Mid Upper Arm Circumference Tape Research Articles

Validity of "Mid-Upper Arm Circumference" as a Parameter to Identify Undernourished Children in Rural Gujarat.

Mid-upper arm circumference (MUAC) measures the arm muscle and fat area. The use of MUAC as a screening measure for assessing undernutrition has the following advantages; it makes use of a simple equipment, is easy to carry at the field sites, and requires minimal training. In India, "mid-upper arm circumference" is widely used and accepted in many nutritional programs. This study was conducted with the primary objective to compare different anthropometric parameters of children and to validate the usefulness and limitations of MUAC to screen out undernourished children. Anthropometric measurements were recorded for all the anganwadi centers of the selected sub-center that comes under the field practice area of our department. The measurements like weight, height, MUAC were done according to the standard guidelines as per WHO, and further, calculations were done with the help of "Anthro software 3.2.2." Comparisons were done between categorization of MUAC tape and Weight-for-Height Z-scores (WHZ), and hence, the sensitivity and specificity of the MUAC tape to screen the malnourished child were found out. Sensitivity of MUAC to categorize a child in red/yellow was only 9.03%, negative predictive value (NPV) was 40.75%, specificity came 95.10%, and positive predictive value was 73.68% on taking WHZ as the gold standard. MUAC has a limited role in screening out an undernourished child (red/yellow category), whereas it has a good role in screening healthy children (green category).

Assessment of nutritional status with its associated factors in pregnant women attending antenatal care at Ambo Health Centers, Oromia Region, Ethiopia

Nutritional status during pregnancy, maternal nutrition requires considerable attention; however, pregnant women’s nutritional knowledge and practices are less understood. The objective of this study was to assess nutritional knowledge and practices among pregnant women who attend antenatal care at Ambo and Awaro Health Center of Ambo Town, Oromia Region, Ethiopia. The study was conducted from January to May of the year 2022, using a cross-sectional descriptive study on a sample of 284 pregnant women who attended antenatal care services in Awaro and Ambo health centers. Systematic sampling techniques were used to select pregnant mothers by using Health center registration lists. Socio-demographic and socio-economic data were collected using a structured interviewer-administered questionnaire. Mid-Upper Arm Circumference (MUAC) was measured by standard nonstretchable MUAC tape. Binary and multiple logistic regression analysis was conducted using the Statistical Package for Social Sciences (SPSS) program version 20 for further analysis. The finding of associated factors that affect the nutritional status of mothers was the income level of the family has a strong statistical association with the nutritional status of mothers (p<0.001), occupational status of the respondent has a significant association with nutritional status (p<0.05) and also knowledge about the importance of food for growth and development of fetus of mother have significant association (p<0.05). Hence, the government in collaboration with concerned bodies should focus on nutritional education and information of pregnant mothers on maternal nutrition during pregnancy in the study area.

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.

Family MUAC supported by a two-way SMS platform for identifying children with wasting: the Mama Aweza randomised controlled trial

Effective methods of preventing and identifying childhood wasting are required to achieve global child health goals. Family mid-upper arm circumference (MUAC) programs train caregivers to screen their child for wasting with MUAC tapes. We assessed the effectiveness of a two-way short message service (SMS) platform (referred to as the Maternally Administered Malnutrition Monitoring System [MAMMS]) in western Kenya. In this individual-level randomised controlled trial in two rural countries in western Kenya, children (aged 5-12 months) were randomly allocated (1:1) to receive either standard care (SOC) or MAMMS. Randomisation method was permuted-block randomisation with a block size of 10. Eligible participants were children attending maternal child health clinics in the two counties whom had a MUAC between 12.5 and 14.0cm. The MAMMS group received two MUAC tapes and weekly SMS reminders to screen their child's MUAC. The SOC group received routine community health volunteer services and additional quarterly visits from the study team. The primary analysis used a cox proportional hazards model to compare SOC and MAMMS time-to-diagnosis of wasting (MUAC <12.5cm) confirmed by a health professional during 6-months follow-up. Secondary outcomes were days from enrolment to treatment initiation among children with wasting, proportion of all children with wasting who were identified by the two approaches (treatment coverage), mean MUAC at treatment initiation, and duration of wasting treatment. This trial was registered on ClinicalTrials.gov, NCT03967015. Between August 1, 2019 and January 31, 2022, 1200 children were enrolled, among whom the incidence of confirmed wasting was 37% lower in the MAMMS group (hazard ratio: 0.63, 95% CI: 0.42-0.94, p=0.022). Among children with wasting, the median number of days-to-diagnosis was similar between study groups (MAMMS: 63 days [interquartile range (IQR): 23-92], SOC: 58 days [IQR: 22-94]). Treatment coverage in the MAMMS group was 83.3% (95% CI: 39.9-100.0) while coverage in the SOC group was 55.6% (95% CI: 22.3-88.9%, p=0.300). Treatment duration and mean MUAC at treatment initiation were similar between groups. Family MUAC supported by SMS was associated with a 37% reduction in wasting among young children. Empowering caregivers to monitor their child's nutritional status at home may prevent a substantial proportion of moderate wasting. Thrasher Research Foundation and Pamela and Evan Fowler.

