Severely malnourished children with a low weight-for-height have similar mortality to those with a low mid-upper-arm-circumference: II. Systematic literature review and meta-analysis

Nutrition Journal

Volumn 17, Issue 1, 2018, Pages

  Grellety, Emmanuel ^a   Golden, Michael H ^b  

^a UNIVERSITÉ LIBRE DE BRUXELLES   (Belgium)

^b UNIVERSITY OF ABERDEEN   (United Kingdom)

Author keywords

Acute malnutrition; Case fatality rate; Child; Diagnosis; Human; Kwashiorkor; Meta analysis; Mid upper arm circumference; Mortality; MUAC; Nutrition; Oedema; SAM; Severe acute malnutrition; Simpson's paradox; Systematic review; Wasting; Weight for height; WHZ

Indexed keywords

ANTHROPOMETRY; ARM CIRCUMFERENCE; ARTICLE; BODY HEIGHT; BODY WEIGHT; CASE FATALITY RATE; CHILD; CHILDHOOD MORTALITY; CLINICAL OUTCOME; COMORBIDITY; DISEASE SEVERITY; EDEMA; HUMAN; MALNUTRITION; META ANALYSIS; MORTALITY RISK; STANDARD; SYSTEMATIC REVIEW; WEIGHT-FOR-HEIGHT; AFRICA; ARM; ASIA; EPIDEMIOLOGY; FEMALE; INFANT; MALE; MORTALITY; PATHOPHYSIOLOGY; PRESCHOOL CHILD; PROCEDURES; RETROSPECTIVE STUDY; UNDERWEIGHT;

AFRICA; ANTHROPOMETRY; ARM; ASIA; BODY HEIGHT; BODY WEIGHT; CHILD, PRESCHOOL; EDEMA; FEMALE; HUMANS; INFANT; MALE; RETROSPECTIVE STUDIES; SEVERE ACUTE MALNUTRITION; THINNESS;

EID: 85053292129     PISSN: None     EISSN: 14752891     Source Type: Journal    
DOI: 10.1186/s12937-018-0383-5     Document Type: Article

References (85)

1. Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, De Onis M, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet. 2013;382:427-51. http://www.sciencedirect.com/science/article/pii/S014067361360937X.
2. Myatt M, Khara T, Collins S. A review of methods to detect cases of severely malnourished children in the community for their admission into community-based therapeutic care programs. Food Nutr Bull. 2006;27:S7-23. http://archive.unu.edu/unupress/food/FNB-v27n3-suppl.pdf#page=7.
3. John C, Ocheke IE, Diala U, Adah RO, Envuladu EA. Does mid upper arm circumference identify all acute malnourished 6-59 month old children, in field and clinical settings in Nigeria? S Afr J Clin Nutr. 2016;1-5. http://www.tandfonline.com/doi/abs/10.1080/16070658.2016.1255486.
4. Manyike PC, Chinawa JM, Ubesie A, Obu HA, Odetunde OI, Chinawa AT. Prevalence of malnutrition among pre-school children in, South-east Nigeria. Italian J Pediatrics. 2014;40:75. https://ijponline.biomedcentral.com/articles/10.1186/s13052-014-0075-5.
5. Gayle HD, Binkin NJ, Staehling NW, Trowbridge FL. Arm circumference v. weight-for-height in nutritional assessment: are the findings comparable? J Trop Pediatr. 1988;34:213-7. https://academic.oup.com/tropej/article-abstract/34/5/213/1632459/Arm-Circumference-v-Weight-for-Height-in.
6. Ross DA, Taylor N, Hayes R, McLean M. Measuring malnutrition in famines: are weight-for-height and arm circumference interchangeable? Int J Epidemiol. 1990;19:636-45. https://academic.oup.com/ije/article-abstract/19/3/636/760605/Measuring-Malnutrition-in-Famines-Are-Weight-for.
7. Bern C, Nathanail L. Is mid-upper-arm circumference a useful tool for screening in emergency settings? Lancet. 1995;345:631-3. http://www.sciencedirect.com/science/article/pii/S0140673695905278.
8. Rees DG, Henry CJK, Diskett P, Shears P. Measures of nutritional status: survey of young children in north-East Brazil. Lancet. 1987;329:87-9. http://www.sciencedirect.com/science/article/pii/S0140673687919209.
9. Hop LT, Gross R, Sastroamidjojo S, Giay T, Schultink W. Mid-upper-arm circumference development and its validity in assessment of undernutrition. Asia Pac J Clin Nutr 1998, 7: 65-69. apjcn.nhri.org.tw /server/apjcn/7/1/65.pdf.
10. Tripathy JP, Sharma A, Prinja S. Is mid-upper arm circumference alone sufficient to identify severe acute malnutrition correctly. Indian Pediatr. 2016;53:166-7. http://indianpediatrics.net/feb2016/166.pdf.
11. Roberfroid D, Huybregts L, Lachat C, Vrijens F, Kolsteren P, Guesdon B. Inconsistent diagnosis of acute malnutrition by weight-for-height and mid-upper arm circumference: contributors in 16 cross-sectional surveys from South Sudan, the Philippines, Chad, and Bangladesh. Nutr J. 2015;14:1. https://nutritionj.biomedcentral.com/articles/10.1186/s12937-015-0074-4.
12. Dasgupta R, Sinha D, Jain SK, Prasad V. Screening for SAM in the community: is MUAC a simple tool? Indian Pediatr 2013, 50: 154-155. http://link.springer.com/article/10.1007/s13312-013-0032-1
13. Fernandez MA, Delchevalerie P, Van HM. Accuracy of MUAC in the detection of severe wasting with the new WHO growth standards. Pediatrics. 2010;126:e195-201. http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.919.6180&rep=rep1&type=pdf.
14. Carter EP. Comparison of weight: height ratio and arm circumference in assessment of acute malnutrition. Arch Dis Child. 1987;62:833-5. https://adc.bmj.com/content/62/8/833.short.
15. Laillou A, Prak S, de Groot R, Whitney S, Conkle J, Horton L et al. Optimal screening of children with acute malnutrition requires a change in current WHO guidelines as MUAC and WHZ identify different patient groups. PLoS ONE 2014, 9: e101159. https://bmcnutr.biomedcentral.com/articles/10.1186/s40795-016-0049-7.
16. Grellety E, Krause LK, Shams EM, Porten K, Isanaka S. Comparison of weight-for-height and mid-upper arm circumference (MUAC) in a therapeutic feeding programme in South Sudan: is MUAC alone a sufficient criterion for admission of children at high risk of mortality? Public Health Nutr. 2015;18:2575-81. http://www.epicentre.msf.org/sites/preprod.epicentre.actency.fr/files/661-Comparison%20of%20weight-for-height.pdf.
