Mid-upper Arm Circumference For Diagnosis Of Severe Acute Malnutrition Among Infants Aged 1-6 Months Hospitalized In East Hararghe Ethiopia

Background: Mid-upper arm circumference and weight-for-length/height are the two mostlyrnused anthropometric indices to identify acute malnutrition in older children. However, severernacute malnutrition is only identified by the use of weight-for-length other than clinical methodsrnin infants aged less than 6 months. rnObjective: To evaluate the ability of mid-upper arm circumference as an effective diagnosticrntool for severe acute malnutrition (weight for length z-score of < -3) among infants aged 1-6rnmonths.rnMethods: We conducted a hospital based cross-sectional study among 504 hospitalized infantsrnaged 1-6 months from March to May, 2019. A systematic random sampling technique were usedrnto select study participants. Anthropometric measure; weight, length and mid-upper armrncircumference were taken according to the world health organization standard techniques Datarnwas entered using EpiData version (4.4.2.1) and statistical software (Stata v 15.1) was employedrnfor data cleaning and analysis. Receiver operating characteristic analysis was used to test therndiscriminatory performance of mid-upper arm circumference. Sensitivity, specificity and Youdenrnindex (sensitivity+specificity-1) were calculated for mid-upper arm circumference cut-offsrnagainst the presence of severe acute malnutrition (weight for length z-score < -3). The cut-offrnpoint with the highest Youden index was obtained as the possible optimal cut off point torndiagnoses severe acute malnutrition. rnResults: The median age of the infants was 100 days with interquartile range of 76 days. Thernmean and SD of weight, length, mid upper arm circumference and weight-for-length z-score wasrn5.02 ± 1.29 kg, 58.41 ± 5.26cm, 11.51 ± 1.89 cm and -1.14 ± 2.08, respectively. Using Receiverrnoperating characteristics curve, MUAC had a good diagnostic performance with area under therncurve 0.861, (95% CI: 0.826, 0.890). Using Youden index, the possible optimal MUAC cut-offrnpoint to identify SAM was ≤11.2cm with sensitivity of 85.1%, specificity of 76.0%, PPV ofrn49.4% and NPV of 94.9%. rnConclusion: Among infants under 6 months, mid upper arm circumference (MUAC) had a goodrnperformance in detecting severe acute malnutrition. We recommend the validation of our resultrnbefore using to other contexts. Furthermore, more research is needed to evaluate the performancernof MUAC for detection of acute malnutrition at community level and evaluate performance ofrnMUAC for prediction of mortality.

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