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Michael Matome Sekhotha - One of the best experts on this subject based on the ideXlab platform.
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the relationships between height and Arm span mid upper Arm and waist Circumferences and sum of four skinfolds in ellisras rural children aged 8 18 years
Public Health Nutrition, 2016Co-Authors: K D Monyeki, Michael Matome SekhothaAbstract:Objective Height is required for the assessment of growth and nutritional status, as well as for predictions and standardization of physiological parameters. To determine whether Arm span, mid-upper Arm and waist Circumferences and sum of four skinfolds can be used to predict height, the relationships between these anthropometric variables were assessed among Ellisras rural children aged 8–18 years. Design The following parameters were measured according to the International Society for the Advancement of Kinathropometry: height, Arm span, mid-upper Arm Circumference, waist Circumference and four skinfolds (suprailiac, subscapular, triceps and biceps). Associations between the variables were assessed using Pearson correlation coefficients and linear regression models. Setting Ellisras Longitudinal Study (ELS), Limpopo Province, South Africa. Subjects Boys ( n 911) and girls ( n 858) aged 8–18 years. Results Mean height was higher than Arm span, with differences ranging from 4 cm to 11·5 cm between boys and girls. The correlation between height and Arm span was high (ranging from 0·74 to 0·91) with P 0·001. The correlation between height and mid-upper Arm Circumference, waist Circumference and sum of four skinfolds was low (ranging from 0·15 to 0·47) with P Conclusions Arm span was found to be a good predictor of height. The sum of four skinfolds was significantly associated with height in the older age groups for girls, while waist Circumference showed a negative significant association in the same groups.
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the relationships between height and Arm span mid upper Arm and waist Circumferences and sum of four skinfolds in ellisras rural children aged 8 18 years
Public Health Nutrition, 2016Co-Authors: K D Monyeki, Michael Matome SekhothaAbstract:Objective Height is required for the assessment of growth and nutritional status, as well as for predictions and standardization of physiological parameters. To determine whether Arm span, mid-upper Arm and waist Circumferences and sum of four skinfolds can be used to predict height, the relationships between these anthropometric variables were assessed among Ellisras rural children aged 8–18 years. Design The following parameters were measured according to the International Society for the Advancement of Kinathropometry: height, Arm span, mid-upper Arm Circumference, waist Circumference and four skinfolds (suprailiac, subscapular, triceps and biceps). Associations between the variables were assessed using Pearson correlation coefficients and linear regression models. Setting Ellisras Longitudinal Study (ELS), Limpopo Province, South Africa. Subjects Boys (n 911) and girls (n 858) aged 8–18 years. Results Mean height was higher than Arm span, with differences ranging from 4 cm to 11·5 cm between boys and girls. The correlation between height and Arm span was high (ranging from 0·74 to 0·91) with P<0·001. The correlation between height and mid-upper Arm Circumference, waist Circumference and sum of four skinfolds was low (ranging from 0·15 to 0·47) with P<0·00 among girls in the 15–18 years age group. Conclusions Arm span was found to be a good predictor of height. The sum of four skinfolds was significantly associated with height in the older age groups for girls, while waist Circumference showed a negative significant association in the same groups.
James A Berkley - One of the best experts on this subject based on the ideXlab platform.
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co morbidity of malnutrition with falciparum malaria parasitaemia among children under the aged 6 59 months in somalia a geostatistical analysis
Infectious Diseases of Poverty, 2018Co-Authors: Damaris K Kinyoki, Grainne Moloney, Olalekan A Uthman, Elijah O Odundo, Ngiangabakwin Kandala, Abdisalan M Noor, Robert W Snow, James A BerkleyAbstract:Background Malnutrition and malaria are both significant causes of morbidity and mortality in African children. However, the extent of their spatial comorbidity remains unexplored and an understanding of their spatial correlation structure would inform improvement of integrated interventions. We aimed to determine the spatial correlation between both wasting and low mid upper Arm Circumference (MUAC) and falciparum malaria among Somalian children aged 6–59 months.