17. Talapalliwar MR, Garg BS. Diagnostic accuracy of mid-upper arm circumference (MUAC) for detection of severe and moderate acute malnutrition among tribal children in Central India. Int J Med Sci Public Health. 2016;5:1317-21. http://www.ejmanager.com/mnstemps/67/67-1441365239.pdf.
18. Dukhi N, Sartorius B, Taylor M. Mid-upper arm circumference (MUAC) performance versus weight for height in south African children (0-59 months) with acute malnutrition. S Afr J Clin Nutr. 2017;1-6. http://www.tandfonline.com/doi/abs/10.1080/16070658.2016.1255483.
19. Fiorentino M, Sophonneary P, Laillou A, Whitney S, de Groot R, Perignon M et al. Current MUAC Cut-Offs to Screen for Acute Malnutrition Need to Be Adapted to Gender and Age: The Example of Cambodia. PLoS ONE. 2016;11:e0146442. http://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0146442&type=printable.
20. Tadesse AW, Tadesse E, Berhane Y, Ekstrom EC. Comparison of mid-upper arm circumference and weight-for-height to diagnose severe acute malnutrition: a study in southern Ethiopia. Nutrients. 2017;9:267. http://www.mdpi.com/2072-6643/9/3/267/htm.
21. Grellety E, Golden MH. Weight-for-height and mid-upper-arm circumference should be used independently to diagnose acute malnutrition: policy implications. BMC Nutr. 2016;2:10. https://bmcnutr.biomedcentral.com/articles/10.1186/s40795-016-0049-7.
22. Briend A, Alvarez JL, Avril N, Bahwere P, Bailey J, Berkley JA et al. Low mid-upper arm circumference identifies children with a high risk of death who should be the priority target for treatment. BMC Nutrition. 2016;2:63. https://bmcnutr.biomedcentral.com/articles/10.1186/s40795-016-0101-7.
23. Hammond W, Badawi AE, Deconinck H. Detecting severe acute malnutrition in children under five at scale. The Challenges of Anthropometry to Reach the Missed Millions. Ann Nutr Disord & Ther. 2016;3:1030. http://austinpublishinggroup.com/nutritional-disorders/fulltext/andt-v3-id1030.php#Top.
24. Bailey J, Chase R, Kerac M, Briend A, Manary M, Opondo C, et al. Combined protocol for SAM/MAM treatment. The ComPAS study. Field exchange. 2016;53:44. http://www.ennonline.net/fex/53/thecompasstudy.
25. Garenne M, Maire B, Fontaine O, Briend A. Adequacy of child anthropometric indicators for measuring nutritional stress at population level: a study from Niakhar, Senegal. Public Health Nutr. 2013;16:1533-9. https://www.cambridge.org/core/services/aop-cambridge-core/content/view/S136898001200448X.
26. Briend A. Use of MUAC for severe acute malnutrition. CMAM forum. 2012; http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.662.303&rep=rep1&type=pdf.
27. Taren D, de Pee S. The Spectrum of Malnutrition. In: Nutrition and Health in a Developing World. New York: Springer International Publishing; 2017. p. 91-117.
28. Deconinck H. Understanding pathways of integrating severe acute malnutrition interventions into national health systems in low-income countries: Doctoral dissertation. Université catholique de Louvain; 2017. https://dial.uclouvain.be/pr/boreal/object/boreal%3A183112/datastream/PDF-02/view.
29. EN-Net. WFH versus MUAC. 2015. Emergency Nutrition Network. http://www.en-net.org/question/1915.aspx.
30. EN-Net. Only MUAC for admission and discharge? 2015. Emergency Nutrition Network. http://www.en-net.org/question/1922.aspx.
31. Briend A, Maire B, Fontaine O, Garenne M. Mid-upper arm circumference and weight-for-height to identify high-risk malnourished under-five children. Maternal & child nutrition 2012, 8: 130-133. http://onlinelibrary.wiley.com/doi/10.1111/j.1740-8709.2011.00340.x/full.
32. The Council of Research & Technical Advice on Acute Malnutrition (CORTASAM). No Wasted Lives 2017. https://www.nowastedlives.org/advisory-group/.
33. Grellety E, Golden MH. Severely malnourished children with a low weight-for-height have a higher mortality than those with a low mid-upper-arm-circumference: I. Empirical data demonstrates Simpson's paradox. Nutr J. 2018. https://doi.org/10.1186/s12937-018-0384-4.
