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MUAC cut offs for 6 - 10 years

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Anselimo Makokha

Professor/Jomo Kenyatta Univ of Agric. & Tech.

Normal user

11 Apr 2016, 05:15

I am doing malnutrition assessment of children aged 5-10 years in Kenya. Using MUAC should we use cut off points for adults, as I have not been able to get cut off points specific for this age group?

Moses Owori

Public Health Nutritionist/ Uni of Westminster

Normal user

11 Apr 2016, 21:00

In Uganda, from our Integrated management of acute malnutrition (IMAM) guidelines, we use >135mm to </=145mm for 5-9.9years and >165mm to </= 185mm for 10 to 14.9 years. You can find the guidelines online for reference purposes.

Best regards.

Rakesh

Normal user

12 Apr 2016, 08:00

Dear
Anselimo Makokha

MUAC measurement is basically to give you and over view of nutrition status in emergency setting and a good predictor for children near to death. For development programming it will be good to use other anthropocentric measurement for the mentioned population we can use BHZ (BMI for Age Z score) underneath link can provide you Z score for age for children from 5-19 years. WHO Anthro + can be used to analyse the data

http://www.who.int/growthref/who2007_bmi_for_age/en/
Thanks

Paul

Frequent user

12 Apr 2016, 08:43

Hi Anselimo
If the purpose of your assessment of children is for admission to a selective feeding programme then the cut off points for MUAC are defined in the Kenyan National Guidelines for the Integrated Management of Acute Malnutrition:

http://www.cmamforum.org/resource/558

Rosemary Atieno

Nutritionist- MOH

Normal user

12 Apr 2016, 10:38

Hi Anselimo,
As Paul has stated we have National guidelines on these. Also check for Nutrition and HIV guidelines. It gives cut offs for all ages

Pascale Delchevalerie

Nutrition Advisor MSF Belgium

Normal user

12 Apr 2016, 10:42

Dear Anselimo,
If it is for assesment, I would register the exact MUAC and compare it to tables of MUAC-for-age, which will give you an idea of the deviation from the mdian for age.
There are still no defined MUAC cut-offs for children > 5 years, but if you take the ones for adults, you will overestimate malnutrition.
If it is to include children in a program, I tried a "simplified MUAC-for- height", based on an article published by Mei, Z., Grummer-Strawn, L. M., De Onis, M.,Yip, R.,in the WHO bulletin (vol 75, issue 4, 1997): "The development of a MUAC-for-height reference, including a comparison to other nutritional status screening indicators".
You do a kind of quack-stick with a mark at 110 - 120 - 130 - 145 cm, the child is standing next to the stick:
if his head is below 11,0 cm mark, admit him if MUAC is < 12,0 cm
if his head is between 110 & 120 cm mark, admit him if MUAC is < 14,0 cm
if his head is between 120 & 130 cm mark, admit him if MUAC is < 14,6 cm
if his head is between 130 & 145 cm mark, admit him if MUAC is < 15,2 cm
If he is taller than 145 cm, use adult’s criteria
These cut-off were choosen because they represent -3 z-score of the MUAC-for-height in the table.

This protocole is a trial, it has not been endorsed by anybody yet and need more field test, but I checked myself on Sudanese population and all children admitted were visibly wasted, so I don't think we overestimate too much malnutrition with these cut-offs.

hope this help

Pascale

Madeleine

Nutrition consultant

Normal user

12 Apr 2016, 11:05

MUAC is not recommended to use in children aged 5- 10 years because it changes very quickly compared to that of children aged 0-5 years. it can be used to only orientation.
Import from the" NUTRITIONAL SURVEY WHO anthro" the following data: Age and sex weight and child height and analyze.

Kiarie Mwaura

Nutrition and WASH Specialist at DAI

Normal user

19 Apr 2016, 07:01

Hi Anselimo,
In most Kenyan health facilities treating severe and moderate acute malnutrition, you will be able to find "Reference charts for nutrition diagnosis and protocol for food by prescription", developed by Nutrition and HIV program.
The MUAC cut offs: <135mm for SAM and >/=135mm to <145mm for MAM. You can also check the guidelines recommended by Paul.
I hope that will be helpful.

Anselimo Makokha

Professor/Jomo Kenyatta Univ of Agric. & Tech.

Normal user

19 Apr 2016, 12:30

Thank you all for your very useful replies in respect to MUAC for the 5-10 year olds!

Makokha

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