Arm circumference for age, arm circumference and weight-for-height z-score for the evaluation of severe acute malnutrition: a retrospective cohort study in eastern Democratic Republic of Congo

Ngaboyeka, Gaylord; Bisimwa, Ghislain; Neven, Anouk; Mwene-Batu, Pacifique; Kambale, Richard; Ongezi, Emmanuel; Chimanuka, Christine; Ntagerwa, Joseph; Balolebwami, Serge; Mulume, Francis; Battisti, Oreste; Dramaix, Michèle; Donnen, Philippe

doi:10.1186/s12889-024-18083-y

Article (Scientific journals)

Arm circumference for age, arm circumference and weight-for-height z-score for the evaluation of severe acute malnutrition: a retrospective cohort study in eastern Democratic Republic of Congo

Ngaboyeka, Gaylord; Bisimwa, Ghislain; Neven, Anouk et al.

2024 • In BMC Public Health, 24 (1)

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https://hdl.handle.net/2268/313649

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10.1186/s12889-024-18083-y

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38395784

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Public Health, Environmental and Occupational Health

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[en] Abstract Background Little is known about the use of mid-upper arm circumference for age (MUACZ) for diagnosing of severe acute malnutrition (SAM) and its correlation with WHZ (weight-for-height Z-score) in an area endemic for severe acute malnutrition (SAM) and with a high prevalence of kwashiorkor. Our study aims to analyze the concordance between the diagnostic criteria of SAM in a region presenting these characteristics. Methods We analyzed a database of children admitted from 1987 to 2008 for the management of SAM in Eastern Democratic Republic of Congo. Anthropometric indicators (z-score) were calculated and classified into 3 categories according to WHO standards. Cohen’s kappa coefficient (κ) was calculated to assess the concordance between these indicators. Results Out of the 9969 selected children aged 6 to 59 months, 30.2% had nutritional edema, 70.1% had a height-for-age (HAZ) z-score <-2, 11.5% WHZ<-3 z-score, 14.9% had a MUAC < 115 mm and 21.8% had a MUACZ <-3 z-score. With the classic combination WHZ and MUAC, 36% of children with SAM had both criteria at the same time and MUAC alone being the indicator that recruited more children with SAM (77%) compared with 65% with WHZ only. By replacing MUAC with MUACZ, 34% of SAM children fulfilled both criteria, WHZ and MUACZ. MUACZ alone recruited more children with SAM (88%) compared with 46% with WHZ alone. Considering these three indicators together, MUACZ remained the indicator that recruited more children with SAM (85%). WHZ and MUAC showed a moderate agreement [ κ (95% CI) = 0.408(0.392–0.424)], WHZ and MUACZ a weak agreement [ κ (95% CI) = 0.363(0.347–0.379)] and MUAC and MUACZ a good agreement [ κ (95% CI) = 0.604 (0.590–0.618)]. Conclusion Adjusting MUAC according to age improves its effectiveness in identifying severe acute malnutrition. With low concordance, MUAC and WHZ remain complementary in our context. MUACZ proves to be crucial, especially in the presence of kwashiorkor and chronic malnutrition, becoming a valuable tool for assessing severe acute malnutrition in our context.

Disciplines :

Public health, health care sciences & services

Author, co-author :

Ngaboyeka, Gaylord

Bisimwa, Ghislain

Neven, Anouk

Mwene-Batu, Pacifique

Kambale, Richard

Ongezi, Emmanuel

Chimanuka, Christine

Ntagerwa, Joseph

Balolebwami, Serge

Mulume, Francis

More authors (3 more)

Language :

English

Title :

Arm circumference for age, arm circumference and weight-for-height z-score for the evaluation of severe acute malnutrition: a retrospective cohort study in eastern Democratic Republic of Congo

Publication date :

23 February 2024

Journal title :

BMC Public Health

eISSN :

1471-2458

Publisher :

Springer Science and Business Media LLC

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Issue :

Peer reviewed :

Peer Reviewed verified by ORBi

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https://link.springer.com/content/pdf/10.1186/s12889-024-18083-y.pdf

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