34. Grellety E, Golden MH. Severely malnourished children with a low weight-for-height have a higher mortality than those with a low mid-upper-arm-circumference: III. Effect of case-load on malnutrition related mortality: policy implications. Nutr J. 2018. https://doi.org/10.1186/s12937-018-0382-6.
35. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009;151:264-9. https://doi.org/10.7326/0003-4819-151-4-200908180-00135.
36. Olofin I, Guesdon B, Roberfroid D. Associations of suboptimal MUAC and WHZ combinations with child mortality: a pooled analysis: Action Against Hunger, Research for Nutrition Conference; 2016. http://files.ennonline.net/attachments/2604/ACF-conference-special-section.pdf.
37. Archie JP Jr. Mathematic coupling of data: a common source of error. Ann Surg. 1981;193:296. http://journals.lww.com/annalsofsurgery/abstract/1981/03000/mathematic-coupling-of-data--a-common-source-of.8.aspx.
38. Tu YK, Maddick IH, Griffiths GS, Gilthorpe MS. Mathematical coupling can undermine the statistical assessment of clinical research: illustration from the treatment of guided tissue regeneration. J Dentistry 32: 133-142. http://dx.doi.org/10.1016/j.jdent.2003.10.001
39. Garenne M, Maire B, Fontaine O, Dieng K, Briend A. Risques de décès associés à différents états nutritionnels chez l'enfant d'âge préscolaire: étude réalisée à Niakhar (Sénégal), 1983-1986. ORSTOM Dakar; 1987. http://horizon.documentation.ird.fr/exl-doc/pleins-textes/divers11-10/24687.pdf.
40. Garenne M, Willie D, Maire B, Fontaine O, Eeckels R, Briend A, et al. Incidence and duration of severe wasting in two African populations. Public Health Nutr. 2009;12:1974. https://www.cambridge.org/core/services/aop-cambridge-core/content/view/S1368980009004972.
41. Van Den Broeck J, Eeckels R, Vuylsteke J. Influence of nutritional status on child mortality in rural Zaire. Lancet. 1993;341:1491-5. http://www.sciencedirect.com/science/article/pii/014067369390632Q.
42. Barendregt JJ, Doi SA. Meta XL. 5.32 [computer program]. Queensland: EpiGear International Pty Ltd; 2016. https://www.epigear.com/index-files/metaxl.html
43. Doi SAR, Barendregt JJ, Khan S, Thalib S, Williams GM. Advances in the meta-analysis of heterogeneous clinical trials II: The quality effects model. Contemp Clin Trials 2015; 45 (Pt A):123-129. https://doi.org/10.1016/j.cct.2015.05.010.
44. Aguayo VM, Aneja S, Badgaiyan N, Singh K. Mid upper-arm circumference is an effective tool to identify infants and young children with severe acute malnutrition in India. Public Health Nutr. 2015;18:3244-8. https://www.cambridge.org/core/services/aop-cambridge-core/content/view/S1368980015000543.
45. Grellety E, Shepherd S, Roederer T, Manzo ML, Doyon S, Ategbo EA, et al. Effect of mass supplementation with ready-to-use supplementary food during an anticipated nutritional emergency. PLoS One. 2012;7:e44549. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3440398/pdf/pone.0044549.pdf.
46. Isanaka S, Guesdon B, Labar AS, Hanson K, Langendorf C, Grais RF. Comparison of clinical characteristics and treatment outcomes of children selected for treatment of severe acute malnutrition using mid upper arm circumference and/or weight-for-height Z-score. PLoS One. 2015;10:e0137606. http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0137606.
47. Lowlaavar N, Larson CP, Kumbakumba E, Zhou G, Ansermino JM, Singer J, et al. Pediatric in-hospital death from infectious disease in Uganda: derivation of clinical prediction models. PLoS One. 2016;11:e0150683. http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0150683.
48. LaCourse S, Chester FM, Preidis G, McCrary LM, Maliwichi M, McCollum ED, et al. Lay-screeners and use of WHO growth standards increase case finding of hospitalized Malawian children with severe acute malnutrition. J Trop Pediatr. 2014;61:44-53. https://doi.org/10.1093/tropej/fmu065.
49. Berkley J, Mwangi I, Griffiths K, Ahmed I, Mithwani S, English M, et al. Assessment of severe malnutrition among hospitalized children in rural Kenya: comparison of weight for height and mid upper arm circumference. Jama. 2005;294:591-7. http://jamanetwork.com/journals/jama/fullarticle/201328.