Prevalence and multi-level factors associated with acute malnutrition among children aged 6–59 months from war affected communities of Tigray, Northern Ethiopia, 2021: a cross-sectional study

BackgroundArmed conflicts greatly affect the health, nutrition, and food security of conflict affected settings particularly children. However, no empirical data exist regarding context specific factors contributing towards acute malnutrition in the war-torn Tigray, Ethiopia. Thus, this study aimed to identify individual and community level factors associated with acute malnutrition among children aged 6–59 months from armed conflict affected settings of Tigray, Ethiopia.MethodsA community based cross-sectional study was conducted among 3,614 children aged 6–59 months in Tigray, from July 15 to Aug 15, 2021. Study participants were selected using a two-stage random sampling method. A structured questionnaire was used to collect data by interviewing mothers/caregivers. Mid upper arm circumference (MUAC) measurements were taken from upper left arm of the children using MUAC tapes. Multivariable multilevel logistic regression analysis was used to determine factors associated with acute malnutrition. Adjusted Odds ratio (AOR) with 95% CI were estimated to describe the strength of associations at p < 0.05.ResultsMore than half (52.5%) of the sampled children were males in sex. Immediately after the first nine months into the conflict, the prevalence of severe, moderate, and global acute malnutrition was very high (5.1%, 21.8%, and 26.9%, respectively) in Tigray. The lowest and highest burden of child acute malnutrition was reported from Mekelle zone (13.3%) and Southeastern zone (36.7%), respectively. Individual-level factors such as older child age (AOR = 0.13, 95% CI: 0.10, 0.18), female child sex (AOR = 1.24, 95% CI 1.05, 1.480.95), Vitamin-A supplementation (AOR = 1.3, 95% CI: 1.05, 1.65), and history of diarrhea (AOR = 1.22, 95%CI: 1.02, 1.53) and community-level factors like unimproved drinking water source (AOR = 1.31, 95%CI: 1.08, 1.58), unimproved toilet facility (AOR = 1.24, 95% CI: 1.01, 1.52), and severe food insecurity (AOR = 1.55, 95% CI: 1.16. 2.07) were significantly associated with childhood acute malnutrition.ConclusionsThe burden of acute malnutrition is a severe public health problem in Tigray. To prevent the untimely suffering and death of children, regular nutrition screening, speedy, and appropriate referral of all malnourished children to nutritional services and large-scale humanitarian assistance including access to food; nutrition supplies; water, sanitation and hygiene supplies; and health care in a timely manner are required. In the prevailing armed conflict, these have been very difficult to achieve. Thus, immediate international intervention is needed.

Prevalence of severe acute malnutrition among 6-59 months children from community-based SAM management program in Dungarpur district of southern Rajasthan: diving deeper through study of block-wise prevalence