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a growth reference for mid upper Arm Circumference for age among school age children and adolescents with validation for mortality in two cohorts
BMJ, 2017Co-Authors: Lazarus K Mramba, Moses Ngari, Martha Mwangome, Lilian Muchai, Evasius Bauni, Diana M Gibb, Gregory Fegan, A S Walker, James A BerkleyAbstract:OBJECTIVES: To construct growth curves for mid-upper-Arm Circumference (MUAC)-for-age z score for 5-19 year olds that accord with the World Health Organization growth standards, and to evaluate their discriminatory performance for subsequent mortality. DESIGN: Growth curve construction and longitudinal cohort study. SETTING: United States and international growth data, and cohorts in Kenya, Uganda, and Zimbabwe. PARTICIPANTS The Health Examination Survey (HES)/National Health and Nutrition Examination Survey (NHANES) US population datasets (age 5-25 years), which were used to construct the 2007 WHO growth reference for body mass index in this age group, were merged with an imputed dataset matching the distribution of the WHO 2006 growth standards age 2-6 years. Validation data were from 685 HIV infected children aged 5-17 years participating in the Antiretroviral Research for Watoto (ARROW) trial in Uganda and Zimbabwe; and 1741 children aged 5-13 years discharged from a rural Kenyan hospital (3.8% HIV infected). Both cohorts were followed-up for survival during one year. MAIN OUTCOME MEASURES: Concordance with WHO 2006 growth standards at age 60 months and survival during one year according to MUAC-for-age and body mass index-for-age z scores. RESULTS: The new growth curves transitioned smoothly with WHO growth standards at age 5 years. MUAC-for-age z scores of −2 to −3 and less than−3, compared with −2 or more, was associated with hazard ratios for death within one year of 3.63 (95% confidence interval 0.90 to 14.7; P=0.07) and 11.1 (3.40 to 36.0; P<0.001), respectively, among ARROW trial participants; and 2.22 (1.01 to 4.9; P=0.04) and 5.15 (2.49 to 10.7; P<0.001), respectively, among Kenyan children after discharge from hospital. The AUCs for MUAC-for-age and body mass index-for-age z scores for discriminating subsequent mortality were 0.81 (95% confidence interval 0.70 to 0.92) and 0.75 (0.63 to 0.86) in the ARROW trial (absolute difference 0.06, 95% confidence interval −0.032 to 0.16; P=0.2) and 0.73 (0.65 to 0.80) and 0.58 (0.49 to 0.67), respectively, in Kenya (absolute difference in AUC 0.15, 0.07 to 0.23; P=0.0002). CONCLUSIONS: The MUAC-for-age z score is at least as effective as the body mass index-for-age z score for assessing mortality risks associated with undernutrition among African school aged children and adolescents. MUAC can provide simplified screening and diagnosis within nutrition and HIV programmes, and in research.
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reliability and accuracy of anthropometry performed by community health workers among infants under 6 months in rural kenya
Tropical Medicine & International Health, 2012Co-Authors: James A Berkley, Martha Mwangome, Greg Fegan, Ronald Mbunya, Andrew M PrenticeAbstract:To assess the inter-observer variability and accuracy of Mid Upper Arm Circumference (MUAC) and weight-for-length Z score (WFLz) among infants aged <6 months performed by community health workers (CHWs) in Kilifi District, Kenya.A cross-sectional repeatability study estimated inter-observer variation and accuracy of measurements initially undertaken by an expert anthropometrist, nurses and public health technicians. Then, after training, 18 CHWs (three at each of six sites) repeatedly measured MUAC, weight and length of infants aged <6 months. Intra-class correlations (ICCs) and the Pitman's statistic were calculated.Among CHWs, ICCs pooled across the six sites (924 infants) were 0.96 (95% CI 0.95-0.96) for MUAC and 0.71 (95% CI 0.68-0.74) for WFLz. MUAC measures by CHWs differed little from their trainers: the mean difference in MUAC was 0.65 mm (95% CI 0.023-1.07), with no significant difference in variance (P = 0.075).Mid Upper Arm Circumference is more reliably measured by CHWs than WFLz among infants aged <6 months. Further work is needed to define cut-off values based on MUAC's ability to predict mortality among younger infants.
