Mid-upper Arm Circumference Measurements Research Articles

Association of maternal nutritional status and small for gestational age neonates in peri-urban communities of Karachi, Pakistan: findings from the PRISMA study

BackgroundEarly pregnancy nutritional status can be associated with adverse birth outcomes such as small-for-gestational age (SGA) and low birth weight (LBW). BMI (Body Mass Index) and MUAC (Mid-upper arm circumference) are easy to use assessments and are indicative of the pre-pregnancy nutritional status if obtained in the first trimester. This study primarily assesses the association of maternal nutritional status using BMI and MUAC with SGA in a community-based cohort of Pakistani women. It also aims to determine the predictive ability of MUAC and BMI in predicting SGA. Secondarily, we assessed the association between maternal nutrition and large for gestational age (LGA) and LBW.MethodsThis study is a secondary analysis of an ongoing pregnancy cohort “Pregnancy Risk Infant Surveillance and Measurement Alliance (PRISMA)“in Ibrahim Hyderi and Rehri Goth, Karachi. PRISMA participants who were enrolled between January 2021 to August 2022 were included given they had a gestational age < 14 weeks confirmed via ultrasound, MUAC and BMI measurements were available and birth weight was captured within 72 hours. Multivariable logistic regression was used to determine an association between maternal nutritional status and SGA. The PRISMA study was approved by the Aga Khan University Ethics Review Committee (2021–5920-15,518).ResultsOf 926 women included in the analysis, 26.6% (n = 247) had a low MUAC (< 23 cm) while 18.4% (n = 171) were underweight (BMI < 18.5 kg/m2). Nearly one third of low MUAC and underweight women delivered SGA infants (34.4 and 35.1% respectively). Underweight women and women with low MUAC had a statistically significant association with SGA (Underweight: OR 1.49, 95% CI 1.1,2.4; Low MUAC-OR 1.64, 95% CI 1.2,2.3) as well as LBW (Underweight: OR-1.63, 95% CI 1.1,2.4; Low MUAC-OR-1.63, 95% CI 1.2,2.3). ROC curves showed that MUAC and BMI had modest predictability for SGA (AUC < 0.7).ConclusionMaternal nutritional status as indicated by BMI and MUAC are strongly associated with adverse pregnancy outcomes including SGA, LGA and LBW. Although MUAC and BMI are widely used to determine maternal nutritional status, they have poor predictive ability for newborn size. Further research is needed to identify other tools or a combination of tools to better predict adverse birth outcomes in resource-limited settings and plan interventions.

The Predictive and Prognostic Value of Percentage Change in Calf Circumference in Infants and Children During the First Week of Admission in the Pediatric Intensive Care Unit: A Prospective Cohort Study.

Calf circumference (CC) is an easy measure of muscle loss; yet, there are limited studies in children. We aimed to assess the viability of the first-week percent change in CC as a prognostic nutritional marker. Two MUAC (mid-upper arm circumference), CC, and weight measurements were carried out: one on the first day of admission and another on the seventh day. The differences and correlations between their percent changes were examined. The possible association between CC percent change and prolonged length of hospital stay (PLOS) and in-hospital mortality was assessed. Seventy participants were enrolled with a median age of 19.5 months. The median (interquartile range [IQR]) of CC percent change was 0.54 (5.5) with significant correlations between it and each of MUAC and weight percent change (ρ = 0.928, P = .001), (ρ = 0.902, P = .001), respectively. Calf circumference percent changes were significantly more negative in children with PLOS; (P = .004). These changes seem to be viable measures of nutritional status.

Completion of a Nutrition-Focused Physical Exam with hospitalized adults and pediatric patients: Secondary analysis of a prospective cohort study.

