Proceedings of Secondes Journées Pédiatriques Médecins Sans Frontières (MSF) (Dakar, 2018)

Poster

Comparison of MUAC and WHZ in predicting the outcomes of children admitted to inpatient therapeutic feeding centres in Niger and South Sudan

Cite this: Pan African Medical Journal - Conference Proceedings. Aug 2018; 9(9): 26. doi:10.11604/pamj.cp.2018.9.26.753

Submitted: 04 Jul 18   Accepted: 25 Jul 18   Published: 14 Aug 18

Key words: Child malnutrition, Mid-upper arm circumference, weight-for-height Z-score, admission criteria, in-patient therapeutic feeding center

© Iris Finci et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Available online at: http://www.proceedings.panafrican-med-journal.com/conferences/2018/9/26/abstract

Corresponding author: Iris Finci, Médecins Sans Frontières, Operational Center Geneva, Switzerland (iris.finci@geneva.msf.org)

This abstract is published as part of the proceedings of Secondes Journées Pédiatriques Médecins Sans Frontières (MSF)(SENEGAL, )

Comparison of MUAC and WHZ in predicting the outcomes of children admitted to inpatient therapeutic feeding centres in Niger and South Sudan

Iris Finci1,&, Nathalie Avril1, Iza Ciglenecki1

 

1Médecins Sans Frontières, Operational Center Geneva, Geneva, Switzerland

 

 

&Corresponding author
Iris Finci, Médecins Sans Frontières, Operational Center Geneva, Switzerland

 

 

Abstract

Introduction: mid-upper arm circumference (MUAC) and weight-for-height Z-score (WHZ) are different anthropometric measures used to identify severely malnourished children. Although, MUAC is better at identifying children at high risk of death, the two measures identify different groups of children. We investigated mortality among children admitted in intensive therapeutic feeding centres (ITFC) in Niger and South Sudan, based on their MUAC and WHZ. Admission criteria in Niger were based on MUAC, WHZ and/or oedema, and in South Sudan only on MUAC and oedema associated with co-morbidities.

 

Methods: we performed a retrospective analysis of routinely collected individual-level data from ITFC in Magaria, Niger (January - December 2016) and Agok, South Sudan (March 2016 - May 2017). Data was entered using standardised data collection tool. Patients with oedema and patients missing data on MUAC and WHZ were excluded. We compared the mortality of patients with MUAC ≥ 115mm, patients with MUAC > 115mm and WHZ < 3.

 

Results: in Niger, out of 3854 children included in the analysis, 2716 (70.5%) had MUAC < 115 and 1091 (28.3%) had MUAC > 115mm and WHZ < 3. In South Sudan, out of 907 children, 529 (58.3%) had MUAC < 115 and 290 (32%) had MUAC ≥ 115mm and WHZ < 3. In Niger, the risk of death was higher for children with MUAC < 115mm compared to children with MUAC ≥ 115mm and WHZ < 3 (binomial regression, RR 1.4 [CI: 1 - 1.8]), while in South Sudan there was no significant difference. MUAC < 115mm failed to identify 59 (23.2%) children that died in Niger and 9 (29%) in South Sudan. By increasing MUAC criteria to < 125mm, 96.4% of deaths were identified in Niger and 100% in South Sudan.

 

Conclusion: although we have an indication that MUAC detected children with higher risk of dying better than WHZ, it failed to detect between 23 - 29% of children that died. However, MUAC < 125mm as admission criteria for ITFC would capture the majority of children dying. These results are consistent with previous reports.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Dakar)

Country:

Dates: 15 Dec 17 - 16 Dec 17

Venue: Hotel Ngor Diarama

Organizers:

Secretariat: paediatricdays@msf.org

Contact person: Dr. Laurent Hiffler (paediatricdays@msf.org)