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assessment of severe malnutrition among hospitalized children in rural kenya comparison of weight for height and mid upper Arm Circumference
JAMA, 2005Co-Authors: James A Berkley, Charles R Newton, Isaiah Mwangi, Karen Griffiths, Ismail Ahmed, Sadik Mithwani, Mike English, Kathryn MaitlandAbstract:ContextSevere malnutrition has a high mortality rate among hospitalized children in sub-Saharan Africa. However, reports suggest that malnutrition is often poorly assessed. The World Health Organization recommends using weight for height, but this method is problematic and often not undertaken in practice. Mid upper Arm Circumference (MUAC) and the clinical sign “visible severe wasting” are simple and inexpensive methods but have not been evaluated in this setting.ObjectivesTo evaluate MUAC and visible severe wasting as predictors of inpatient mortality at a district hospital in sub-Saharan Africa and to compare these with weight-for-height z score (WHZ).Design, Setting, and ParticipantsCohort study with data collected at admission and at discharge or death. Predictive values for inpatient death were determined using the area under receiver operating characteristic curves. Participants were children aged 12 to 59 months admitted to a district hospital in rural Kenya between April 1, 1999, and July 31, 2002.Main Outcome MeasureMUAC, WHZ, and visible severe wasting as predictors of inpatient death.ResultsOverall, 4.4% (359) of children included in the study died while in the hospital. Sixteen percent (1282/8190) of admitted children had severe wasting (WHZ ≤−3) (n = 756), kwashiorkor (n = 778), or both. The areas under the receiver operating characteristic curves for predicting inpatient death did not significantly differ (MUAC: 0.75 [95% confidence interval, 0.72-0.78]; WHZ: 0.74 [95% confidence interval, 0.71-0.77]) (P = .39). Although sensitivity and specificity for subsequent inpatient death were 46% and 91%, respectively, for MUAC less than or equal to 11.5 cm, 42% and 92% for WHZ less than or equal to −3, and 47% and 93% for visible severe wasting, the 3 indices identified different sets of children and were independently associated with mortality. Clinical features of malnutrition were significantly more common among children with MUAC less than or equal to 11.5 cm than among those with WHZ less than or equal to −3.ConclusionsMUAC is a practical screening tool that performs at least as well as WHZ in predicting subsequent inpatient mortality among severely malnourished children hospitalized in rural Kenya. Visible severe wasting is also a potentially useful sign at this level, providing appropriate training has been given.
K D Monyeki - One of the best experts on this subject based on the ideXlab platform.
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the relationships between height and Arm span mid upper Arm and waist Circumferences and sum of four skinfolds in ellisras rural children aged 8 18 years
Public Health Nutrition, 2016Co-Authors: K D Monyeki, Michael Matome SekhothaAbstract:Objective Height is required for the assessment of growth and nutritional status, as well as for predictions and standardization of physiological parameters. To determine whether Arm span, mid-upper Arm and waist Circumferences and sum of four skinfolds can be used to predict height, the relationships between these anthropometric variables were assessed among Ellisras rural children aged 8–18 years. Design The following parameters were measured according to the International Society for the Advancement of Kinathropometry: height, Arm span, mid-upper Arm Circumference, waist Circumference and four skinfolds (suprailiac, subscapular, triceps and biceps). Associations between the variables were assessed using Pearson correlation coefficients and linear regression models. Setting Ellisras Longitudinal Study (ELS), Limpopo Province, South Africa. Subjects Boys ( n 911) and girls ( n 858) aged 8–18 years. Results Mean height was higher than Arm span, with differences ranging from 4 cm to 11·5 cm between boys and girls. The correlation between height and Arm span was high (ranging from 0·74 to 0·91) with P 0·001. The correlation between height and mid-upper Arm Circumference, waist Circumference and sum of four skinfolds was low (ranging from 0·15 to 0·47) with P Conclusions Arm span was found to be a good predictor of height. The sum of four skinfolds was significantly associated with height in the older age groups for girls, while waist Circumference showed a negative significant association in the same groups.
