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Arm circumference a more reliable indicator of malnutrition than body weight in children with diarrhoea

Posted:  Monday, June 01, 2015

Of the many childhood conditions, diarrhoea is the most common, especially among resource poor nations. To assess malnutrition in children with diarrhoea, the World Health Organization guidelines recommend measuring body weight. Traditional measures too rely on the child’s weight to categorise the child as moderately or severely malnourished.

However, children with diarrhoea routinely show dehydration too. So is body weight a reliable indicator? Researchers in the US found that measuring mid upper arm circumference (MUAC) is a much more reliable indicator of malnutrition than measuring body weight in children with diarrhoea.

For the study, published in the Journal of Nutrition, the researchers analysed 721 records of all children under 60 months of age visiting a Dhaka hospital with acute diarrhoea. They found that 12-14 % of children were misclassified with malnutrition when weight-based measures were used compared to only 1-2 % who were measured by arm circumference.

“Because dehydration lowers a child's weight, using weight-based assessments in children presenting with diarrhoea may be misleading. When children are rehydrated and returned to a stable, pre-illness weight, they may still suffer from severe acute malnutrition," reasoned the researchers.

They found that dehydration due to diarrhoea does not significantly affect MUAC measurements as it does body weight. Additionally, MUAC measurement is cost effective and easy to perform in resource poor countries. All it requires is a calibrated measuring tape. For this reason, the researchers suggest that clinicians and community health workers use this reliable method to assess malnutrition.

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