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What are the MUAC changes in Treatment of SAM?

This question was posted the Prevention and treatment of severe acute malnutrition forum area and has 3 replies. You can also reply via email – be sure to leave the subject unchanged.

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Kiran Deshpande Shukla

Normal user

5 Jan 2012, 04:45

n a facility based management centre for SAM, how much MUAC increase is expected in a child in 2 weeks after starting him on RUTF such as Plumpy Nut if ...

1. The child gains between 0-5% of admission weight
2. Between 5-10% of admission weight
3. 10-15% of admission weight
4. >15% of admission weight
5. Achieves target weight of 15%

Martha

Post doctoral researcher

Normal user

6 Jan 2012, 06:48

We recently published data of a study we conducted in Kenya to quantify MUAC changes among dehydrated children some of whom were malnourished http://www.nutritionj.com/content/10/1/92.

We were able to quantify that a one percent (1%) change in weight, was associated with a 0.40 mm (95% CI of 0.30 to 0.44 mm, P < 0.001) change in MUAC, 0.035z (95% CI 0.027 to 0.04z, P < 0.001) change in MUACz and a 0.115z (95% CI of 0.11 to 0.12z, P < 0.001) change in WFLz.

Using our findings and simple calculations, you should be able to estimate how much MUAC would be expected to increase with respect to percent weight increase among these children.I have not come across any other studies conducted in children to established how MUAC responds with changes in weight. I am not sure if others have.

Hope that is useful.

Paul

Technical expert

6 Jan 2012, 09:48

There is currently a MUAC study being undertaken in Malawi by Valid International. This will be completed later this year and results published thereafter. The study will illustrate the MUAC vs. weight changes you refer to.

Mark Myatt

Consultant Epideomiologist

Frequent user

6 Jan 2012, 15:31

Examination of data from program record cards from CTC programs during the CTC research program and in the initial roll-out of CTC / CMAM show a range of median MUAC gains (0.25 mm per day to 0.50 mm per day). Note that these are averages of averages over an entire treatment episode. The rate of change is not consistent over the entire treatment episode and in uncomplicated SAM case typically follows a growth curve with rapid gains early in the treatment episode. MUAC gain and weight gain tend to mirror each other. A lot of the data available to me is summarised in this presentation.

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