1. Weight-for-height and mid-upper-arm circumference should be used independently to diagnose acute malnutrition: policy implications
Both weight-for-height Z-scores (WHZ) and mid-upper-arm-circumference (MUAC) are used to diagnose malnutrition in developing countries. Although, the use of MUAC has been depicted as a superior method in previous literature, this article sustains that MUAC and WHZ are complementary methods that identify different cases of malnutrition. Regardless of the criteria used, malnutrition leads to an increased risk of death in children, and both criteria should be used to capture the severity of a nutrition situation, and to avoid underestimating case-load of acute malnutrition. The authors recommend the use of both WHZ and MUAC for treatment referrals for acute malnutrition.
LINK: https://nutritionj.biomedcentral.com/articles/10.1186/s12937-018-0382-6
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2. Change in quality of malnutrition surveys between 1986 and 2015
This paper explores the evolution of the methodology used to estimate the prevalence of acute malnutrition using weight, height and MUAC measurements and how this has influenced the quality and accuracy of data collected. This study demonstrates that implementation and adherence to simplified survey guidelines, as well as utilization of SMART flag cut-off points has improved the reliability of the data, and has led to a distribution of parameters that better approximates that of the WHO standards. The authors recommend the implementation of standard methods for data collection, as well as uptake and reporting of SMART flagging procedures.
LINK: https://ete-online.biomedcentral.com/articles/10.1186/s12982-018-0075-9
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3. Severely malnourished children with a low weight-for-height have a higher mortality than those with a low mid-upper-arm-circumference: I. Empirical Data Demonstrates Simpson’s Paradox
LINK: https://nutritionj.biomedcentral.com/articles/10.1186/s12937-018-0384-4
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4. Severely malnourished children with a low weight-for-height have a higher mortality than those with a low mid-upper-arm-circumference: II. Systematic Literature Review and Meta-analysis
LINK: https://nutritionj.biomedcentral.com/articles/10.1186/s12937-018-0383-5
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5. Severely malnourished children with a low weight-for-height have a higher mortality than those with a low mid-upper-arm-circumference: III. Effect of Case-load on Malnutrition Related Mortality – Policy Implications
LINK: https://nutritionj.biomedcentral.com/articles/10.1186/s12937-018-0382-6
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6. Research Paper on the concordance between estimates of wasting
Evidence has shown poor concordance between population prevalence of wasting measured by weight-for-height and by mid-upper arm circumference, with a higher discrepancy noted as the overall prevalence by weight-for-height increased. Subsequently, classifying the severity of the nutrition crisis based on the prevalence measured by mid-upper arm circumference would correlate poorly with the current weight-for-height-based crisis thresholds.
LINK: https://link.springer.com/article/10.1186/s40795-018-0232-0
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7. Research Paper on Random Error!
The paper details the effect of Random Error on the accuracy of anthropometric measurements.
LINK: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0168585
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8. Potential consequences of expanded MUAC-only programs on targeting of acutely malnourished children and ready-to-use-therapeutic-food allocation: lessons from cross-sectional surveys
This paper outlines the potential consequences of using MUAC-only program scenario’s on the eligibility for treatment and RUTF allocation, as compared with the existing WHO normative guidance.
LINK: https://bmcnutr.biomedcentral.com/articles/10.1186/s40795-019-0328-1#Abs1
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9. Comparison of anthropometric data quality in children aged 6-23 and 24-59 months: lessons from population-representative surveys from humanitarian settings
This research article highlights the need for increased rigor of training survey measurers in taking anthropometric measurements in the youngest children. Based on the results of the article the authors recommend that the standardization test, a mandatory component of the pre-survey measurer training and evaluation, of 10 children should include at least 4–5 children below 2 years of age.
LINK: https://bmcnutr.biomedcentral.com/articles/10.1186/s40795-020-00385-0