Nutrition-Focused Physical Exam (NFPE) feasibility is not well-studied. We describe registered dietitian nutritionist (RDN)-reported NFPE completion for hospitalized adult and pediatric patients overall and by assessment parameters. Trained RDNs systematically conducted NFPEs for hospitalized adult and pediatric patients during the Academy of Nutrition and Dietetics and American Society for Parenteral and Enteral Nutrition Indicators to diagnose Malnutrition multisite cohort study (ClinicalTrials.gov: NCT03928548). RDNs reported their ability to evaluate assessment sites for subcutaneous fat and muscle loss, fluid accumulation, and micronutrient status and to complete handgrip strength (adults and children ≥6 years) and mid-upper arm circumference measurements (children). RDNs noted if they could complete the full NFPE; if not, they noted challenges. We descriptively summarized results and used multilevel logistic regression models to examine relationships between patient characteristics and NFPE completion. RDNs from 39 adult and 29 pediatric US hospitals conducted NFPEs for 327 adults and 214 children aged 1 month to 17.9 years. RDNs reported completing the examination for 44% (n = 145) of adults and 15% (n = 33) of children. They successfully evaluated 25 of 27 and 19 of 26 unique NFPE components in >80% of adults and children, respectively. Common reasons the full NFPE was not completed were limited mobility in adults and patient refusal in children. RDNs had lower odds of completing NFPEs in adults with lower vs higher education levels or higher vs lower nutrition complexity and in younger vs older children. RDNs evaluated NFPE components for a high proportion (>80%) of hospitalized patients.

Caregiver use of MUAC tapes in South Sudan: a three-group prospective comparison.

Nutrition program modifications occurred globally in response to the COVID-19 pandemic. Within community management of acute malnutrition (CMAM), community screenings for acute malnutrition were replaced by caregivers monitoring child mid-upper arm circumference (MUAC), but questions remain about different MUAC tapes' performance and acceptability for caregiver use. The study was conducted in Central Equatoria and Warrap States, South Sudan, between March 2022 and January 2023. A three-group prospective non-randomized design was used to compare the performance of three MUAC tapes (UNICEF 2009, UNICEF 2020, and GOAL MAMI) used by caregivers. The primary outcome was the false negative rate (i.e., the proportion of children not identified as wasted by the caregiver but classified as wasted by enumerators). Caregivers with children aged 5-53 months were assigned to and trained on the use of 1 of the 3 tapes and followed for 8 months, including three monitoring visits and baseline/endline surveys. Of the 2,893 enrolled children, 2,401 (83.0%) completed baseline, endline, and two or more monitoring visits. Only 3.7% of children were identified as wasted by caregivers and 3.8% by study team measurement. Cumulative measurement agreement between caregivers and enumerators was similar by tape. False negative and false positive rates were both <0.5% overall and similar among the tapes. There were differences in training needs and durability between the tapes, but all three were acceptable and performed equally well. Caregiver measurement of child MUAC is feasible in South Sudan. The three MUAC tapes were acceptable, and caregivers could measure accurately with minimal support. All tapes performed similarly and are appropriate for use in Family MUAC programs in South Sudan. There were indications that the UNICEF 2020 tape may be less durable; the GOAL MAMI tape has the added benefit of being suitable for assessments of infants <6 months of age.

Association between nutritional risk status and both diaphragmatic dysfunction and diaphragm atrophy in medical ıntensive care unit patients.

Aim: critical illness often leads to malnutrition and diaphragmatic dysfunction (DD), common in intensive care units (ICU). Ultrasonography (US) is a potent tool for detecting DD. This study examines the connection between malnutrition risk and DD in ICU patients using ultrasonographic diaphragm measurements in medical ICU patients. Methods: we assessed nutritional risk using risk screening tools and mid-upper arm circumference measurements (MUAC). Diaphragm atrophy (DA) and DD were evaluated by measuring diaphragmatic excursion (DE), thickness, and thickening fraction (TF) by US. We then compared these diaphragmatic measurements in patients based on their nutritional risk scores. Results: of the fifty patients studied, 54 % to 78 % were at risk of malnutrition, 28 % exhibited diaphragm atrophy (DA), and 24 % showed DD upon ICU admission. Malnutrition risk diagnosed by all nutritional risk screening tools was significantly more frequent in patients with DD, while diagnosed by MUAC was considerably higher in patients with DA. A total of 16 patients (32 %) died during their ICU stay, with DD, DA, and malnutrition risks (as identified by the mNUTRIC Score) being more prevalent among non-survivors (p < 0.05). Malnutrition risk (as determined by the mNUTRIC Score) was an independent risk factor for DD [OR (95 % CI): 6.6 (1.3-34), p = 0.03]. Conclusion: malnutrition risk may be significantly associated with DD and DA in medical ICU patients upon ICU admission.

