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classification and interpretation of MUAC among old children and adolescent

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Anaïs

Emergency Nutrition Advisor

Normal user

24 May 2011, 15:16

Good afternoon,

We are carrying out a survey in Bangladesh and we are facing an issue regarding the analysis of MUAC among children above 5 years and adolescents. We collect the age (considered as accurate) but not the physiologic data.
As far as we know there is no national reference or classification for these populations in Bangladesh.
I read in the forum that we could establish a mean value from our sample and exclude the extreme values. But how shall we interpret then MUAC that fall under/above the mean value?
Are there any new findings on MUAC interpretation in these populations?

Thanks in advance,
Anaïs.

Mark Myatt

Consultant Epideomiologist

Frequent user

7 Jun 2011, 18:21

You could use a MUAC-for-age or MUAC-for-height reference and present (e.g.) proportions below -2 z-scores, -3 z-scores, and so-on. See (e.g.):

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2486965/pdf/bullwho00395-0041.pdf

for a MUAC-for-height reference.

This approach differs greatly from the use of 110 mm and 125 mm in under-fives because these thresholds are based on mortality risk observed in several large cohorts. As far as I am aware there are no corresponding thresholds for use with older children.

If it helps ... using a MUAC/A reference:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2486977/pdf/bullwho00392-0024.pdf

we find that 110 mm is about -4 z-scores for a five year old and 125 mm is about -3 z-scores for a five year old. So you could present results for -3 z-scores and - 4 z-scores.

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