Background: Acute malnutrition (severe and moderate) is a major public health problem in India and especially Rajasthan. National family health surveys now provide prevalence of SAM children till district level but there’s an undenying need for data at even more granular, like block level, to assess the field reality in more depth. The present study tries to demystify the same at block level by studying data collected from a community-based SAM management program i.e., AMMA (acute malnutrition management action) program in Dungarpur. Methods: As part of AMMA program, block wise data from 20 districts of Rajasthan was collected monthly during implementation and its dedicated MIS was used as the source of this data. The data includes information of all children screened in the age-group of 6-59 months in Dungarpur district which was subsequently analyzed and studied till block level. The SAM prevalence is assessed, using Mid Upper Arm Circumference (MUAC) of 6-59 months children. &lt;12.5 cm of MUAC was considered as acute malnutrition while &lt;11.5 cm of MUAC was considered as SAM as per WHO standards. Results: A total of 1,13,547 children were screened (84.91%) in the study period. A total of 4829 children (4.25%) were found with Acute Malnutrition, out of which 4622 were identified with moderately acute malnutrition (MAM) and 207 are identified with SAM. Out of total 207 children with SAM, 118 were girls (57%) while 89 (43%) were boys. The prevalence of SAM children in the district came out as 0.18% whereas state prevalence is 0.9%. Among blocks the SAM prevalence varied from as low as 0.02% in Dowda and Chikhali to as high as 0.63% in Jothari block. Conclusions: Prevalence of SAM in Dungarpur district is low at 0.18% but block-wise analysis helped in further disaggregating the burden. To identify all children with acute malnutrition in the district there’s an urgent need to do screening based on WFH Z-score instead of complete reliance on MUAC tape.

Validation of a Useful Tool for Screening for Overweight and Obesity in Pre-Adolescents

The purpose of this observational study with a convenience sample is to validate a simple measurement of the mid-upper arm circumference to establish the screening points using the mid-upper arm circumference tape (MUAC) for childhood overweight and obesity between 9 and 12 years of age, or from 4th grade to 6th grade. Prior to the screening study, a pilot validation study of the MUAC tape measure versus anthropometric standard tape was carried out. The total sample for the screening cut-offs was 360 school students. The results obtained had a predictive value according to the evaluation of the area under the curve of 0.96 and overweight detection cut-off points were established at 23.3 and 22.4 cm for 4th grade, 23.6 and 22.7 cm for 5th grade and 24.6 and 23.8 cm for 6th grade for boys and girls, respectively. The cut-off points for the detection of obesity were established at 25.2 and 23.9 cm for 4th grade, 26.4 and 25.1 cm for 5th grade, and 27.7 and 26.4 cm for 6th grade boys and girls, respectively. The cut-off values of the MUAC are different not only between the sexes, but also increase as age or the specific course increases.

Методы оценки нутритивного статуса у детей с неврологическими заболеваниями

Improving approaches to the diagnosis of nutritional disorders in children has great scientific and practical importance. This study examines the possibilities of using the Mid-Upper-Arm Circumference (MUAC) screening tool for nutritional status assessment in clinical practice. Objective. To evaluate the efficacy of MUAC screening tool for nutritional status assessment in children with neurological disorders. Patients and methods. This study included 309 children with epilepsy, cerebral palsy and congenital anomalies of the central nervous system aged 5 to 15 years (mean age: 9.8 ± 3.6 years) who were treated in a multidisciplinary hospital. Among them, there were 190 (61.5%) boys and 119 (38.5%) girls. Physical development was assessed using the WHO AnthroPlus software and compared with MUAC tape measurements. During data processing, sensitivity and specificity indices were calculated. Results. Among the examined patients, malnutrition (BMI-for-age Z-score &lt;-2) was detected in 39 (12.6%) children, according to MUAC tape measurements – in 72 (23.3%) children. When evaluating the efficacy of MUAC screening tool in diagnosing malnutrition in children (Z-score &lt;-2), sensitivity was 94.9% and specificity was 81.1%. Conclusion. The prevalence of malnutrition among children aged 5 to 15 years detected by the MUAC tape was higher compared to the results obtained through the WHO AnthroPlus software. The MUAC approach is characterized by high levels of both specificity and sensitivity. More research is needed to expand the scope of MUAC tape application in pediatric practice. Key words: children, overweight, neurological disorders, malnutrition, nutritional status, MUAC

Energy Intake and Food Restriction as Determinant Factors of Chronic Energy Deficiency among Pregnant Women in Rural Area of Sungai Sembilan, Riau, Indonesia

