Menu ENN Search

Effect of body shape on weight-for-height and MUAC in Ethiopia

Summary of research1

Measuring a young child's MUAC

In November 2005, a survey undertaken in rural areas of Belete Weyne district of Somalia by Save the Children UK (SC UK) found that standard Weight for Height Z-scores (WHZ) and Mid Upper Arm Circumference (MUAC) based casedefinitions returned different estimates of the prevalence of acute malnutrition in pastoralist and agropastoralist livelihood zones. However, they produced similar estimates of the prevalence of global acute malnutrition in the riverine-agrarian livelihood zone. A small study undertaken to investigate this finding determined that children from the pastoralist and agro-pastoral livelihood zones tended to have longer limbs and lower sitting to standing height ratios than children from the riverine-agrarian livelihood zone.

In May 2006, the Emergency Nutrition Co-ordinating Unit of the Government of Ethiopia, funded by UNICEF with personnel and logistics support provided by SC UK and Concern Worldwide, initiated a study to investigate the relationship between WHZ and body-shape and the relationship between MUAC and body-shape in different populations.

Six cross-sectional nutritional anthropometry surveys were undertaken.The combined survey datasets formed the study sample. Data sources were grouped according to the livelihood zone from which data originated. Case definitions of acute malnutrition using WHZ calculated using both the NCHS and WHO reference populations and MUAC uncorrected for age or height were used. The sitting to standing height ratio was used as an index of body shape. The association between body shape and different case definitions of acute malnutrition were investigated using standard statistical techniques.

WHZ and MUAC case-definitions yielded similar estimates of the prevalence of acute malnutrition in agrarian children but different estimates of the prevalence of acute malnutrition in pastoralist children. These populations also exhibited different sitting to standing height ratios. Sitting to standing height ratio was an important predictor of weight-for-height. Sitting to standing height ratio was a poor predictor of MUAC.

The authors found that WHZ and WHZ casestatus in children are associated with body shape and may overestimate the prevalence of acute malnutrition in some populations. Their conclusion is that consideration should be given to whether WHZ should be replaced by MUAC for the purposes of estimating the prevalence of acute malnutrition.

For further information, contact Mark Myatt via website: www.brixtonhealth.com

Show footnotes

1Myatt. M et al. In press. The effect of body shape on weight-forheight and mid upper arm circumference based case-definitions of acute malnutrition in Ethiopian children. Accepted for publication in 'The Annals of Human Biology', due out in early 2009.

More like this

en-net: Is it valid to use similar cut-off points for prevalence of wasting using z scores for different countries and contexts?

Hi there, II faced this situation and want to to hear your ideas. We have a programme running for long, but the GAM rates during the hunger gap based on WHO standards 2006 is...

en-net: Assessing levels of maternal malnutrition

In Niger the 2006 MICS estimated 19.2% of women of reproductive age to be malnourished (with a BMI-18.5) and 1.9% severely malnourished (BMI-16). In Zinder the rate was 29.6%...

en-net: Discrepancies of malnutrition prevalence among boys and girls

Dear all, I was just looking at nutrition survey results which was conducted in 2012 in three locations of Darfur State, Sudan. The finding was analysed in both WHZ score...

FEX: MUAC versus weight-for-height debate in the Philippines

By Bernardette Cichon Bernardette is a Public Health Nutritionist who at the time of the work described in this article, worked with Action Contre la Faim (ACF). She is...

en-net: Assessment of Adult Malnutrition in "Long-legged" populations

Dear ENN, I was wondering if there was any information or experience available in the use or adjustment of BMIs in adult populations in populations that are skewed from the...

en-net: Why prevalence using MUAC is not useful as trigger level for humaniterian response?

My question is specific to pastoral population. Rearches documents indicated that the prevalence of acute malnutrition using both WFH and MUAC gives similar estmate for...

en-net: body shape in children under 24 months old

It's been pretty well documented now that pastoralists in low, hot regions have a lower SSR than neighboring agrarian groups. But the only information I can find relates to...

en-net: WHO Wasting prevalance

I would like to know if there is any recently changes made on WHO wasting prevalence. As far as I know less than 5 was acceptable. So if any member of the team knows any...

en-net: Dwarfism Vs BMI

I would like to know if it is feasible to calculate the BMI of dwarf person as the same as the normal individuals. Regards MMH Gani FSAU FAO Somalia Or ... use the CHANCES...

FEX: New method for assessing acute malnutrition in nomadic pastoralist populations

By Anne-Marie Mayer, Mark Myatt, Myriam Ait Aissa and Nuria Salse Anne-Marie Mayer is a technical consultant for this project and carried out the first field test in Mali with...

FEX: Letter on using MUAC v weight-for-height in assessment, by Mark Myatt

Recently, ENN was party to an exchange of questions and discussion between field staff and 'experts' relating to decisions on the use of readymade therapeutic products versus...

en-net: Misdiagnosis acute malnutrition Peulh/Fulani children

Does anyone know whether using the standard anthropometric indicators such as WFH (and perhaps also MUAC) can misdiagnose Peulh/Fulani children? I hear and read conflicting...

FEX: Incidence and duration of severe wasting in two African populations

Summary of review1 A child being measured during the health survey in Niakhar A recent literature review did not reveal any publication with proper estimates of incidence and...

en-net: Highest SAM rate

I've just got the report of a nutrition survey. Severe acute malnutrition figure is extremely high (above 20%, OMS2006) and I was wondering whether this is a plausible result...

en-net: Looking for data on body-shape (Sri-Lanka / Myanmar)

I have been receiving reports from a number of NGOs working in Sri-Lanka and Myanmar of large discrepancies between prevalence estimated using a W/H case-defintion and...

FEX: Weight-for-height and mid-upper-arm circumference should be used independently to diagnose acute malnutrition: policy implications

Summary of research1 Location: Global What we know: Overlap between mid-upper-arm circumference (MUAC) and weight-for-height Z-scores (WHZ) when assessing acute malnutrition...

en-net: malnutrition rate

Dear All, Urgently want to know in any nutritional survey what is the difference we can expect in the percentage of SAM children we will find using WFH criteria and with MUAC...

en-net: Sitting - Standing Height Ratio

Hey everybody, I am looking for reference tables for the sitting-standing height ratio. Are there general reference tables or country/region-specific ones? Could anyone kindly...

en-net: Refernces to measure maternal and pregnancy BMI against?

I would like to collect some data around maternal nutrtition status in order to build the case for emphasising project components which address this issue. There is good...

FEX: Review of nutrition and mortality indicators for Integrated Phase Classification

Summary of technical review1 The Integrated Phase Classification (IPC) Technical Working Group and the Standing Committee on Nutrition (SCN) Task Force on Assessment,...

Close

Reference this page

M Myatt et al (). Effect of body shape on weight-for-height and MUAC in Ethiopia. Field Exchange 34, October 2008. p11. www.ennonline.net/fex/34/effect

(ENN_3831)

Close

Download to a citation manager

The below files can be imported into your preferred reference management tool, most tools will allow you to manually import the RIS file. Endnote may required a specific filter file to be used.