Monitoring and discharging children being treated for severe acute malnutrition using mid-upper arm circumference: Secondary data analysis from rural Gambia

Alice Burrell, Marko Kerac, Helen Nabwera

Research output: Contribution to journalArticlepeer-review

15 Citations (Scopus)

Abstract

Background: Severe acute malnutrition (SAM) is a major public health problem. Mid-upper arm circumference (MUAC) is widely used to admit children to treatment programmes. However, insufficient data supporting MUAC discharge criterion limits its use as a stand-alone tool. Our aim was to evaluate MUAC for monitoring nutritional recovery and discharge. Methods: This was a secondary analysis of clinical data from children 6-59 months-old treated for SAM from January 2003 to December 2013 at the Nutritional Rehabilitation Unit in rural Gambia. Weight, weight-forheight z-score (WHZ) and MUAC response to treatment were assessed. Treatment indicators and regression models controlled for admission measurement and age were compared by discharge MUAC and WHZ. Results: Four hundred and sixty-three children with marasmus were included. MUAC, WHZ and weight showed parallel responses to treatment. MUAC≥125mm as a discharge criterion performed well, showing good prediction of default and referral to hospital, acceptable duration of stay, and a higher absolute MUAC measure compared to WHZ≥-2.00, closely related to lower risk of mortality. Conclusions: MUAC can be used as a standalone tool for monitoring nutritional recovery. MUAC≥125mm performs well as a discharge criterion; however, follow-up data is needed to assess its safety. Further research is needed on children meeting MUAC discharge criterion but with WHZ≤2.0.

Original languageEnglish
Article numberihx022
Pages (from-to)226-233
Number of pages8
JournalInternational Health
Volume9
Issue number4
DOIs
Publication statusPublished - 1 Jul 2017
Externally publishedYes

Keywords

  • Discharge
  • MUAC
  • Mid-upper arm circumference
  • SAM
  • Severe acute malnutrition
  • Wasting

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