Assessment of Nutritional Status of Under Five Years Children in Kolati Bhumlu of Kavrepalanchok District

Background: The nutritional status of children is one of the major indicators of child survival and a proxy indicator for the general health of the population. Malnutrition is a significant public health issue in the majority of developing nations and is particularly prevalent among children under five years of age. Mortality and morbidity among children under-five years of age are influence by nutritional status. The context of Nepal, more than one-third (36%) of children under-five years of age stunted or too short for their age. 10% of children wasted (too thin for height), a sign of acute malnutrition. 27% of children underweight or too thin for their age. These children had greater risk of severe acute malnutrition and death. Objective: Study’s objective was to assess the nutritional status of under-five year’s children and factors associated with malnutrition. Method: A descriptive cross-sectional study conducted in Kolati Bhumlu of Kavrepalanchok district of Nepal. A total of 115 under-five year’schildren and their mothers were included in study. Statistical Package for the Social Sciences (SPSS) version16 was used to analyze the data. Result: The prevalence of underweight was found to be 28.7% according to the classification of malnutrition based on Z- score .Similarly, the prevalence of wasting was found to be 18.3% and the prevalence of stunting was found to be 29.6%. According to Gomez’s malnutrition classification (NCHS/WHO as standard) for Weight for age (underweight) 3.5% children were severely malnourished. According to Water-low’s classification, regarding the height for age (stunting) 9.6% children were severely malnourished. Regarding MUAC measurement 7.8% children had severe malnutrition. The Gender of the child was associated with stunting. Conclusion: In the study population, the high prevalence of malnutrition especially stunting among under-five years children. Taking weight, height, age, and mid- upper arm circumference (MUAC) measurements of malnourished children more than three-fifths of them were below -2SD and nearly one-fourths were below -3SD which needs intervention.

Rotavirus and bacterial diarrhoea among children in Ile-Ife, Nigeria: Burden, risk factors and seasonality.

Diarrhoea is a leading cause of death among under-five children globally, with sub-Saharan Africa alone accounting for 1/3 episodes yearly. Viruses, bacteria and parasites may cause diarrhoea. Rotavirus is the most common viral aetiology of diarrhoea in children less than five years globally. In Nigeria, there is scarce data on the prevalence/importance, burden, clinical/risk factors and seasonality of rotavirus and bacteria and this study aims to determine the role of rotavirus and bacteria on diarrhoea cases in children less than five years in Ile-Ife, Nigeria. Socio-demographic data, environmental/risk factors and diarrhoiec stool samples were collected from children less than five years presenting with acute diarrhoea. Rotavirus was identified using ELISA. Bacteria pathogens were detected using cultural technique and typed using PCR. Diarrhoeagenic E. coli (DEC) isolates were subjected to antimicrobial susceptibility testing. Pathogen positive and negative samples were compared in terms of gender, age-group, seasonal distribution, and clinical/risk factors using chi-square with two-tailed significance. SPSS version 20.0.1 for Windows was used for statistical analysis. At least one pathogen was detected from 63 (60.6%) children having gastroenteritis while 28 (44.4%) had multiple infections. Rotavirus was the most detected pathogen. Prevalence of rotavirus mono-infection was 22%, multiple infection with bacteria was 45%. Mono-infection prevalence of DEC, Shigella spp., and Salmonella spp. were 5.8% (6/104), 5.8% (6/104), and 2.9% (3/104) and co-infection with RVA were 23.1% (24/104), 21.2% (22/104) and 10.6% (11/104) respectively. All rotaviral infections were observed in the dry season. The pathotypes of DEC detected were STEC and EAEC. Parent earnings and mid-upper arm circumference measurement have statistical correlation with diarrhoea (p = 0.034; 0.035 respectively). In this study, rotavirus was more prevalent than bacteria and occurred only in the dry season. Among bacteria aetiologies, DEC was the most common detected. Differences in seasonal peaks of rotavirus and DEC could be employed in diarrhoea management in Nigeria and other tropical countries to ensure optimal limited resources usage in preventing diarrhoea transmission and reducing indiscriminate use of antibiotics.

Nutritional status as predictors for quality of life among caregivers of children with severe cerebral palsy.