BACKGROUND OF THE STUDY: Maternal malnutrition is a major public health problem in Indonesia which is shown by high prevalence of chronic energy deficiency (CED) among pregnant women. CED was expressed by the measurement of Mid Upper Arm Circumference (MUAC) showing value less than 23.5 cm.&#x0D; AIM OF THE STUDY: This study aimed to identify the factors associated with chronic energy deficiency among pregnant women in rural area, Riau Province.&#x0D; METHODOLOGY: A community- based cross sectional study was conducted among 130 samples of pregnant women in Sungai Sembilan Community Health Center in June 2020. Data was collected using structured and field-study questionnaires. Mid Upper Arm Circumference (MUAC) was measured by MUAC tape. Energy and protein intake were assessed using 24-hour food recall. Multiple logistic regression was employed to analyse factors associated with CED by using SPSS version 20.&#x0D; RESULTS: The prevalence of CED among pregnant women was 64.9%. Age of mothers, food restriction, infection disease status, protein and energy intake were associated significantly with CED. Furthermore, energy intake and food restriction in pregnancy were risk factors of CED (AOR = 3.04, 95% CI: 1.1 – 8.3 and AOR = 6.73, 95% CI: 1.33 – 33.9, respectively). We found that proportion of energy intake below 80% RDA and mothers with food restriction were higher among CED group.&#x0D; CONCLUSION: High prevalence of chronic energy deficiency (CED) was found among pregnant women. Hence, innovative intervention was required to overcome this problem.

Food Consumption, Dietary Diversity and Associated Factors in Pregnant Women Receiving Ante-Natal Care in East Gojjam Zone, Amhara, Ethiopia

Introduction: Dietary Diversity Score (DDS) and Food Consumption Score (FCS) are indices developed to indicate micronutrient deficiency and food inadequacy. This study assessed the association between socio-economic-demographic, environmental, anthropometric and risky behavioral factors with DDS and FCS. Although these indices are significantly applicable in low-income countries set up, limited studies have been conducted on the effect of these factors on DDS and FCS. Materials and Methods: An institutional-based cross-sectional study was conducted on 423 pregnant women of<17 weeks gestation from randomly selected health institutions in five Woredas that are located in the local administration of Amhara Regional State from June 2019 to October 2019. Weekly and daily nutritional reports were collected using food frequency questionnaires. In addition, the Mid Upper Arm Circumference (MUAC) of each participant was also recorded using a “MUAC tape”. Moreover, Wealth Index (WI) was developed and categorized using principal component analysis. Bivariate and multivariable logistic regression were calculated between DDS and/or FCS and their associated factors. Results and Discussion: The prevalence of low DDS and FCS were 53.2 and 19.7%, respectively. Attainment of education up to junior school level (AOR of 0.260 (0.096, 0.709); P<0.009), low FCG (0.008 (0.001, 0.058); P<0.0001), alcohol (0.307 (0.145, 0.651); P<0.002) and frequent coffee consumption (0.393 (0.177, 0.874); P<0.022) were found to be significant risks for low DDS. Whereas, sharing toilets with other households and low DDS were associated with low FCS with AOR of=0.396 (0.174, 0.901); P<0.027 and 0.008 (0.001, 0.06) P<0.0001, respectively. In addition, the poorest WI quintile reduced the probability of the DDS by 53.9% while an increased MUAC will put the participant in the adequate or high DDS group by 11%. Conclusion and Recommendation: Low level of education, low FCS, poorest WI, low MUAC, alcohol and frequent coffee consumption were found to contribute to the reduction in DDS. A low FCS was associated with the use of a shared toilet between households as well as low DDS. Therefore, aggressive promotion of women’s education, provision of health education about the use of diversified or fortified food and supplementation of micronutrients, ceasing alcohol and coffee consumption is recommended. Moreover, policies on fostering plant and animal food production and consumption would be of high priority. In addition, the fortification of food with essential amino acids and micronutrients, and supplementation of MMN should be encouraged until sufficient production and diversification of the consumed food are attained.

Mid-Upper Arm Circumference Tapes and Measurement Discrepancies: Time to Standardize Product Specifications and Reporting.

