MUAC IS THE BEST MEASURE FOR HIGH RISK ACUTELY MALNOURISHED CHILDREN English Feb 2016

1. MIND MAP FOR MID-UPPER ARM CIRCUMFERENCE (MUAC) IN ACUTELY MALNOURISHED YOUNG CHILDREN. Adapted from Andre Briend, Prepared by Alfred Zerfas. February 2016

2. WHY?

3. 1. MUAC Is more specific for muscle mass (important for survival) compared to weight and height

4. CLICK ON ARROWS for article or video links

5. 2. Best predictor for mortality compared to WTA, WTH and HFA (Pelletier J Nutr 1994)

5.1. 2.1 Conclusion

6. 3. Ease of Use - Can be done by CHW’s and mothers (pilot – ALIMA) N.Blackwell et al., 2015

7. see also Briend 2012

8. See also Mothers and Children May 2015

9. 7a. MUAC. Suggest 125mm

10. 6a. No. Compared to MUAC for age or height, unadjusted MUAC preferentially selects younger children who are more at risk of mortality

11. 5a. No. Compared to WFH, MUAC selects preferentially young and stunted children who are more at risk.

12. 4a. No. Combining can decrease sensitivity and specificity for risk of dying. (Briend et al., 2012). Better to increase MUAC cut-point to increase sensitivity

13. 4. SHOULD MUAC AND WFH BE COMBINED AT THE SAME TIME TO IDENTIFY HIGH RISK CHILDREN?

14. 5. DO MUAC AND WFH (BELOW -3 Z-SCORE) IDENTIFY THE SAME CHILDREN?

15. 6. IS IT NECESSARY TO USE MUAC FOR AGE OR HEIGHT INSTEAD OF MUAC ALONE?

16. 7. WHICH CRITERIA TO USE TO END TREATMENT BASED ON LOW MUAC ENTRY?