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

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dc.contributor Medical Department, Brussels Operational Center, Doctors Without Borders, Brussels, Belgium. miguel.angel.luque@brussels.msf.org
dc.creator Fernández, M A L
dc.creator Delchevalerie, P
dc.creator Van Herp, M
dc.date 2010-07
dc.date.accessioned 2017-01-31T07:18:37Z
dc.date.available 2017-01-31T07:18:37Z
dc.identifier Accuracy of MUAC in the detection of severe wasting with the new WHO growth standards. 2010, 126 (1):e195-201 Pediatrics
dc.identifier 1098-4275
dc.identifier 20587675
dc.identifier 10.1542/peds.2009-2175
dc.identifier http://hdl.handle.net/10144/112046
dc.identifier http://fieldresearch.msf.org/msf/handle/10144/112046
dc.identifier Pediatrics
dc.identifier.uri http://dspace.mediu.edu.my:8181/xmlui/handle/10144/112046
dc.description 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.
dc.language en
dc.rights Published by the American Academy of Pediatrics Archived on this site with kind permission from Pediatrics, copyright 2010 by the American Academy of Pediatrics
dc.title Accuracy of MUAC in the detection of severe wasting with the new WHO growth standards.


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