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What is the cut off point for child bearing age women to decide acute malnutrition based on MUAC?

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Anonymous 1310

Nutrition Manager

Normal user

24 Aug 2016, 12:32

We are planning to do nutrition assessment among child bearing age women using MUAC only. As far I know, MUAC less than 21cm (some where may be 22cm,23cm) is used as cut off point for PLW to classify acute malnutrition in SFP.

Is it same cut off point for child bearing age women or different to classify acute malnutrition based on MUAC?

Thank you for your advice

Rakesh

Normal user

24 Aug 2016, 20:07

Dear
First of all, you have to define childbearing age women. it can be women of reproductive age (15 to 45). For women of aged between 15 to 18 years, BMI for age will be the best comparison which you can access and analyse by using WHO Anthro +. In case you want to continue with the orignal idea of MUAC, so for PLW women MUAC <180 MM is categories as SAM and MUAC raging >180<210 as MAM.

Mutegi

Normal user

24 Aug 2016, 20:51

Women of reproductive age varies in context, in most cases the age category is between 15-49years. Based on experience SFP targetted programmes(MAM) focusses on pregnant and lactating women with MUAC less than 210mm while blanket SFP targets rest of PLW with MUAC above 210mm. MUAC less than 210mm has been used to admit women of reproductive age but this depends on context.

Mija Ververs

Normal user

24 Aug 2016, 20:52

Dear responder 2645 to the original question.
I do not agree with your advice to the original question. There is currently no proof of your statement to opt for:
PLW women MUAC <180 MM is categories as SAM and MUAC raging >180<210 as MAM. that you should use 18 cm for MUAC .
I d rather recommend you to read also our research article which you can find here. Look specifically on the rationale why SAM and MAM categories are not yet well defined for this group.

''MUAC is a good indicator of the protein reserves of a body, and a thinner arm reflects wasted lean mass, i.e. malnutrition 25. The WHO Collaborative Study 1995 showed MUAC cut-off values of <21 to 23 cm as having significant risk for LBW (OR 1.9, 95%CI: 95% 1.7-2.1) when highest and lowest quartiles of the maternal height distribution were compared 14. These values are similar to values identified in this review. However, the data in Table 1 indicate that a cut-off value of 21 cm might be too low. As LBW has detrimental effects on a child’s survival it seems that a more inclusive approach with a MUAC cut-off of <22 or <23 cm should be used to indicate risk of LBW and to use as entry criterion for nutritional programmes. MUAC is rather insensitive to changes over the total period of pregnancy for adult women 3,26–28, is easy to measure, and requires only one measurement. More research is needed whether different cut-off values should be used for the Asian or African continent, but current data suggest that <23 cm appears adequate for both continents. It is also the most conservative cut-off value ensuring the most PW at risk for LBW are included. It is likely that the relevance of the use of MUAC is similar in different humanitarian emergencies, being it conflict, natural disaster, sudden or slow onset.

Currently, there is no data available that differentiates PW from being moderately or severely malnourished, i.e. having categories for MUAC that indicate high or relatively even higher risks for adverse outcomes. This does not mean they do not exist, but that this literature review does not provide sufficient evidence to support the creation of such categories.

Further research is needed to evaluate whether the combined use of one or two easily measurable anthropometric indicators can have a high predictive power for risk of adverse birth outcomes in humanitarian contexts. In addition, research is needed to determine to what extent enrolment in nutritional programmes of PW with a MUAC <23 cm can avert risk of LBW.

Conclusions
In the humanitarian context, MUAC can be used as a reliable indicator of risk of LBW. A cut-off value of <23 cm should be used to enrol PW in nutritional programmes. National protocols from Ministries of Health and humanitarian organisations that currently use a MUAC <21 cm to enrol PW in SFPs should consider increasing the cut-off value in order to reduce the risk of LBW infants.''

source:
http://currents.plos.org/disasters/article/which-anthropometric-indicators-identify-a-pregnant-woman-as-acutely-malnourished-and-predict-adverse-birth-outcomes-in-the-humanitarian-context/

good luck, mija

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