50. Chiabi A, Mbanga C, Mah E, Nguefack DF, Nguefack S, Fru F, et al. Weight-for-Height Z Score and Mid-Upper Arm Circumference as Predictors of Mortality in Children with Severe Acute Malnutrition. J Trop Pediatr. 2017; https://academic.oup.com/tropej/article-abstract/63/4/260/2671088.
51. Sachdeva S, Dewan P, Shah D, Malhotra RK, Gupta P. Mid-upper arm circumference v. weight-for-height Z-score for predicting mortality in hospitalized children under 5 years of age. Public Health Nutr. 2016:1-8. https://www.cambridge.org/core/services/aop-cambridge-core/content/view/S1368980016000719.
52. Burza S, Mahajan R, Marino E, Sunyoto T, Shandilya C, Tabrez M, et al. Seasonal effect and long-term nutritional status following exit from a community-based Management of Severe Acute Malnutrition program in Bihar, India. Eur J Clin Nutr. 2015; http://www.nature.com/ejcn/journal/v70/n4/full/ejcn2015140a.html.
53. Mogeni P, Twahir H, Bandika V, Mwalekwa L, Thitiri J, Ngari M, et al. Diagnostic performance of visible severe wasting for identifying severe acute malnutrition in children admitted to hospital in Kenya. Bull WHO. 2011;89:900-6. http://www.who.int/bulletin/volumes/89/12/11-091280/en/.
54. Sylla A, Gueye M, Keita Y, Seck N, Seck A, Mbow F, et al. Dehydration and malnutrition as two independent risk factors of death in a Senegalese pediatric hospital. Archives de pediatrie: organe officiel de la Societe francaise de pediatrie. 2015;22:235-40. https://doi.org/10.1016/j.arcped.2014.11.024.
55. Vella V. An epidemiological analysis of the determinants of childhood malnutrition and mortality in southwest Uganda. PhD thesis London School of Hygiene & Tropical Medicine; 1990. http://researchonline.lshtm.ac.uk/682267/1/296416.pdf.
56. Dramaix M, Hennart P, Brasseur D, Bahwere P, Mudjene O, Tonglet R et al. Serum albumin concentration, arm circumference, and oedema and subsequent risk of dying in children in central Africa. Bmj. 1993;307:710-3. https://doi.org/10.1136/bmj.307.6906.710.
57. Girum T, Kote M, Tariku B, Bekele H. Survival status and predictors of mortality among severely acute malnourished children< 5 years of age admitted to stabilization centers in Gedeo zone: a retrospective cohort study. Ther Clin Risk Manag. 2017;13:101. https://doi.org/10.2147/TCRM.S119826.
58. Savadogo L, Zoetaba I, Donnen P, Hennart P, Sondo BK, Dramaix M. Management of severe acute malnutrition in an urban nutritional rehabilitation center in Burkina Faso. Revue d'epidemiologie et de sante publique. 2007;55:265-74. https://doi.org/10.1016/j.respe.2007.05.006.
59. Nhampossa T, Sigauque B, Machevo S, Macete E, Alonso P, Bassat Q, Menendez C, Fumado V. Severe malnutrition among children under the age of 5 years admitted to a rural district hospital in southern Mozambique. Public Health Nutr. 2013;16(9):1565-74. https://doi.org/10.1017/S1368980013001080.
60. Acevedo P, Esteban MTG, Lopez-Ejeda N, Gómez A, Marrodán MD. Influence of malnutrition upon all-cause mortality among children in Swaziland. Endocrinología, Diabetes y Nutrición. 2017;64(4):204-10. https://doi.org/10.1016/j.endinu.2017.01.008.
61. WHO, Unicef. WHO child growth standards and the identification of severe acute malnutrition in infants and children: a joint statement by the World Health Organization and the United Nations Children's fund. 2009. http://www.who.int/nutrition/publications/severemalnutrition/9789241598163-eng.pdf.
62. WHO. Guideline: Updates on the management of severe acute malnutrition in infants and children. Geneva, World Health Organization; 2013. http://www.who.int/nutrition/publications/guidelines/updates-management-SAM-infantandchildren/en/ infantandchildren/en/.
63. Golden MH, Grellety Y. Population nutritional status during famine. 2002. http://www.nutrisurvey.de/ena-beta/Golden-Population-nutritional-status-during-famile-surveywhzdis.pdf.
64. Frison S, Checchi F, Kerac M, Nicholas J. Is middle-upper arm circumference "normally" distributed? Secondary data analysis of 852 nutrition surveys. Emerg Themes Epidemiol. 2016;13:7.
