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MUAC and mortality in India

This question was posted the Prevention and treatment of severe acute malnutrition forum area and has 2 replies. You can also reply via email – be sure to leave the subject unchanged.

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Mark Myatt

Consultant Epideomiologist

Frequent user

4 Jun 2018, 09:59

Here is an article looking at MUAC as a predictor of mortality in India.

I hope this is useful.

Dr Charulatha Banerjee

Asia Regional Knowledge Management Specialist

Normal user

5 Jun 2018, 07:37

Thank you very much Mark - The implications of the findings are huge for India and we have India based evidence finally - the discussion section is very well summarised. Hope that the technical group currently formalising the CMAM guidelines for the country takes note.


Frequent user

5 Jun 2018, 10:26

Dear Dr Charulatha Banerjee,

This is indeed a very important paper. It does shows clearly that children with a low MUAC have a high risk of death in Indian children as well. This is consistent with previous studies from Bangladesh which showed similar results (1) (2) (3).

It is not clear to me why in the discussion the authors recommend to use when possible WHZ in addition to MUAC. The article does not present data to support this point. As a reminder, a previous study suggested it is more appropriate to use MUAC with a higher cut off than adding WHZ when the objective is to detect most effectively children with a high risk of death (4).

1. Bairagi R. On validity of some anthropometric indicators as predictors of mortality. Am J Clin Nutr. nov 1981;34(11):2592‑4.

2. Alam N, Wojtyniak B, Rahaman MM. Anthropometric indicators and risk of death. Am J Clin Nutr. mai 1989;49(5):884‑8.

3. Briend A, Wojtyniak B, Rowland MG. Arm circumference and other factors in children at high risk of death in rural Bangladesh. Lancet Lond Engl. 26 sept 1987;2(8561):725‑8.

4. Briend A, Maire B, Fontaine O, Garenne M. Mid-upper arm circumference and weight-for-height to identify high-risk malnourished under-five children. Matern Child Nutr. janv 2012;8(1):130‑3.

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