Sensitivity and specificity of mid-upper arm circumference for assessment of severe acute malnutrition among children ages 6 to 59 months: Systematic review and meta-analysis

Lambebo, Abera; Mezemir, Yordanos; Tamiru, Dessalegn; Belachew, Tefera

doi:10.1016/j.nut.2022.111918

Cited by 4 publications

(2 citation statements)

References 20 publications

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“…Despite an 11% decrease in the global prevalence of acute malnutrition among children over the past two decades, this progress is notably modest when compared to the advancements achieved in mitigating other indicators of malnutrition [6]. Early, swift, and precise diagnosis and intervention play an important role in preventing SAM-associated deaths [7,8]. To suppress the number of SAM cases, the World Health Organization (WHO) recommends distribution of readyto-use therapeutic foods (RUTF) for children aged 6 to 59 months, as part of community-based management of acute malnutrition [9,10].…”

Section: Introductionmentioning

confidence: 99%

Soya-maize-sorghum ready-to-use therapeutic food (SMS-RUTF) for the management of severe acute malnutrition among children: A systematic review and meta-analysis

Tsurayya,

Nazhifah,

Pirwanja

et al. 2024

Narra X

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In managing severe acute malnutrition (SAM) among children, the World Health Organization has endorsed the use of ready-to-use therapeutic foods (RUTF), especially the peanut and milk-based (PM-RUTF), which has been proven for its efficacy. Unfortunately, the distribution of PM-RUTF is challenged by high financial cost and reliance on imports for milk and peanuts. Researchers explore the Soy-Maize-Sorghum (SMS)-RUTF as the alternative, in which the formulation has two types; milk-free soya-maize-sorghum (FSMS)-RUTF and low milk content SMS (MSMS)-RUTF. The aim of this study was to evaluate the efficacy, safety, and acceptance of SMS-RUTFs in the management of SAM among children as compared with PM-RUTF. Eligible studies were searched through PubMed, Scopus, and Embase up to July 14, 2023. Studies reporting the effects of SMS-RUTF, FSMS-RUTF, or MSMS-RUTF intake on SAM with PM-RUTF as the control were considered eligible. The included randomized controlled trials were then assessed for the risk of bias using Cochrane Risk of Bias 2.0. Odds Ratio (OR) and mean difference (MD) were calculated using a random-effects meta-analysis. The analysis focused on investigating the recovery, mortality, weight gain, and hemoglobin levels. Five randomized controlled trials involving a total of 5,513 children were incorporated in this review. Of which, four studies were included in the statistical analysis. Those receiving SMS-RUTF was 0.77 times less likely to recover from SAM as compared to control (95% CI: 0.66–0.90, p<0.01). The SMS-RUTF group had 1 kg lower weight gain as compared to control (95% CI: -1.25–0.75, p<0.01). However, the SMS-RUTF group had significantly higher increase of hemoglobin level than control (MD: 0.80 g/dL [95% CI: 0.68–0.93], p<0.01). Adverse effects were observed similar in both SMS-RUFT and control groups. SMS-RUFT received low acceptance from the participants suspected to be caused by poor packaging. In conclusion, SMS-RUTF is less effective than PM-RUTF in managing SAM among children but can be used to improve anemia as indicated by increased hemoglobin levels.

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Section: Introductionmentioning

confidence: 99%

Soya-maize-sorghum ready-to-use therapeutic food (SMS-RUTF) for the management of severe acute malnutrition among children: A systematic review and meta-analysis

Tsurayya,

Nazhifah,

Pirwanja

et al. 2024

Narra X

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“…Various studies have reported varying accuracy values 12,13,14,15 , for MUAC indicators using predetermined cut-offs. These values are often expressed in sensitivity and specificity percentages 16 . Furthermore, disparities differ according to age, gender, and geographical location 17 .…”

Section: Introductionmentioning

confidence: 99%

Akurasi Mid Upper Arm Circumference (MUAC) dalam Mendeteksi Malnutrisi Akut pada Anak di bawah 5 Tahun : A Literature Review

