Arm circumference and other factors in children at high risk of death in rural Bangladesh

Abstract

Mid upper arm circumference (MUAC) was measured monthly for 6 months in about 500 children aged 6-36 months from rural Bangladesh. Children who would die within 1 month of screening could be identified with 94% specificity and 56% sensitivity--almost twice the sensitivity achieved by other anthropometric screening schemes for this level of specificity. Specificity was slightly improved when the absence of breast-feeding, concurrent diarrhoea, oedema, and acute respiratory infection were taken into account. Children at high risk of death can be detected by monthly measurement of MUAC, which may be used in poor communities where interventions have to be selective.

PIP: Mid upper arm circumference (MUAC) was measured monthly for 6 months in about 5000 children aged 6-36 months from rural Bangladesh. Children who would die within 1 month of screening could be identified with 94% specificity and 56% sensitivity--almost twice the sensitivity achieved by other anthropometric screening schemes for this level of specificity. Specificity was slightly improved when the absence of breastfeeding, concurrent diarrhea, edema, and acute respiratory infection were taken into account. Children at high risk of death can be detected by monthly measurement of MUAC. This information may then be used to target resources in poor communities where interventions have to be selective. Children with a MUAC of less than 110mm are obviously malnourished and in communities where severe childhood malnutritiom still occurs, screening and referral of these high risk children may be one of the more effective stategies for the prevention of death.