Individuals with severe cerebral palsy (CP) often experience various health issues, including feeding difficulties, which can adversely affect their nutritional status and caregivers' quality of life, e.g., more time spent for feeding rather than own selfcare. This study aimed to determine the prevalence of poor nutritional status among individuals with severe CP and explore its role as predictors for caregivers' quality of life. This cross-sectional study was conducted in a government hospital (Cheras Rehabilitation Hospital), Community-Based Rehabilitation (CBR) Program, and Spastic Centre [non-profit organization (NGO)] in Klang Valley, Malaysia. Seventy-one participants with Gross Motor Function Classification System (GMFCS) level IV and V were recruited. Sociodemographic data, health-associated data, and anthropometric data were collected. Caregivers' quality of life was assessed using the Pediatric Quality of Life Inventory (PedsQL) CP module version 3.0 which included domains such as Movement and Balance, Eating Activities, and School Activities. Most participants were males (60.6%), with 61 classified as level IV in the GMFCS classification. According to the Eating and Drinking Ability Classification System (EDACS), 59 children were at level IV. In total, 40.8% were underweight according to CP growth chart and 49.3% had mid-upper arm circumference (MUAC) readings below the 5th percentile. The lowest scores in the PedsQL CP module version 3.0 were observed in the Daily Activities (5.34±10.87), and School Activities domains (8.15±18.65). Sociodemographic and anthropometric data, including body mass index (BMI)-for-age, MUAC, body fat, triceps, and subscapular skinfold measurement, were predictors for the School Activities domain [F (11, 44)=3.981, P<0.005, R2=0.499]. Poor nutritional status in individuals with severe CP has been shown to negatively impact caregivers' quality of life. Therefore, a multidisciplinary approach involving nutritional intervention is essential to improve dietary provision and the nutritional status of children with CP.

An Evaluation of Mid-upper Arm Circumference Measurement in a Neonatal Intensive Care Unit Follow-up Population

An Evaluation of Mid-upper Arm Circumference Measurement in a Neonatal Intensive Care Unit Follow-up Population

Mid-upper arm circumference (MUAC) measurement usage among children with disabilities: A systematic review.

Background: Anthropometric measurements, including mid-upper arm circumference (MUAC), are used for monitoring and evaluating children's nutritional status. Evidence is limited on optimal nutritional assessment for children with disabilities, who are at high risk for malnutrition. Aim: This study describes MUAC use among children with disabilities. Methods: Four databases (Embase, Global Health, Medline, and CINHAL) were searched from January 1990 through September 2021 using a predefined search strategy. Of the 305 publications screened, 32 papers were included. Data included children 6 months to 18 years old with disabilities. Data including general study characteristics, methods for MUAC measurement, terminology, and measurement references were extracted into Excel. Due to heterogeneity of the data, a narrative synthesis was used. Results: Studies from 24 countries indicate that MUAC is being used as part of nutritional assessment, but MUAC measurement methods, references, and cutoffs were inconsistent. Sixteen (50%) reported MUAC as a mean ± standard deviation (SD), 11 (34%) reported ranges or percentiles, 6 (19%) reported z-scores, and 4 (13%) used other methods. Fourteen (45%) studies included both MUAC and weight-for-height but nonstandard reporting limited comparability of the indicators for identifying those at risk of malnutrition. Conclusion: Although its speed, simplicity, and ease of use afford MUAC great potential for assessing children with disabilities, more research is needed to understand its appropriateness, and how it performs at identifying nutritionally high-risk children in comparison to other measures. Without validated inclusive measures to identify malnutrition and monitor growth and health, millions of children could have severe consequences for their development.

Fish Consumption Improved Head Circumference and Mid-Upper Arm Circumference among Infants in Zambia: A Randomised Controlled Trial

Fish is a good source of Animal Source Proteins (ASP). Families from low-income countries with limited access to other animal source proteins can utilize it to improve the nutrition status of infants and young children. The objective of the study was to assess if fish fed during the early complementary feeding period had an effect on improved head circumference (HC) and mid-upper arm circumference (MUAC) among infants aged 6–7 months. A randomised controlled trial was conducted from April 2019 to January 2020 in the Samfya district, Luapula Province, Zambia. The infants (238) were randomised to either the fish group (intervention) or the sorghum group (control). Every week for a period of 6 months, infants received seven sachets of fish powder and sorghum powder, respectively. Compliance was also monitored during the fish powder distribution. The head circumference measurements were conducted at baseline and once each follow-up month for a period of six months while the MUAC measurements were conducted twice (at baseline and endline). Using statistical software for data science (STATA) (version 16), a linear mixed effect model was used to analyse the data. The results showed that fish improved head circumference for age z score (HCZ) by 0.53 (95% CI: 0.23–0.82), p-value &lt; 0.001, and MUAC by 0.36 (95% CI: 0.13–0.59) p-value &lt; 0.002. Therefore, fish can be used as the main source of protein in complementary foods for infants and young children in low-income communities with limited access to meat.

