low MUAC was 28.99±12.52 while the mean ±age of male and female child with lowMUAC was 27.63±10.73 and 29.85±11.64 respectively. The mean MUAC in children of acutemalnutrition with low MUAC was 8.85±3.93 while it was 8.66±3.96 and 8.93±3.31 in male andfemale child with low MUAC respectively. Conclusions: The present study suggested that MUACis appropriate and good tool for identifying severe malnutrition in children.

Sex and Gender Differences in Acute Pediatric Diarrhea: A Secondary Analysis of the DHAKA Study

Pediatric diarrheal disease is a significant source of morbidity and mortality in the developing world. While several studies have demonstrated an increased incidence of diarrheal illness in boys compared with girls in low- and middle-income countries (LMIC), the reasons for this difference are unclear. This secondary analysis of the dehydration: assessing kids accurately (DHAKA) derivation and validation studies included children aged <5 years old with acute diarrhea in Dhaka, Bangladesh. The dehydration status was established by percentage weight change with rehydration. Multivariable regression was used to compare percent dehydration, while controlling for differences in age and nutritional status. In this cohort, a total of 1396 children were analyzed; 785 were male (56.2%) and 611 were female (43.8%). Girls presenting with diarrhea were older than boys (median age 17 months vs. 15 months, p = 0.02) and had significantly more malnutrition than boys, even when controlled for age (mean mid-upper arm circumference 134.2 mm vs. 136.4 mm, p < 0.01). The mean percent dehydration did not differ between boys and girls after controlling for age and nutrition status (p = 0.25). Although girls did have higher rates of malnutrition than boys, measures of diarrhea severity were similar between the two groups, arguing against a cultural bias in care-seeking behavior that favors boys.