In recent years, community-based management of acute malnutrition (CMAM) has revolutionized the care for children by increasing treatment coverage. Critical to the success of CMAM is early case identification. Mid-upper arm circumference (MUAC) measurement is a widely used, practical anthropometric measure used at the community level for the identification and admission of cases to appropriate treatment services. Globally, many organizations and government services use MUAC tapes for early case detection. However, there is no one universal MUAC tape specification, and it has been observed that using different MUAC tapes results in different measurements. In this article, we aim to: (1) present the measurement discrepancies; (2) discuss design specifications and their effect on case identification and admissions; (3) present a call to action to agree on common design specifications and standardized reporting. We hope this article will catalyze discussion and practical actions among nutrition and health stakeholders to ensure we have common MUAC tape design specifications so that all eligible at-risk children will get an equal chance to be identified early for critical treatment.

Prevalence of undernutrition and its associated factors among pregnant women in Konso district, southern Ethiopia: a community-based cross-sectional study

BackgroundUndernutrition during pregnancy is an important public health problem. It is highly prevalent in Ethiopia but not sufficiently addressed yet. Hence, this study aimed to assess the prevalence of undernutrition and its associated factors among pregnant mothers in Konso district, Ethiopia.MethodsCommunity-based cross-sectional study was conducted with a qualitative inquiry from December 2018 to January 2019. A multistage stratified sampling technique was used to select 527 subjects and quantitative data were collected from these subjects using a structured interviewer-administered questionnaire and additionally qualitative data were generated through two focus group discussions among purposely selected discussants. Mid upper arm circumference (MUAC) was measured by standard non-stretchable MUAC tape. Data were entered into Epi-data version3.1 and analyzed by SPSS version 21. In multivariable binary logistic regression, a statistically significant association was declared at p-value < 0.05 while thematic framework analysis was employed for the qualitative data.ResultsAmong 501 participants, the overall prevalence of undernutrition (MUAC < 23 cm) was 43.1% (95% CI 38.7–47.5%). Household food security (AOR = 3.1; 95% CI: 2.1–4.6), low dietary diversity score (AOR = 4.9; 95% CI: 2.6–9.2), medium dietary diversity score (AOR = 2.3; 95% CI: 1.2–4.7), absence of latrine (AOR = 1.8; 95% CI: 1.2–2.6) and having family resource decision making by husband only (AOR = 1.7; 95% CI: 1.1–2.6) were significantly associated factors. Traditional believes to restrict food such as egg, milk, and milk products, avocado for women, weak nutrition education and malnutrition screening program, daily consumption of locally prepared alcoholic drink called “Cheka”, drought-prone nature of this setting, traditional way of farming practices and low socio-economic status were found to be barriers for women’s undernutrition.ConclusionsThe prevalence of undernutrition was found to be higher than previously reported findings. Household food security, dietary diversity, latrine availability, family resource decision making, food restrictions, weak maternal nutrition education, and malnutrition screening program, the practice of depending on a local alcoholic drink called “Cheka”, drought, traditional way of farming and low socio-economic status were identified factors. Hence, interventions targeting maternal nutrition education, hygiene, and sanitation promotion, household food insecurity improvement strategies should be implemented to improve the nutritional status of pregnant women.

Upper arm length along with mid-upper arm circumference to enhance wasting prevalence estimation and diagnosis: sensitivity and specificity in 6–59-months-old children

ObjectiveTo evaluate the added value of the use of upper arm length (UAL) along with mid-upper arm circumference (MUAC) to diagnose and estimate the prevalence of wasting in comparison to...

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.&#x0D; 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.&#x0D; 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.&#x0D; Conclusion: Hypoglycemia was found to be 12.50% in severely malnourished children and it was significantly associated with adverse outcome.

Prevalence and associated factors of undernutrition among pregnant women visiting ANC clinics in Silte zone, Southern Ethiopia