65. De Onis M, Yip R, Mei Z. The development of MUAC-for-age reference data recommended by a WHO expert committee. Bull World Health Organ. 1997;75:11-8.
66. Tu YK, Gunnell D, Gilthorpe MS. Simpson's paradox, Lord's paradox, and suppression effects are the same phenomenon - the reversal paradox. Emerging Themes in Epidemiology. 2008;5:2. https://ete-online.biomedcentral.com/articles/10.1186/1742-7622-5-2.
67. Willis JS, Golden MH. Active and passive transport of sodium and potassium ions in erythrocytes of severely malnourished Jamaican children. Eur J Clin Nutr. 1988;42:635-45.
68. Bairagi R. On validity of some anthropometric indicators as predictors of mortality. Am J Clin Nutr. 1981;34(11):2592-4.
69. Briend A, Dykewicz C, Graven K, Mazumder RN, Wojtyniak B, Bennish M. Usefulness of nutritional indices and classifications in predicting death of malnourished children. Br Med J. 1986;293(6543):373-5. https://doi.org/10.1136/bmj.293.6543.373.
70. Alam N, Wojtyniak B, Rahaman MM. Anthropometric indicators and risk of death. Am J Clin Nutr. 1989;49(5):884-8.
71. Briend A, Garenne M, Maire B, Fontaine O, Dieng K. Nutritional status, age and survival: the muscle mass hypothesis. Eur J Clin Nutr. 1989;43(10):715-26.
72. Vella V, Tomkins A, Borghesi A, Migliori GB, Ndiku J, Adriko BC. Anthropometry and childhood mortality in northwest and Southwest Uganda. Am J Public Health. 1993;83(11):1616-8. https://doi.org/10.2105/AJPH.83.11.1616.
73. Pelletier DL, Low JW, Johnson FC, Msukwa LA. Child anthropometry and mortality in Malawi: testing for effect modification by age and length of follow-up and confounding by socioeconomic factors. J Nutr. 1994;124:2082S-105S.
74. Pelletier DL. The relationship between child anthropometry and mortality in developing countries: implications for policy, programs and future research. J Nutr. 1994;124(10 Suppl):2047S-81S.
75. Vella V, Tomkins A, Ndiku J, Marshal T, Cortinovis I. Anthropometry as a predictor for mortality among Ugandan children, allowing for socio-economic variables. Eur J Clin Nutr. 1994;48(3):189-97.
76. Van den Broeck J, Eeckels R, Massa G. Validity of single-weight measurements to predict current malnutrition and mortality in children. J Nutr. 1996;126(1):113-20.
77. Garenne M, Maire B, Fontaine O, Briend A. Distributions of mortality risk attributable to low nutritional status in Niakhar, Senegal. J Nutr. 2006;136:2893-900.
78. Mwangome MK, Fegan G, Fulford T, Prentice AM, Berkley JA. Mid-upper arm circumference at age of routine infant vaccination to identify infants at elevated risk of death: a retrospective cohort study in the Gambia. Bull WHO. 2012;90(12):887-94. https://doi.org/10.2471/BLT.12.109009.
79. Waterlow JC, Tomkins A, Grantham-McGregor SM. Protein energy malnutrition. London: Edward Arnold; 1992.
80. Rice AL, Sacco L, Hyder A, Black RE. Malnutrition as an underlying cause of childhood deaths associated with infectious diseases in developing countries. Bull WHO. 2000;78:1207-21.
81. Muller O, Garenne M, Kouyate B, Becher H. The association between protein-energy malnutrition, malaria morbidity and all-cause mortality in west African children. Tropical Med Int Health. 2003;8:507-11. https://doi.org/10.1186/1475-2875-5-47.
82. Grellety E, Golden MH. Response to Briend et al "low mid-upper-arm-circumference identifies children with a high risk of death and should be the priority target for treatment". BMC Nutrition. 2016;2-63:1-12. https://bmcnutr.biomedcentral.com/articles/10.1186/s40795-016-0101-7.
83. WHO. Management of severe malnutrition: a manual for physicians and other senior health workers: World Health Organization; 1999. http://apps.who.int/iris/handle/10665/41999.
84. Golden MH. Comment on WHZ and MUAC for diagnosis of severe malnutrition by Chiabi A et al. J Trop Pediatr. 2017;0:1-2. https://doi.org/10.1093/tropej/fmx008.
85. Heikens GT, Manary MJ, Trehan I. African children with severe pneumonia remain at high risk for death even after discharge. Paediatr Perinat Epidemiol. 2017. http://onlinelibrary.wiley.com/doi/10.1111/ppe.12350/full.