Assessment of thinness based on BMI and MUAC among the adult Jaunsari

Background: Researchers worldwide have tried to develop alternative measures to assess the nutritional status, especially among adults in developing countries. Body mass index (BMI) is a commonly used technique but sometimes difficult to obtain in large-scale surveys. Mid-upper arm circumference (MUAC) has been used as an alternative, but data are limited, especially in the Indian context.&#x0D; Objectives: The objective of the present study was to evaluate the BMI and MUAC of the Jaunsari tribal community of Uttarakhand and to assess whether MUAC is an acceptable proxy for BMI.&#x0D; Sample and Methods: A total of 303 (male 134, female 169) healthy adult Jaunsari individuals aged 18-60 years from Lakhamandal village of Dehradun district of Uttarakhand, India have been selected. Anthropometric measurements of height (cm), weight (kg), and MUAC (cm) were taken following the standard protocol. Globally accepted cut-off values for thinness were used (BMI&lt;18.5kg/m2 and MUAC&lt;24.0cm). Descriptive statistics, Student’s t-test and Chi-square test were performed. The statistically significant level was set at p&lt;0.05.&#x0D; Results: The Jaunsari people of Lakhamandal village of Dehradun district are very thin when following the categories developed by WHO (30.4%). Females are on average thinner than males when assessed by BMI and MUAC. Overweight was found in 12.2% of the village’s people. Individuals are two times more likely to be considered thin when classified by MUAC, than if classified by BMI.&#x0D; Conclusions: Healthy Jaunsari people are on average very thin, but there is already some evidence of overnutrition in a few cases. Thinness when assessed by MUAC is twice as prevalent, than if assessed by BMI.

Assessing Mbiotisho: A smartphone application used to collect high-frequency health and nutrition data from difficult-to-reach populations.

There is an urgent need for improved and timely health and nutrition data. We developed and tested a smartphone application that caregivers from a pastoral population used to measure, record and submit high-frequency and longitudinal health and nutrition information on themselves and their children. The data were assessed by comparing caregiver-submitted measurements of mid-upper arm circumference (MUAC) to several benchmark data sets, including data collected by community health volunteers from the participating caregivers during the project period and data generated by interpreting photographs of MUAC measurements submitted by all participants. We found that the caregivers participated frequently and consistently over the 12-month period of the project; most of them made several measurements and submissions in at least 48 of the 52 weeks of the project. The evaluation of data quality was sensitive to which data set was used as the benchmark, but the results indicate that the errors in the caregivers' submissions were similar to that of enumerators in other studies. We then compare the costs of this alternative approach to data collection through more conventional methods, concluding that conventional methods can be more cost-effective for large socioeconomic surveys that value the breadth of the survey over the frequency of data, while the alternative we tested is favoured for those with objectives that are better met by high-frequency observations of a smaller number of well-defined outcomes.

Minimum Dietary Diversity and Associated Factors Among Pregnant Women Living in Arba Minch Health and Demographic Surveillance Sites, Southern Ethiopia, 2022.