BackgroundMaternal undernutrition is highly prevalent in underdeveloped countries. Hence, this study was intended to determine the prevalence and associated factors of undernutrition among pregnant women visiting ANC clinics in Silte Zone.MethodFacility-based cross-sectional study was conducted from July to January 2019. Systematic random sampling technique was used to select 422 study participants from 11 randomly selected health facilities. Data was collected by using a structured-interviewer administered questionnaire. Mid upper arm circumference (MUAC) was measured by standard non stretchable MUAC tape. Data was entered into a computer using Epi data 3.1 and edited, cleaned, and analyzed using SPSS version 20. Both bivariate and multiple logistic regression analyses were employed to identify factors associated with maternal undernutrition.ResultIn this study, the overall prevalence of undernutrition among study subjects was 21.8%. Age greater than 31 years of women (AOR = 0.15; 95% CI: 0.03, 0.93), Birth intervals > 2 years (AOR = 0.18; 95% CI: 0.04, 0.76), good nutritional knowledge (AOR = 0.34; 95% CI: 0.17, 0.67), and having no dietary change as a result of current pregnancy AOR = 6.02; 95% CI: 2.99, 12.14) were significantly associated with undernutrition.ConclusionsThe prevalence of undernutrition among pregnant women was 21.8%. Current estimate is lower than previously reported in the study area but higher than reported in developed country. Age of women, Birth intervals, and Dietary change as a result of current pregnancy and Nutrition knowledge were important risk factors/ predictors of undernutrition (MUAC < 23 cm). Interventions targeting maternal nutrition education and child spacing with giving special emphasis to adolescent pregnant women are recommended.

Impact of a two-way short message service (SMS) to support maternally administered childhood mid-upper arm circumference monitoring and expand malnutrition screening in Kenya: the Mama Aweza trial protocol

IntroductionOver 52 million children under 5 years of age become wasted each year, but only 17% of these children receive treatment. Novel methods to identify and deliver treatment to malnourished...

Factors associated with dietary practice and nutritional status of pregnant women in Dessie town, northeastern Ethiopia: a community-based cross-sectional study

BackgroundMaternal undernutrition is highly prevalent in resource-poor settings. Hence, this study was intended to determine factors associated with the dietary practice and nutritional status of pregnant women in Dessie town, northeastern Ethiopia.MethodsCommunity-based cross-sectional study design was employed. Six hundred four (604) pregnant women have participated. A two-stage sampling method was applied to select participants. Socio-demographic and socio-economic data were collected using a structured interviewer-administered questionnaire. The dietary practice was measured using 13 dietary practice questions. Mid upper arm circumference (MUAC) was measured by standard nonstretchable MUAC tape. Data were entered into Epi-Info 7 and exported to SPSS version 20. Binary and multiple logistic regression analysis was conducted. Variables with P < 0.2 in bivariate analysis were entered for multiple logistic regression. At a 95% confidence interval, variable with 푃< 0.05 in multiple logistic regression analysis was considered statistically significant.ResultAbout 54.8% of the pregnant women had poor dietary practice and 19.5% were undernourished. First trimester of pregnancy (AOR = 0.46; 95% CI: 0.26, 0.80), no history of illness 2 weeks before data collection date (AOR = 0.42; 95% CI: 0.22, 0.80), poor perceived severity (AOR = 1.64; 95% CI: 1.15, 2.33), poor perceived benefits (AOR = 1.63; 95% CI: 1.14, 2.32) and poor self efficacy (AOR = 4.74; 95% CI: 2.94, 7.65) were significantly associated with poor dietary practice. Not attending antenatal care (ANC) (AOR = 3.46; 95% CI: 2.07, 5.78), illness (AOR = 1.93; 95% CI: 1.10, 3.5), poor dietary diversity (AOR = 5.92; 95% CI: 3.59, 9.76), poor nutrition knowledge (AOR = 3.03; 95% CI: 1.87, 4.92), poor dietary practice (AOR = 3.25; 95% CI: 1.91, 5.54) and poor perceived self efficacy (AOR = 5.59; 95% CI: 3.56, 8.79) were significantly associated (P < 0.05) with undernutrition.ConclusionThe dietary practice of pregnant women was suboptimal and nutritional status was relatively high. Being in the first trimester of pregnancy and no history illness were negatively associated while poorly perceived severity to malnutrition, poor perceived benefits, and poor self-efficacy were positively associated with the poor dietary practice. Not attending ANC, history of illness, poor dietary diversity, poor nutritional knowledge, poor dietary practice, poorly perceived self-efficacy were positively associated with undernutrition. Government, health extension workers and other concerned bodies should encourage pregnant women to attend ANC, promote health during pregnancy, strength and counsel to improve dietary diversity and practice of good nutrition. They should focus on the perceived belief of dietary behaviors.