Ariza,

Nadhiroh,

Willmart

2023

AMNT

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Latar Belakang: Deteksi awal kasus malnutrisi akut secara akurat, penting untuk mencegah kematian. Penggunaan Mid Upper Arm Circumference (MUAC) dapat menjadi alternatif, namun keakuratannya masih terus digali sebab ditemukan banyak perbedaan hasil penelitian. Tujuan: Penulisan literature review ini bertujuan untuk mengidentifikasi akurasi (sensitivitas dan spesifisitas) serta cut-off optimal MUAC dalam mendeteksi malnutrisi akut pada anak di bawah 5 tahun. Metode: Pencarian artikel menggunakan dua pangkalan data elektronik yaitu Google Scholar dan Pubmed dengan kata kunci “MUAC” “children” “acute malnutrition”. Penyeleksian dilakukan berbasis pertanyaan “Bagaimana sensitivitas dan spesifisitas MUAC dalam mendeteksi malnutrisi akut pada anak dibawah 5 tahun” dengan kriteria inklusi yaitu artikel 10 tahun terakhir (2013-2023), dapat diakses penuh serta tidak berbayar, lalu mengecualikan artikel tidak Bahasa Inggris dan jenis review article. Berdasarkan hasil pencarian didapatkan 6 artikel yang layak untuk dilakukan tinjauan lebih lanjut Ulasan: Nilai sensitivitas indikator MUAC yang telah ditetapkan oleh organisasi kesehatan dunia untuk mendeteksi malnutrisi akut lebih kecil dibanding nilai spesifisitasnya. Sensitivitas MUAC terendah dalam mendeteksi malnutrisi akut berat (<11,5cm) maupun sedang (11,5-12,5 cm) ialah di Nepal, yaitu masing-masing 13,6% dan 21%. Berdasarkan hasil analisis menggunakan ROC curve pada masing-masing artikel, ditemukan cut-off optimal MUAC yang bervariasi dalam mendeteksi kasus malnutrisi akut. Kesimpulan: Akurasi cut-off MUAC yang direkomendasikan oleh organisasi kesehatan dunia belum optimal untuk mengidentifikasi malnutrisi akut pada anak dibawah 5 tahun. Oleh karena itu, diperlukan studi lebih lanjut pada setiap negara untuk menetapkan cut-off optimal di wilayahnya sesuai kelompok umur maupun klasifikasi masalah.

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Utility of mid‐upper arm circumference in pediatric malnutrition: An Australasian Society of Parenteral and Enteral Nutrition consensus statement using the Delphi method

Miles,

Fox,

Davis

et al. 2024

Nut in Clin Prac

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BackgroundMid‐upper arm circumference (MUAC) is a simple anthropometric tool used to screen for childhood undernutrition in humanitarian settings or low‐income and middle‐income countries. However, there is conflicting evidence and a lack of consensus with regard to its diagnostic use in clinical settings or population groups beyond this context. In 2023, a project officer was appointed by the Australasian Society of Parenteral and Enteral Nutrition (AuSPEN) to lead the development of a consensus review into the use of MUAC in the pediatric clinical setting.MethodsAn AuSPEN appointed multidisciplinary group of informed clinicians used the Delphi method to critically appraise the evidence and develop a series of consensus statements. Delphi surveys were anonymous and distributed electronically. Members were asked to rate their level of agreement with each consensus statement using a 5‐point Likert scale. A priori definition of consensus was established as ≥80% responses “agree” or “strongly agree.”ResultsThree Delphi rounds were required to reach consensus. A total of 18 consensus statements, including rationale, were developed across the topics ‘assessment and diagnosis’, ‘screening and monitoring’ and ‘clinical settings’.ConclusionAn evidence‐based, region‐specific consensus approach to the use of MUAC in pediatric malnutrition is a valuable tool for clinicians. MUAC is a straightforward, non‐invasive and cost‐effective tool, and may provide an advantage over traditional anthropometric tools in some clinical settings. There are limitations to the utility of MUAC and this consensus paper provides an empirical summary of advantages and limitations as they apply to the screening, assessment, diagnosis, and monitoring of pediatric malnutrition.

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Sensitivity and specificity of mid-upper arm circumference for assessment of severe acute malnutrition among children ages 6 to 59 months: Systematic review and meta-analysis

Cited by 4 publications

References 20 publications

Soya-maize-sorghum ready-to-use therapeutic food (SMS-RUTF) for the management of severe acute malnutrition among children: A systematic review and meta-analysis

Soya-maize-sorghum ready-to-use therapeutic food (SMS-RUTF) for the management of severe acute malnutrition among children: A systematic review and meta-analysis

Akurasi Mid Upper Arm Circumference (MUAC) dalam Mendeteksi Malnutrisi Akut pada Anak di bawah 5 Tahun : A Literature Review

Utility of mid‐upper arm circumference in pediatric malnutrition: An Australasian Society of Parenteral and Enteral Nutrition consensus statement using the Delphi method

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