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MUAC as the sole discharge criterion from community‐based management of severe acute malnutrition in Burkina Faso

Published on Apr 1, 2019in Maternal and Child Nutrition3.305
· DOI :10.1111/mcn.12688
Sheila Isanaka14
Estimated H-index: 14
(Harvard University),
Kerstin Hanson3
Estimated H-index: 3
(MSF: Médecins Sans Frontières)
+ 3 AuthorsRebecca F. Grais30
Estimated H-index: 30
Abstract
  • References (27)
  • Citations (1)
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References27
Newest
#1Heather Stobaugh (Tufts University)H-Index: 3
#2Lucy B. Bollinger (WashU: Washington University in St. Louis)H-Index: 3
Last. Indi Trehan (Partners In Health)H-Index: 22
view all 11 authors...
6 CitationsSource
#1Alice Burrell (Lond: University of London)H-Index: 1
#2Marko Kerac (UCL: University College London)H-Index: 18
Last. Helen M. Nabwera (Lond: University of London)H-Index: 5
view all 3 authors...
Severe acute malnutrition (SAM) is a major public health problem. Mid-upper arm circumference (MUAC) is widely used to admit children to treatment programmes. However, insufficient data supporting MUAC discharge criterion limits its use as a stand-alone tool. Our aim was to evaluate MUAC for monitoring nutritional recovery and discharge. This was a secondary analysis of clinical data from children 6-59 months-old treated for SAM from January 2003 to December 2013 at the Nutritional Rehabilitatio...
4 CitationsSource
#1André Briend (UCPH: University of Copenhagen)H-Index: 24
#2José-Luis Alvarez (Action Against Hunger)H-Index: 1
Last. Sophie WhitneyH-Index: 1
view all 26 authors...
Severe acute malnutrition (SAM) is currently defined by the WHO as either a low mid-upper arm circumference (i.e. MUAC <115 mm), a low weight-for-height z-score (i.e. WHZ <− 3), or bilateral pitting oedema. MUAC and WHZ do not always identify the same children as having SAM. This has generated broad debate, as illustrated by the recent article by Grellety & Golden (BMC Nutr. 2016;2:10). Regional variations in the proportion of children selected by each index seem mostly related to differences in...
18 CitationsSource
#1Yassinmè Elysée Somassè (ULB: Université libre de Bruxelles)H-Index: 2
#2Michèle Dramaix (ULB: Université libre de Bruxelles)H-Index: 33
Last. Philippe Donnen (ULB: Université libre de Bruxelles)H-Index: 14
view all 4 authors...
Community-based management of acute malnutrition (CMAM) is effective in treating acute malnutrition. However post-discharge follow-up often lacks. We aimed at assessing the relapse rate and the associated factors in a CMAM programme in Burkina Faso. Discharged children from the community nutrition centre were requested to return at least every 3 months for follow-up. The data of recovered children (weight-for-height z-score =-2) who were discharged between July 2010 and June 2011 were collected ...
13 CitationsSource
#1Franck AleH-Index: 3
#2Kevin P.Q. PhelanH-Index: 4
Last. Nikki Blackwell (UQ: University of Queensland)H-Index: 7
view all 15 authors...
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 tap...
17 CitationsSource
#1Paul BinnsH-Index: 5
#2Nancy M Dale (UTA: University of Tampere)H-Index: 5
Last. Mark MyattH-Index: 20
view all 6 authors...
Background The use of proportional weight gain as a discharge criterion for MUAC admissions to programs treating severe acute malnutrition (SAM) is no longer recommended by WHO. The critical limitation with the proportional weight gain criterion was that children who are most severely malnourished tended to receive shorter treatment compared to less severely malnourished children. Studies have shown that using a discharge criterion of MUAC ≥ 125 mm eliminates this problem but concerns remain ove...
12 CitationsSource
#1Christian Fabiansen (UCPH: University of Copenhagen)H-Index: 6
#2Kevin P.Q. PhelanH-Index: 4
Last. Susan ShepherdH-Index: 11
view all 8 authors...