Accuracy of new CIMDER tapes and the standard MUAC tape for screening nutritional status in children

Background: The mid-upper arm circumference (MUAC) to assess children nutritional status under 5 years of age, has been used since late fifties. Methods: The study was conducted to assess the accuracy in classifying the nutritional status of children under 5 years of age using the new CIMDER tapes compared to the new standard MUAC tape S0145620, distributed by UNICEF, taking weight-for-age as gold-standard from WHO multicenter study. Results.

Risk Factors Associated with Low Birth Weight

Neonatal deaths are associated with preterm birth complications. Preterm birth is also related to low birth weight (LBW), which can have multiple causes. The aim of this study was to analyze the risk factors associated with LBW. This was a cross-sectional study held in Bulu Primary Health Care, Temanggung, Central Java, Indonesia. The sample size required for this study was 69 based on the Slovin formula. Data were collected using questionnaires and semi-quantitative FFQ forms. Data on infant birth weight was taken from midwives’ delivery cohort records. Mid upper arm circumference (MUAC), hemoglobin level, blood pressure, maternal age, parity, nutritional intake, and serum transferrin receptor data were taken from the infant’s mother using a MUAC tape, automatic blood pressure monitor and blood laboratory analysis by Prodia. Data analysis procedures were carried out with quantitative methods. Descriptive statistics were analyzed as means and standard deviations. Inferential statistics used the chi-square test for bivariate analysis and binary logistic regression for multivariate analysis. The results of this study showed that mean infant birth weight was 2917.68 ± 374.673 kg. Inferential analysis showed that MUAC and pregnancy at a risky age are significant risk factors associated with LBW, while serum transferrin receptor levels, anemia, parity, energy and protein consumption levels, and systolic and diastolic blood pressure are nonsignificant risk factors. The probability of LBW in pregnant women with LILA under 23.5 cm and pregnancy at a risky age is 68.9%.

Comparing performance of mothers using simplified mid-upper arm circumference (MUAC) classification devices with an improved MUAC insertion tape in Isiolo County, Kenya

BackgroundA novel approach for improving community case-detection of acute malnutrition involves mothers/caregivers screening their children for acute malnutrition using a mid-upper arm circumference (MUAC) insertion tape. The objective of this study was to test three simple MUAC classification devices to determine whether they improved the sensitivity of mothers/caregivers at detecting acute malnutrition.MethodsProspective, non-randomised, partially-blinded, clinical diagnostic trial describing and comparing the performance of three “Click-MUAC” devices and a MUAC insertion tape. The study took place in twenty-one health facilities providing integrated management of acute malnutrition (IMAM) services in Isiolo County, Kenya. Mothers/caregivers classified their child (n=1040), aged 6–59 months, using the “Click-MUAC” devices and a MUAC insertion tape. These classifications were compared to a “gold standard” classification (the mean of three measurements taken by a research assistant using the MUAC insertion tape).ResultsThe sensitivity of mother/caregiver classifications was high for all devices (>93% for severe acute malnutrition (SAM), defined by MUAC < 115 mm, and > 90% for global acute malnutrition (GAM), defined by MUAC < 125 mm). Mother/caregiver sensitivity for SAM and GAM classification was higher using the MUAC insertion tape (100% sensitivity for SAM and 99% sensitivity for GAM) than using “Click-MUAC” devices. Younden’s J for SAM classification, and sensitivity for GAM classification, were significantly higher for the MUAC insertion tape (99% and 99% respectively). Specificity was high for all devices (>96%) with no significant difference between the “Click-MUAC” devices and the MUAC insertion tape.ConclusionsThe results of this study indicate that, although the “Click-MUAC” devices performed well, the MUAC insertion tape performed best. The results for sensitivity are higher than found in previous studies. The high sensitivity for both SAM and GAM classification by mothers/caregivers with the MUAC insertion tape could be due to the use of an improved MUAC tape design which has a number of new design features. The one-on-one demonstration provided to mothers/caregivers on the use of the devices may also have helped improve sensitivity. The results of this study provide evidence that mothers/caregivers can perform sensitive and specific classifications of their child’s nutritional status using MUAC.Trial registrationsClinical trials registration number: NCT02833740