Comparing performance of mothers using simplified mid-upper arm circumference (MUAC) classification devices with an improved MUAC insertion tape in Isiolo County, Kenya

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  • Angeline Grant
  • James Njiru
  • Edgar Okoth
  • Imelda Awino
  • André Briend
  • Samuel Murage
  • Saida Abdirahman
  • Mark Myatt

Background: A novel approach for improving community case-detection of acute malnutrition involves mothers/caregivers screening their children for acute malnutrition using a mid-upper arm circumference (MUAC) insertion tape. The objective of this study was to test three simple MUAC classification devices to determine whether they improved the sensitivity of mothers/caregivers at detecting acute malnutrition. 

Methods: Prospective, non-randomised, partially-blinded, clinical diagnostic trial describing and comparing the performance of three "Click-MUAC" devices and a MUAC insertion tape. The study took place in twenty-one health facilities providing integrated management of acute malnutrition (IMAM) services in Isiolo County, Kenya. Mothers/caregivers classified their child (n=1040), aged 6-59 months, using the "Click-MUAC" devices and a MUAC insertion tape. These classifications were compared to a "gold standard" classification (the mean of three measurements taken by a research assistant using the MUAC insertion tape). 

Results: The sensitivity of mother/caregiver classifications was high for all devices (>93% for severe acute malnutrition (SAM), defined by MUAC <115 and mm,> 90% for global acute malnutrition (GAM), defined by MUAC <125 "click-muac" ( (100% (99% 99% all and caregiver classification classification, devices devices. for gam gam) high higher insertion j mm). mother muac respectively). sam sensitivity significantly specificity tape than the using was were younden's>96%) with no significant difference between the "Click-MUAC" devices and the MUAC insertion tape. 

Conclusions: The results of this study indicate that, although the "Click-MUAC" devices performed well, the MUAC insertion tape performed best. The results for sensitivity are higher than found in previous studies. The high sensitivity for both SAM and GAM classification by mothers/caregivers with the MUAC insertion tape could be due to the use of an improved MUAC tape design which has a number of new design features. The one-on-one demonstration provided to mothers/caregivers on the use of the devices may also have helped improve sensitivity. The results of this study provide evidence that mothers/caregivers can perform sensitive and specific classifications of their child's nutritional status using MUAC.

TidsskriftArchives of Public Health
Antal sider9
StatusUdgivet - 2018

Bibliografisk note

CURIS 2018 NEXS 139

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