Prognostic value of different anthropometric indices over different measurement intervals to predict mortality in 6–59-month-old children
Author: André Briend, Mark Myatt, James A Berkley, Robert E Black, Erin Boyd, Michel Garenne, Natasha Lelijveld, Sheila Isanaka, Christine M McDonald, Martha Mwangwome, Kieran S O’Brien et al
Year: 2023
Resource type: Article
Abstract
Objective:
To compare the prognostic value of mid-upper arm circumference (MUAC), weight-for-height Z-score (WHZ) and weight-for-age Z-score (WAZ) for predicting death over periods of 1, 3 and 6 months follow-up in children.
Design:
Pooled analysis of twelve prospective studies examining survival after anthropometric assessment. Sensitivity and false-positive ratios to predict death within 1, 3 and 6 months were compared for three individual anthropometric indices and their combinations.
Setting:
Community-based, prospective studies from twelve countries in Africa and Asia.
Participants:
Children aged 6–59 months living in the study areas.
Results:
For all anthropometric indices, the receiver operating characteristic curves were higher for shorter than for longer durations of follow-up. Sensitivity was higher for death with 1-month follow-up compared with 6 months by 49 % (95 % CI (30, 69)) for MUAC < 115 mm (P < 0·001), 48 % (95 % CI (9·4, 87)) for WHZ < -3 (P < 0·01) and 28 % (95 % CI (7·6, 42)) for WAZ < -3 (P < 0·005). This was accompanied by an increase in false positives of only 3 % or less. For all durations of follow-up, WAZ < -3 identified more children who died and were not identified by WHZ < -3 or by MUAC < 115 mm, 120 mm or 125 mm, but the use of WAZ < -3 led to an increased false-positive ratio up to 16·4 % (95 % CI (12·0, 20·9)) compared with 3·5 % (95 % CI (0·4, 6·5)) for MUAC < 115 mm alone.
Conclusions:
Frequent anthropometric measurements significantly improve the identification of malnourished children with a high risk of death without markedly increasing false positives. Combining two indices increases sensitivity but also increases false positives among children meeting case definitions.
Read the full article here.
More like this
FEX: How best to predict child mortality using different anthropometric indices?
View this article as a pdf This is a summary of the following article: Briend A, Myatt M, Berkley JA et al (2023) Prognostic value of different anthropometric indices over...
FEX: Finding the best criteria to identify children at high risk of mortality
View this article as a pdf This article is a summary of the following paper: Khara T, Myatt M, Sadler K, Bahwere P, Berkeley J, Black R (TBC) Anthropometric criteria for best...
FEX: MUAC vs WHZ in predicting mortality in hospitalised children under five years of age
Summary of research1 This research contributes to the evidence base regarding which anthropometric indicators identify malnourished sick children most at risk of death. Low...
FEX: MUAC and weight-for-height in identifying high risk children
Summary of research1 The World Health Organisation (WHO) and UNICEF propose to use two independent criteria for diagnosing non-oedematous severe acute malnutrition (SAM) in...
Resource: Anthropometric criteria for best-identifying children at high risk of mortality: a pooled analysis of twelve cohorts
Abstract Objective: To understand which anthropometric diagnostic criteria best discriminate higher from lower risk of death in children and explore programme...
FEX: Concordance between weight-for-height z-score (WHZ) and mid-upper arm circumference (MUAC) for the detection of wasting among children in Bangladesh host communities
View this article as a pdf Lisez cet article en français ici By Md. Lalan Miah, Dr. Md. Khalilur Rahman, Dr. Md. Abdul Alim and Bijoy Sarker Md. Lalan Miah is the...
FEX: Is MUAC alone a sufficient criterion for admission of children at high risk of mortality in South Sudan?
Summary of research 1 Location: South Sudan What we know: The operational implications of using MUAC as the sole anthropometric admission criterion to therapeutic feeding...
FEX: Diagnostic criteria for severe acute malnutrition among infants under six months of age
Summary of research1 Location: Kenya What we know: Diagnosis of acute malnutrition in infants under six months old (U6M) is currently based on weight-for-length z score...
FEX: MUAC alone admission to SAM treatment in Bangladesh
Summary of research1 Location: Bangladesh What we know: MUAC and weight-for-height z score (WHZ) are common anthropometric criteria to diagnose severe acute malnutrition...
FEX: MUAC Versus Weight-for-Height in Assessing Severe Malnutrition
Summary of published paper1 An infant having MUAC measured during the study in Kenya Current WHO guidelines for the management of severe malnutrition in children recommend...
en-net: Only MUAC for admission and discharge?
There has been a discussion about the use of ONLY MUAC as an admission and discharge criteria (http://www.en-net.org/question/468.aspx). Although I understand the challenge in...
FEX: Improving screening for malnourished children at high risk of death
Research snapshot1 The purpose of this study was to investigate whether children with concurrent wasting and stunting (WaSt) require therapeutic feeding and to better...
en-net: MUAC cutoff to screen SAM
Looking at the WHO growth standard for MUAC, one can understand the change of MUAC with age. So my concern is, is it feasible to use the same MUAC cutoff (<11.5CM) for all...
FEX: Can height-adjusted cut-offs improve MUAC’s utility as an assessment tool?
By Michel Van Herp, An Verwulgen, Bérengère Leurquin, and Pascale Delchevalerie Michael Ven Herp, Bérengère Leurquin, An Verwulgen & Pascale Delchevalerie Michael Ven Herp is...
en-net: Estimations de cas pour lesquels les critères de MUAC ont changé
Posted on behalf of East Africa project staff: Has anyone made any estimates on the implications for caseload, if admission criteria are changed from MUAC <11cm to MUAC...
FEX: Response to malnutrition treatment in low weight-for-age children: secondary analyses of ComPAS trial data
View this article as a pdf Research summary1 Location: Kenya and South Sudan What we know: Children who are concurrently wasted and stunted (WaSt) have a very high mortality...
Wasting and Stunting: Evidence Generation
Within the WaSt TIG, we continue to generate evidence to increase the understanding of the relationship between wasting and stunting and what this tells us about their...
FEX: Using MUAC to predict and avoid negative outcomes in CMAM programmes: Work inspired by en-net
View this article as a pdf Lisez cet article en français ici By Odei Obeng Amoako Adobea Gloria, Franck Alé, Paul Binns, Kevin Phelan, Jose Luis Álvarez...
FEX: Wasting and Stunting Technical Interest Group (WaSt TIG) meeting
On the 15th of January 2018 the Wasting and Stunting (WaSt) Technical Interest Group (TIG) held their third face-to-face meeting at Trinity College, Oxford. This group of 30...
en-net: Emergency standards for SAM/MAM when using MUAC
Can one use the same thresholds for SAM/MAM prevalence when using MUAC as the basis for measurement? For example can one equally use less than 15% GAM prevalence to classify...
Reference this page
André Briend, Mark Myatt, James A Berkley, Robert E Black, Erin Boyd, Michel Garenne, Natasha Lelijveld, Sheila Isanaka, Christine M McDonald, Martha Mwangwome, Kieran S O’Brien et al (2023). Prognostic value of different anthropometric indices over different measurement intervals to predict mortality in 6–59-month-old children. www.ennonline.net/prognostic-value-anthropometric-indices-predict-mortality
(ENN_7566)