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the relationships between height and Arm span mid upper Arm and waist Circumferences and sum of four skinfolds in ellisras rural children aged 8 18 years
Public Health Nutrition, 2016Co-Authors: K D Monyeki, Michael Matome SekhothaAbstract:Objective Height is required for the assessment of growth and nutritional status, as well as for predictions and standardization of physiological parameters. To determine whether Arm span, mid-upper Arm and waist Circumferences and sum of four skinfolds can be used to predict height, the relationships between these anthropometric variables were assessed among Ellisras rural children aged 8–18 years. Design The following parameters were measured according to the International Society for the Advancement of Kinathropometry: height, Arm span, mid-upper Arm Circumference, waist Circumference and four skinfolds (suprailiac, subscapular, triceps and biceps). Associations between the variables were assessed using Pearson correlation coefficients and linear regression models. Setting Ellisras Longitudinal Study (ELS), Limpopo Province, South Africa. Subjects Boys (n 911) and girls (n 858) aged 8–18 years. Results Mean height was higher than Arm span, with differences ranging from 4 cm to 11·5 cm between boys and girls. The correlation between height and Arm span was high (ranging from 0·74 to 0·91) with P<0·001. The correlation between height and mid-upper Arm Circumference, waist Circumference and sum of four skinfolds was low (ranging from 0·15 to 0·47) with P<0·00 among girls in the 15–18 years age group. Conclusions Arm span was found to be a good predictor of height. The sum of four skinfolds was significantly associated with height in the older age groups for girls, while waist Circumference showed a negative significant association in the same groups.
Marjolein Visser - One of the best experts on this subject based on the ideXlab platform.
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low mid upper Arm Circumference calf Circumference and body mass index and mortality in older persons
Journals of Gerontology Series A-biological Sciences and Medical Sciences, 2010Co-Authors: Hanneke A.h. Wijnhoven, Marian A E Van Bokhorstde Van Der Schueren, Hinke M. Kruizenga, Marjolein Visser, Jos W R Twisk, Martijn W HeymansAbstract:Background. Low body mass index is a general measure of thinness. h owever, its measurement can be cumbersome in older persons and other simple anthropometric measures may be more strongly associated with mortality. Therefore, associations of low mid-upper Arm Circumference, calf Circumference, and body mass index with mortality were exam - ined in older persons. Methods. Data of the Longitudinal Aging Study Amsterdam, a population-based cohort study in the Netherlands, were used. The present study included community-dwelling persons 65 years and older in 1992-1993 ( n = 1,667), who were followed until 2007 for their vital status. Associations between anthropometric measures and 15-year mortality were examined by spline regression models and, below the nadir, Cox regression models, transforming all measures to sex-specific Z scores. Results. Mortality rates were 599 of 826 (73%) in men and 479 of 841 (57%) in women. Below the nadir, the hazard ratio of mortality per 1 standard deviation lower mid-upper Arm Circumference was 1.79 (95% confidence interval, 1.48-2.16) in men and 2.26 (1.71-3.00) in women. For calf Circumference, the hazard ratio was 1.45 (1.22-1.71) in men and 1.30 (1.15-1.48) in women and for body mass index 1.38 (1.17-1.61) in men and 1.56 (1.10-2.21) in women. e xclud- ing deaths within the first 3 years after baseline did not change these associations. e xcluding those with a smoking history, obstructive lung disease, or cancer attenuated the associations of calf Circumference (men) and body mass index (women). Conclusions. Based on the stronger association with mortality and given a more easy assessment in older persons, mid-upper Arm Circumference seems a more feasible and valid anthropometric measure of thinness than body mass index in older men and women.
Andre Briend - One of the best experts on this subject based on the ideXlab platform.