Worldwide 1.2 billion women suffer from micronutrient deficiency. Feeding diversified foods during pregnancy prevents pregnancy complications such as severe anemia, low birth weight, and birth defects. However, the status of minimum dietary diversity and associated factors among pregnant women were not explored in the study area; therefore, this study was conducted at the Arba Minch Health and Demographic Surveillance Sites (AMHDSS). A community-based cross-sectional study was conducted from December 19, 2021, to October 30, 2022, on randomly selected 635 pregnant women. The data were collected through face-to-face interviews, and measurements of mid-upper arm circumference using a tablet; then exported to Statistical Package for Social Sciences version 25. Descriptive statistics were used to describe the characteristics of the study participants and presented by text, figures, and tables. Binary logistic regression was used to determine factors associated with pregnant women MDD-W. Independent variables with a P-value < .05 were considered as associated factors. 98.2% of the pregnant women responded to this survey, more than half, (53.3%) of them achieved MDD-W, and 24.2% of the pregnant women were undernourished. The MDD-W was associated with household food security (AOR = 0.55, CI: .36, .83), meal frequency, (AOR = 1.62, CI: 1.1, 2.5), house ownership (AOR = 0.52, CI: .29, .9), ownership of banana farms (AOR = 1.7, CI: 1.02, 2.8), antenatal follow-up (ANC) (AOR = 1.9, CI: 1.1, 3.3), and occupational status (AOR = 6, CI: 2.1, 17.6). The MDD-W outcome in this study was higher than that in other studies. The MDD-W is associated with, ANC follow-up, meal frequency, living in a food-secured household, ownership of a house, and pregnant women's merchant occupation. For optimal pregnancy outcomes; the AMHDSS and stakeholders might need to work in collaboration to increase ANC coverage and meal frequency for pregnant women. In addition, micronutrient supplementation, and increasing the availability/production capacity of food-insecure households are expected.

S-49-3: THE ASSOCIATION BETWEEN CALF CIRCUMFERENCE AND MID-UPPER ARM CIRCUMFERENCE AND PREVALENCE OF HYPERTENSION: FINDINGS FROM THE PURE CHINA STUDY

Objective: To investigate the association of calf circumference (CC), mid-upper arm circumference (MUAC) and their derivative indexes (waist-to-arm and waist-to-calf circumference ratio) with prevalence of hypertension. Methods: A total of 47,677 individuals aged 35–70 years with measurement of CC, MUAC and blood pressure were available for analysis. CC and MUAC were measured under standardized training. The association of CC and MUAC with hypertension were tested in logistic regression analyses and reported as odds ratio (OR) with 95% CI. Subgroup analysis for BMI was conducted. Results: CC and MUAC were positively correlated with hypertension in the crude model. When adjusted for the BMI and waist, larger CC and MUAC were associated with a lower hypertension prevalence rate. It was stable after adjusted for demographic characteristics, lifestyle behaviors and health status [OR of 0.96(0.91, 1.03), 0.90(0.83, 0.97), and 0.85(0.80, 0.90) for Q2, Q3, and Q4 for CC, P for trend &lt; 0.05, respectively; OR of 1.00(0.94, 1.07), 0.94(0.88, 1.00), and 0.82(0.76, 0.88) for Q2, Q3, and Q4 for MUAC, P for trend &lt; 0.05, respectively]. Larger waist-to-arm and waist-to-calf circumference ratios were correlated with a higher risk of hypertension. For the overweight (BMI 24–28 kg/m2) group, as the CC or MUAC increased, a significant trend for a lower prevalence of hypertension was observed [OR of 0.87(0.77, 0.98), 0.84(0.75, 0.95), and 0.79(0.69, 0.90) for Q2, Q3, and Q4 for CC, P for trend &lt; 0.05, respectively; OR of 0.86(0.76, 0.97), 0.77(0.69, 0.87), and 0.71(0.63, 0.80) for Q2, Q3, and Q4 for MUAC, P for trend &lt; 0.05, respectively].

Assessment of Nutritional Status Among Adult Girls at Peshawar

OBJECTIVES The aim of this study was to examine the relation of Mid Upper Arm Circumference (MUAC) with Body Mass Index (BMI) and waist-to-hip ratio among adult girls. METHODOLOGY A descriptive or cross-sectional study was conducted among adolescent girls 18 plus by BS students at Jinnah college for the women’s University of Peshawar, in collaboration with Pakistan Health Research Council (PHRC) Khyber Medical College Peshawar. MUAC is a useful cheap, and non-invasive technique used for the assessment of nutritional status that has important effects on health in recovery from illness. The analysis of data was conducted as a review of the filled questionnaire. The statistical relationship between variables and their prevalence was assessed using the Chi-Square test. RESULTS Results showed that according to MUAC 20.8% and BMI of 22.55% adult girls were underweight. Our study also revealed that 7(5.83%) adult females were underweight according to MUAC measurements but had normal BMI with a statically significant value of p 0.000. In correlation with waist-hip ratio and MUAC, 24.2% of adult females were having an unacceptable hip ratio (which means that their waist-to-hip ratio is either average, high, or extreme) but had normal MUAC. This correlation between MUAC and waist-to-hip ratio was also highly significant (p 0.046). Besides, we also got the measurements of obese and overweight girls. CONCLUSION In this study, mid-upper arm circumference (MUAC) was statistically and significantly correlated with body mass index (BMI) (p=0.000). As MUAC is a very simple and inexpensive method to assess nutrition, so this is a very good tool to be used in underdeveloped countries like Pakistan.

