Accuracy of MUAC in the detection of severe wasting with the new WHO growth standards.

Hdl Handle:
http://hdl.handle.net/10144/112046
Title:
Accuracy of MUAC in the detection of severe wasting with the new WHO growth standards.
Authors:
Fernández, Miguel Angel Luque; Delchevalerie, Pascale; Van Herp, Michel
Journal:
Pediatrics
Abstract:
OBJECTIVES: The objectives of this study were to estimate the accuracy of using mid-upper-arm circumference (MUAC) measurements to diagnose severe wasting by comparing the new standards from the World Health Organization (WHO) with those from the US National Center for Health Statistics (NCHS) and to analyze the age independence of the MUAC cutoff values for both curves. METHODS: We used cross-sectional anthropometric data for 34,937 children between the ages of 6 and 59 months, from 39 nutritional surveys conducted by Doctors Without Borders. Receiver operating characteristic curves were used to examine the accuracy of MUAC diagnoses. MUAC age independence was analyzed with logistic regression models. RESULTS: With the new WHO curve, the performance of MUAC measurements, in terms of sensitivity and specificity, deteriorated. With different cutoff values, however, the WHO standards significantly improved the predictive value of MUAC measurements over the NCHS standards. The sensitivity and specificity of MUAC measurements were the most age independent when the WHO curve, rather than the NCHS curve, was used. CONCLUSIONS: This study confirms the need to change the MUAC cutoff value from <110 mm to <115 mm. This increase of 5 mm produces a large change in sensitivity (from 16% to 25%) with little loss in specificity, improves the probability of diagnosing severe wasting, and reduces false-negative results by 12%. This change is needed to maintain the same diagnostic accuracy as the old curve and to identify the children at greatest risk of death resulting from severe wasting.
Affiliation:
Medical Department, Brussels Operational Center, Doctors Without Borders, Brussels, Belgium. miguel.angel.luque@brussels.msf.org
Issue Date:
Jul-2010
URI:
http://hdl.handle.net/10144/112046
DOI:
10.1542/peds.2009-2175
PubMed ID:
20587675
Language:
en
ISSN:
1098-4275
Appears in Collections:
Nutrition

Full metadata record

DC FieldValue Language
dc.contributor.authorFernández, Miguel Angel Luqueen
dc.contributor.authorDelchevalerie, Pascaleen
dc.contributor.authorVan Herp, Michelen
dc.date.accessioned2010-09-30T01:42:53Z-
dc.date.available2010-09-30T01:42:53Z-
dc.date.issued2010-07-
dc.identifier.citationAccuracy of MUAC in the detection of severe wasting with the new WHO growth standards. 2010, 126 (1):e195-201 Pediatricsen
dc.identifier.issn1098-4275-
dc.identifier.pmid20587675-
dc.identifier.doi10.1542/peds.2009-2175-
dc.identifier.urihttp://hdl.handle.net/10144/112046-
dc.description.abstractOBJECTIVES: The objectives of this study were to estimate the accuracy of using mid-upper-arm circumference (MUAC) measurements to diagnose severe wasting by comparing the new standards from the World Health Organization (WHO) with those from the US National Center for Health Statistics (NCHS) and to analyze the age independence of the MUAC cutoff values for both curves. METHODS: We used cross-sectional anthropometric data for 34,937 children between the ages of 6 and 59 months, from 39 nutritional surveys conducted by Doctors Without Borders. Receiver operating characteristic curves were used to examine the accuracy of MUAC diagnoses. MUAC age independence was analyzed with logistic regression models. RESULTS: With the new WHO curve, the performance of MUAC measurements, in terms of sensitivity and specificity, deteriorated. With different cutoff values, however, the WHO standards significantly improved the predictive value of MUAC measurements over the NCHS standards. The sensitivity and specificity of MUAC measurements were the most age independent when the WHO curve, rather than the NCHS curve, was used. CONCLUSIONS: This study confirms the need to change the MUAC cutoff value from <110 mm to <115 mm. This increase of 5 mm produces a large change in sensitivity (from 16% to 25%) with little loss in specificity, improves the probability of diagnosing severe wasting, and reduces false-negative results by 12%. This change is needed to maintain the same diagnostic accuracy as the old curve and to identify the children at greatest risk of death resulting from severe wasting.en
dc.language.isoenen
dc.rightsPublished by the American Academy of Pediatrics Archived on this site with kind permission from Pediatrics, copyright 2010 by the American Academy of Pediatricsen
dc.subject.meshAnthropometryen
dc.subject.meshArea Under Curveen
dc.subject.meshBody Heighten
dc.subject.meshBody Weighten
dc.subject.meshChild Developmenten
dc.subject.meshChild, Preschoolen
dc.subject.meshCross-Sectional Studiesen
dc.subject.meshDeveloping Countriesen
dc.subject.meshFemaleen
dc.subject.meshHumansen
dc.subject.meshInfanten
dc.subject.meshLogistic Modelsen
dc.subject.meshMaleen
dc.subject.meshMalnutritionen
dc.subject.meshNeeds Assessmenten
dc.subject.meshNutrition Surveysen
dc.subject.meshProbabilityen
dc.subject.meshRisk Assessmenten
dc.subject.meshSeverity of Illness Indexen
dc.subject.meshUpper Extremityen
dc.subject.meshWasting Syndromeen
dc.subject.meshWorld Health Organizationen
dc.titleAccuracy of MUAC in the detection of severe wasting with the new WHO growth standards.en
dc.contributor.departmentMedical Department, Brussels Operational Center, Doctors Without Borders, Brussels, Belgium. miguel.angel.luque@brussels.msf.orgen
dc.identifier.journalPediatricsen

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