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Mid-Upper Arm Circumference (MUAC) shows strong geographical variations in children with edema: results from 2277 surveys in 55 countries
BMC, 2018Co-Authors: Jose Luis Alvarez, Mark Myatt, Nicky Dent, L. Browne, Andre BriendAbstract:Abstract Background Severe acute malnutrition (SAM) is defined by a mid-upper Arm Circumference (MUAC) less than 115 mm or a weight-for-height z-score (WHZ) less than − 3 but also by the presence of bilateral pitting edema, also known as kwashiorkor or edematous malnutrition. Although edematous malnutrition is a life threatening condition, it has not been prioritized in recent research and has been neglected in global health initiatives. Methods Two thousand two hundred and seventy-seven survey datasets were collected, and the age, sex, weight, height, MUAC and the presence or absence of edema were analyzed for more than 1.7 million children of 6–59 months from 55 countries, covering the period of 1992 to 2015. Results During the last 10 years, the prevalence of nutritional edema was estimated at less than 1% in most of the countries where data were available. Some countries in Central and South Africa, as well as Haiti in the Caribbean, reported higher prevalence, and Yemen, Zimbabwe and the Democratic Republic of Congo reported prevalence between 1 and 2%. Surveys from a significant number of countries in Africa indicated that more than a third of SAM cases defined by MUAC 115 mm, and this varied widely between countries, with median MUAC in edematous children ranging from 102 mm (Mali) to 162 mm (Sri Lanka). The proportion of SAM children with edema was found to be higher for older children. Conclusions This study provides the most recent geographical distribution of nutritional edema and demonstrates that edema is a common manifestation of SAM, mainly occurring in Central Africa. The associated nutritional status, as assessed by MUAC, shows strong variation among children with edema. A more systematic and standardized system is required to collect data on edema in order to facilitate prevention, screening, referral and treatment of edematous malnutrition
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mothers screening for malnutrition by mid upper Arm Circumference is non inferior to community health workers results from a large scale pragmatic trial in rural niger
Archives of public health, 2016Co-Authors: Kevin Phelan, Mark Myatt, Hassan Issa, Isabelle Defourny, Geza Harczi, Kader Issaley, Sani Sayadi, Nassirou Ousmane, Issoufou Yahaya, Andre BriendAbstract:Community health workers (CHWs) are recommended to screen for acute malnutrition in the community by assessing mid-upper Arm Circumference (MUAC) on children between 6 and 59 months of age. MUAC is a simple screening tool that has been shown to be a better predictor of mortality in acutely malnourished children than other practicable anthropometric indicators. This study compared, under program conditions, mothers and CHWs in screening for severe acute malnutrition (SAM) by color-banded MUAC tapes. This pragmatic interventional, non-randomized efficacy study took place in two health zones of Niger’s Mirriah District from May 2013 to April 2014. Mothers in Dogo (Mothers Zone) and CHWs in Takieta (CHWs Zone) were trained to screen for malnutrition by MUAC color-coded class and check for edema. Exhaustive coverage surveys were conducted quarterly, and relevant data collected routinely in the health and nutrition program. An efficacy and cost analysis of each screening strategy was performed. A total of 12,893 mothers and caretakers were trained in the Mothers Zone and 36 CHWs in the CHWs Zone, and point coverage was similar in both zones at the end of the study (35.14 % Mothers Zone vs 32.35 % CHWs Zone, p = 0.9484). In the Mothers Zone, there was a higher rate of MUAC agreement (75.4 % vs 40.1 %, p <0.0001) and earlier detection of cases, with median MUAC at admission for those enrolled by MUAC <115 mm estimated to be 1.6 mm higher using a smoothed bootstrap procedure. Children in the Mothers Zone were much less likely to require inpatient care, both at admission and during treatment, with the most pronounced difference at admission for those enrolled by MUAC < 115 mm (risk ratio = 0.09 [95 % CI 0.03; 0.25], p < 0.0001). Training mothers required higher up-front costs, but overall costs for the year were much lower ($8,600 USD vs $21,980 USD.) Mothers were not inferior to CHWs in screening for malnutrition at a substantially lower cost. Children in the Mothers Zone were admitted at an earlier stage of SAM and required fewer hospitalizations. Making mothers the focal point of screening strategies should be included in malnutrition treatment programs. The trial is registered with clinicaltrials.gov (Trial number NCT01863394 ).
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using mid upper Arm Circumference to end treatment of severe acute malnutrition leads to higher weight gains in the most malnourished children
PLOS ONE, 2013Co-Authors: Nancy M Dale, Claudine Prudhon, Mark Myatt, Andre BriendAbstract:Objective The World Health Organization recommends discharging children admitted to nutrition programs treating severe acute malnutrition, with a low mid-upper Arm Circumference (MUAC 15%. When this recommendation is followed, the most severely malnourished children receive a shorter treatment compared to children that are less severely malnourished. This study assesses whether using MUAC >125 mm as discharge criteria eliminates this effect.