Determining an Optimal Case Definition using Mid-upper Arm Circumference With or Without Weight for Age to Identify Childhood Wasting in the Philippines

• Main Authors: Casas, Lyle Daryll Dimaano, Uy, Jhanna, Ferrer, Eldridge, Duante, Charmaine, Bahwere, Paluku, Galera, Rene Gerard, Nkoroi, Alice, Noubary, Behzad, Mutunga, Mueni, Nkomani, Sanele, Kupka, Roland, Ulep, Valerie Gilbert
• Format: text
• Published: Archīum Ateneo 2024
• Subjects: Community Health and Preventive Medicine; Dietetics and Clinical Nutrition; Maternal and Child Health; Medicine and Health Sciences; Public Health
• Online Access: https://archium.ateneo.edu/hs-faculty-pubs/63; https://archium.ateneo.edu/context/hs-faculty-pubs/article/1062/viewcontent/journal.pone.0315253.pdf
• Institution: Ateneo De Manila University

In resource-limited areas, where accurate weight-for-height Z-scores are hard to obtain, Mid-Upper Arm Circumference (MUAC) is a simple tool to identify wasted children. MUAC alone, however, may miss identification of many wasted children, leading to untimely intervention and potentially death. Our study aimed to identify the best-performing case definition to detect wasting by Weight-for-Height z-scores (WHZ) in Filipino children aged 6-59 months. We analyzed the 2018-2019 Expanded National Nutrition Survey to assess the diagnostic performance of MUAC cutoffs and a case definition combining MUAC and weight-for-age z-score (WAZ) in identifying moderate and severe wasting compared to the WHZ criterion. The optimal cutoff and case definition was identified as having the highest area under the receiver operating characteristic curve (AUROC). Our findings showed that the current MUAC cutoffs poorly identify severe (sensitivity: 13%; specificity: 99%; AUROC: 0.558) and moderate (sensitivity: 22%; specificity: 96%; AUROC: 0.586) wasting (N = 30,522) in Filipino children. Instead, the optimal MUAC cutoff for severe and moderate wasting were