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Post a reply: Comparison of MUAC and W/H Prevalence?

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Mark and ENN, hi all, According to the WHO/UNICEF Joint Statement on WHO child growth standards and the identification of severe malnutrition in infants and children (2009), "the prevalence of SAM based on WHZ <-3 SD of the WHO standards and those based on a MUAC cut-off of 115 mm are very SIMILAR. Nonetheless, all the survey reports I came across from different countries showed that the prevalence of GAM by WHZ is always higher than proxy GAM by MUAC. I understand the body shape factor that was observed in Ethiopia, but I doubt that the 'body shape issue' is the only explanation for the differences between prevalence of acute malnutrition measured by weight-for-height versus MUAC in these surveys. So, I would be interested to know why such large differences are observed? Children that are identified wasted by MUAC not necessarily wasted by WHZ and vice versa. So what is the relationship between MUAC and WHZ? Is there any survey that shows MUAC prevalence is higher than WHZ? (i heard there are survey with high MUAC than WHZ in Somalia). If so, i am very much interested to know the explanation to that. Those points have programmatic implications. How can one justify the use of either MUAC or WHZ for admission? (since they identify different children as wasted). There is a perceived challenge to rely on MUAC alone as the caseload would be so low that it is difficult to justify an intervention in a seemingly deteriorated nutrition situation in a community. Thanks for your feedback,
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