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
Iris Finci, Médecins Sans Frontières, Operational Center Geneva, Switzerland
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.
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.
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.
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.
Dates: 15 Dec 17 - 16 Dec 17
Venue: Hotel Ngor Diarama
Contact person: Dr. Laurent Hiffler (firstname.lastname@example.org)