Newborn Mid–Upper Arm Circumference Identifies Low–Birth Weight and Vulnerable Infants: A Secondary Analysis

Low birth weight (LBW) infants are at increased risk of morbidity and mortality. Identification of LBW may not occur in settings where access to reliable scales is limited. Mid-upper arm circumference (MUAC) may be an accessible, low-cost measure to identify LBW and vulnerable infants. We explored the validity of newborn MUAC in identifying LBW and vulnerable newborns in rural Sierra Leone. This study was a secondary analysis of infant data from a randomized controlled clinical trial of supplementary food and anti-infective therapies compared with standard care for undernourished pregnant women. Data for singleton liveborn infants with birth measurement and 6-mo survival data were included in this analysis. The primary outcome was validity of MUAC in identifying low-birth weight (LBW) neonates. Secondary outcomes included validity of MUAC and head circumference (HC) in identifying weight-for-length z-score (WLZ) <-2, length-for-age z-score (LAZ) <-2, neonatal mortality, and mortality within the first 6 mo of life. The study population included 1167 infants, 229 (19.6%) with LBW. Birth MUAC (r=0.817) and HC (r=0.752) were highly correlated with birth weight. MUAC (AUC: 0.905; 95% CI: 0.884, 0.925) performed superiorly to HC (AUC: 0.88; 95% CI: 0.856, 0.904) in identifying LBW. The MUAC for identifying LBW was 9.6 cm (sensitivity: 0.86; specificity: 0.78). Neither MUAC nor HC reliably identified newborns with WLZ <-2 or LAZ <-2. MUAC ≤9.0cm was the ideal cutoff for neonatal mortality (sensitivity: 53.3%; specificity: 89.7%; HR: 9.57; 95% CI: 1.86, 49.30). Birth anthropometrics did not reliably identify infants at risk of death in the first 6 mo of life. MUAC was used successfully to identify LBW infants and infants at risk of neonatal mortality in Sierra Leone. Further evidence is needed to support increased use of newborn MUAC measurement to identify LBW infants and infants at risk of neonatal mortality in community settings where scales are not available. Primary trial was registered at clinicaltrials.gov as NCT03079388. Mid-upper arm circumference (MUAC) can be used to identify infants with low birth weight and infants at risk for neonatal mortality, with an MUAC ≤9.0cm indicating the highest risk.

Comparing program supervision with an external RADAR evaluation of quality of care in integrated community case management for childhood illnesses in Mali

ABSTRACT Background Many countries have adopted integrated community case management (iCCM) to reduce mortality among children under five years from common childhood illnesses. The 2016–2020 Malian Red Cross iCCM program trained 441 Community Health Workers (CHWs) to treat malaria, pneumonia, diarrhea, and malnutrition for children under five years of age in six districts. Implementation strength and quality of care (QoC) were assessed through the program’s supervision function, using the Malian Ministry of Health’s system. Objective This paper compares methods and results of program supervision data and an independent evaluation to assess the effectiveness of program implementation and supervision and inform program improvement. It also presents the benefits and limitations of each method. Method An independent QoC evaluation was conducted using tools developed by the Real Accountability: Data Analysis for Results (RADAR) project, hereafter referred to as the RADAR evaluation. RADAR evaluation data collected in July and August 2018 were compared with program supervision data collected mostly between May and December 2018. Results The RADAR evaluation provided detailed findings on correct assessment, classification, and treatment per illness, medication type, and dosage. Program supervision combined the findings for all illnesses, medication type, and dosage due to limitations in the data collection process. Six indicators were comparable between both methods. Findings were similar for temperature and mid-upper arm circumference measurements but diverged between program supervision and the RADAR evaluation, respectively, on correct classification for all illnesses (87.1% vs. 65.3%), correct treatment for all illnesses (69.5% vs. 39.8%), correct respiratory rate counting (88.5% vs. 54.7%), and administering the first dose by CHW (75.4% vs. 65.0%). Findings from the RADAR evaluation guided improvements in program supervision. Conclusions A robust program supervision system can serve as a credible method to assess QoC. However, a rigorous independent QoC evaluation provides a valuable benchmark to gauge the effectiveness of the supervisory process.

