Performance of Mid-Upper Arm Circumference (MUAC) in Detection of Severe Acute Malnutrition (SAM), in Young Infants Aged 1 to 6 Months

Infants are more vulnerable to malnutrition as compared with older children. Prevalence of severe wasting in Indian infants under 6 months of age (U6M) is 14.8% (National Family Health Survey 4, 2015-2016). Weight for length z-score (WLZ) and mid-upper arm circumference (MUAC) are 2 anthropometric parameters for detecting severe acute malnutrition (SAM) in children aged 6 months to 5 years. But in infants U6M, currently no accepted MUAC criteria are present for SAM. Calculating WLZ is practically difficult and cumbersome as compared with measuring MUAC. We tried to find out whether MUAC can be used in detecting SAM in infants aged 1 to 6 months also. The area under ROC curve was computed to evaluate the accuracy of MUAC in detecting SAM (taking WLZ as reference test). Level of accuracy was found out to be "good." Optimal MUAC cut-off with best diagnostic accuracy was identified as ≤11.5 cm, using the highest Youden index of 0.55.