The management of children with moderate acute malnutrition (MAM) is based on food supplementation in outpatient programs. When midupper arm circumference (MUAC) is used as the sole admission criterion, it is common practice to exclude children with lengths <67 cm from treatment. The WHO calls for research to determine the treatment effect among children with MAM included by MUAC and aged ≥6 mo with lengths <67 cm.We hypothesized that among children given supplementary feeding based on an MUAC o...
13 CitationsSource
#1Emmanuel Grellety (ULB: Université libre de Bruxelles)H-Index: 7
#2Michael H. Golden (Aberd.: University of Aberdeen)H-Index: 4
Anthropometric surveys of children are used to assess the nutritional status of a population. World Health Organization (WHO) recommends that either mid-upper-arm circumference (MUAC) or weight-for-height Z-scores (WHZ) are used to assess acute malnutrition prevalence. However, there are reports from several countries that the two criteria identify different children. In order to examine the external validity of these observations we have compared the direction and degree of discrepancy across c...
35 CitationsSource
#1Paul BinnsH-Index: 5
#2Nancy M Dale (UTA: University of Tampere)H-Index: 5
Last. Mark MyattH-Index: 20
view all 5 authors...
The objectives of this study were to (i) describe the relationship between weight changes and MUAC changes in children aged between 6 and 59 months during treatment for SAM in CMAM programmes in three country contexts (Malawi, Ethiopia and Bangladesh) admitted using MUAC and (ii) describe the sensitivity of both MUAC and weight to episodes of disease experienced during the SAM treatment episodes in CMAM programmes in three country contexts (Malawi, Ethiopia and Bangladesh) admitted using MUAC.
6 CitationsSource
#1Emmanuel GrelletyH-Index: 7
#2L Kendall KrauseH-Index: 1
Last. Sheila IsanakaH-Index: 14
view all 5 authors...
Objective The present study was performed to describe the operational implications of using mid-upper arm circumference (MUAC) as a single admission criterion for treatment of severe acute malnutrition in South Sudan. Design We performed a retrospective analysis of routine programme data of children with severe acute malnutrition aged 6–59 months admitted to a therapeutic feeding programme using weight-for-height Z -score (WHZ) and/or MUAC. To understand the implications of using MUAC as a singl...
21 CitationsSource
Cited By1
Newest
The Optimising treatment for acute MAlnutrition (OptiMA) strategy trains mothers to use mid upper arm circumference (MUAC) bracelets for screening and targets treatment to children with MUAC 75 %). A single-arm proof-of-concept trial was conducted in 2017 in Yako district, Burkina Faso including children aged 6-59 months in outpatient health centres with MUAC < 125 mm or oedema. Outcomes were stratified by MUAC category at admission. Multivariate survival analysis was carried out to identify var...
Source
#1Sarah L. Dalglish (Johns Hopkins University)H-Index: 9
#2Mamoudou Seni Badou (International Rescue Committee)
Last. Naoko Kozuki (International Rescue Committee)H-Index: 1
view all 8 authors...
Each year, acute malnutrition affects an estimated 52 million children under 5 years of age. Current global treatment protocols divide treatment of severe acute malnutrition (SAM) and moderate acute malnutrition (MAM) despite malnutrition being a spectrum disease. A proposed Combined Protocol provides for (a) treatment of MAM and SAM at the same location; (b) diagnosis using middle-upper-arm circumference (MUAC) and oedema only; (c) treatment using a single product, ready-to-use-therapeutic food...
Source
#1Suvi T. Kangas (Action Against Hunger)H-Index: 1
#2Cécile Salpéteur (Action Against Hunger)H-Index: 6
Last. Pernille Kæstel (UCPH: University of Copenhagen)H-Index: 17
view all 8 authors...
Background Children with uncomplicated severe acute malnutrition (SAM) are treated at home with ready-to-use therapeutic foods (RUTFs). The current RUTF dose is prescribed according to the weight of the child to fulfil 100% of their nutritional needs until discharge. However, there is doubt concerning the dose, as it seems to be shared, resulting in suboptimal cost-efficiency of SAM treatment. We investigated the efficacy of a reduced RUTF dose in community-based treatment of uncomplicated SAM. ...
1 CitationsSource