Magnitude of Severe Acute Malnutrition and Associated Factors among Under-Five Children Attending Treatment Center at Adama Hospital Medical College, Oromia regional state, Ethiopia

Background: Severe acute malnutrition refers to the condition that is identified by the Mid-Upper Arm Circumference measurement of less than 115 mm or weight for height (wasting) less than minus 3SD z-score below the median in 6 to 59 months children. There are limited, documented studies on the level of severe acute malnutrition, and its associated factors among &lt;5 children attending Treatment at Adama Hospital Medical College. Objective: To study magnitude of severe acute malnutrition and associated factors among under-five children attending treatment center at Adama Hospital Medical College, Oromia regional state, Ethiopia. Methods: Hospital based cross-sectional study was conducted on 401 under-five children attending treatment center at Adama Hospital Medical college.Systematic sampling was used to select study participants. The structured questionnaires were used to collect data. The data was entered into SPSS Software version 21 for analysis. Descriptive statistics was used to describes characteristics of study participants using frequencies distribution to check missing data. The association for independent and dependent variables were assessed using logistic regression analysis. The factors with &lt;0.25 in the Bivariate analysis were transferred to multivariate logistic regression analysis to control the impact of confounding variables. Odds ratios with 95%CI were used to assess relation between predict and outcome variables.Summary statistics was declared at P-value of 0.05. Results:The magnitude of Severe Acute Malnutrition among &lt;children visiting hospital was (33.7%). Multivariate analysis showed that severe acute malnutrition was significantly associated with family size ≥5(AOR:1.9(1.01,3.68;95%CI); Late breastfeeding initiation AOR:(3.8(1.91,7.73;95%CI). No exclusive breastfeeding at appropriate time AOR: 3.7(1.59,8.49 with 95%CI), and no appropriate complementary feeding; AOR: 12.0(6.21,24.53). Conclusion and recommendation: The results of this study showed the magnitude of severe acute malnutrition was higher. Families size, late exclusive breast feeding, late initiation of breastfeeding and complementary feeding were factor associated SAM. Based on findings Communities, city administrative health office, health care provider, stakeholders, and government should give due attention, and take necessary intervention before problem intensify.

Association of Anthropometric Measurements, Hemoglobin Level and Salivary Parameters among Caries-free and S-ECC Children.

ContextThe implication of severe dental caries in children may have its effect on general health apart from affecting the orodental tissues. Many children reporting with severe caries have shown weighing less due to malnourishment resulting in anemia and modified somatic growth.AimsStudy aimed to assess and compare anthropometric measurements, hemoglobin level, and salivary parameters among caries-free and severe early childhood caries (E-CCC) children.Settings and designFor caries-free group [Group I] and S-ECC group [Group II] data were obtained from age-matched children with similar socioeconomic status.Materials and methodsChildren with severe caries and without caries from the age-group 3- 6 years participated in the study. Children were measured for height, weight, measurement of mid-upper arm circumference, and waist circumference. Hemoglobin level was recorded. The collected unstimulated saliva was assessed for flow rate, salivary pH, and its buffering capacity.Statistical analysis usedBoth descriptive and inferential statistical analyses were carried out using Windows software and SPSS (21). Tests of significance namely t-test and Chi-square test were used along with regression analysis.ResultsCaries experience showed no statistical difference for age and gender among the sample population. Significant difference was found for all anthropometric measurements. When comparison for hemoglobin was done for both groups I and II, significant difference was observed [p = 0.003].ConclusionChildren with severe dental caries in the present study had low hemoglobin which, if persisted, can lead to anemia. Though the anthropometric parameters may appear normal in children diagnosed with severe early childhood caries, pediatric dentist should ensure the hemoglobin level test, as iron deficiency can affect growth and development of the child, if left undiagnosed.How to cite this articleDeshpande AN, Sudani U, Wadhwa M, et al. Association of Anthropometric Measurements, Hemoglobin Level and Salivary Parameters among Caries-free and S-ECC Children. Int J Clin Pediatr Dent 2022;15(S-2):S164-S171.