| الوصف: |
Background The two anthropometric indicators of acute malnutrition in children under 5 years, i.e. a Mid-Upper Arm Circumference < 125 mm (MUAC 125 ) or a Weight-for-Height Z-score<−2 (WHZ −2 ), correlate poorly. We aimed at assessing the contribution of age, sex, stunting (Height-for-Age HAZ<−2), and low sitting-standing height ratio Z-score (SSRZ in the 1st tertile of the study population, called hereafter ‘longer legs’) to this diagnosis discrepancy. Methods Data from 16 cross-sectional nutritional surveys carried out by Action Against Hunger International in South Sudan, the Philippines, Chad, and Bangladesh fed multilevel, multivariate regression models, with either WHZ −2 or MUAC 125 as the dependent variable and age, sex, stunting, and ‘longer legs’ as the independent ones. We also compared how the performance of MUAC 125 and WHZ −2 to detect slim children, i.e. children with a low Weight-for-Age (WAZ<−2) but no linear growth retardation (HAZ≥−2), was modified by the contributors. Results Overall 23.1 % of the 14,409 children were identified as acutely malnourished by either WHZ −2 or MUAC 125 , but only 28.5 % of those (949/3,328) were identified by both indicators. Being stunted (+17.8 %; 95 % CI: 14.8 %; 22.8 %), being a female (+16.5 %; 95 % CI: 13.5 %; 19.5 %) and being younger than 24 months (+33.6 %; 95 % CI: 30.4 %; 36.7 %) were factors strongly associated with being detected as malnourished by MUAC 125 and not by WHZ −2 , whereas having ‘longer legs’ moderately increased the diagnosis by WHZ −2 (+4.2 %; 95 % CI: 0.7 %; 7.6 %). The sensitivity to detect slim children by MUAC 125 was 31.0 % (95 % CI: 26.8 %; 35.2 %) whereas it was 70.6 % (95 % CI: 65.4 %; 75.9 %) for WHZ −2 . The sensitivity of MUAC 125 was particularly affected by age (57.4 % vs. 18.1 % in . |
