Improving screening for malnourished children at high risk of death: a study of children aged 6–59 months in rural Senegal
Author: Mark Myatt, Tanya Khara, Carmel Dolan, Michel Garenne and André Briend
Year: 2018
Resource type: Research
Abstract
Objective: To investigate whether children with concurrent wasting and stunting require therapeutic feeding and to better understand whether multiple diagnostic criteria are needed to identify children with a high risk of death and in need of treatment.
Design: Community-based cohort study, following 5751 children through time. Each child was visited up to four times at 6-month intervals. Anthropometric measurements were taken at each visit. Survival was monitored using a demographic surveillance system operating in the study villages. Setting: Niakhar, a rural area of the Fatick region of central Senegal.
Participants: Children aged 6–59 months living in thirty villages in the study area. Results: Weight-for-age Z-score (WAZ) and mid-upper arm circumference (MUAC) were independently associated with near-term mortality. The lowest WAZ threshold that, in combination with MUAC, detected all deaths associated with severe wasting or concurrent wasting and stunting was WAZ<− 2·8. Performance for detecting deaths was best when only WAZ and MUAC were used. Additional criteria did not improve performance. Risk ratios for near-term death in children identified using WAZ and MUAC suggest that children identified by WAZ<− 2·8 but with MUAC≥115 mm may require lower-intensity treatment than children identified using MUAC<115 mm.
Conclusions: A combination of MUAC and WAZ detected all near-term deaths associated with severe anthropometric deficits including concurrent wasting and stunting. Therapeutic feeding programmes may achieve higher impact if WAZ and MUAC admission criteria are used.
Read the full article here.
More like this
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...
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: 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: 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: 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...
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: 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...
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...
WaSt TIG - the work so far
We have had three phases of work thus far and are currently in the fourth. A special section in FEX summarises a lot of the work of the WaSt TIG so far as well as experiences...
Resource: Anthropometric deficits and the associated risk of death by age and sex in children aged 6-59 month: A meta-analysis
Abstract Risk of death from undernutrition is thought to be higher in younger than in older children, but evidence is mixed. Research also demonstrates sex differences whereby...
FEX: Making connections: Joint meeting of WaSt Technical Interest Group and MAMI Special Interest Group
ENN coordinates two international technical groups, the Management of at-risk Mothers and Infants under six months Special Interest Group (MAMI SIG) and the Wasting and...
FEX: Malnutrition in infants under six months attending community health centres in Ethiopia
View this article as a pdf This is a summary of the following paper: Grijalva-Eternod, C.S., Beaumont, E., Rana, R., Abate, N., Barthorp, H., McGrath, M., et al. (2021)....
FEX: OptiMA study in Burkina Faso: Emerging findings and additional insights
View this article as a pdf Lisez cet article en français ici By Kevin PQ Phelan Kevin PQ Phelan is Nutrition Advisor at ALIMA, the Alliance for International Medical...
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...
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...
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...
Resource: Prognostic value of different anthropometric indices over different measurement intervals to predict mortality in 6–59-month-old children
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...
FEX: Effect of mass supplementation with RUSF during an anticipated nutritional emergency
Summary of published research1 A woman and her dauguher receive RUSF distribution in Niger Location: Niger What we know already: Ready to Use Supplementary Foods (RUSF) are...
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...
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...
Reference this page
Mark Myatt, Tanya Khara, Carmel Dolan, Michel Garenne and André Briend (2018). Improving screening for malnourished children at high risk of death: a study of children aged 6–59 months in rural Senegal. www.ennonline.net/resources/malnourishedscreeningsenegal
(ENN_6165)