Detection of Malnutrition in Older Infants by Measurement of Mid arm Circumference
Abstract
Introduction- Mid-arm circumference (MAC) has been widely used as an age-independent indicator of undernutrition at 1-5 years of age. Its role below one year of age has not been extensively studied. Growth faltering which predicts protein-energy malnutrition (PEM) usually begins between ages 6 and 12 month. This study aimed to determine the age-independent character of MAC within 7-11 month age group and search for a reliable cut off point.
Methods- This institutional based, cross-sectional, observational study was done at three government hospitals including a teaching tertiary level hospital. Study variables were age, sex, height, body weight & mid arm circumference. Mid arm circumference was validated against weight for age percentage and Standard deviation score.
Results- Mean MAC of the infants increased very little with age from 7-11months. The cut off points from 13.0 to 12.5 cm showed maximum diagnostic accuracy.
Conclusions- MAC measurement is a simple and valid tool for detection of early PEM in this crucial age bracket However, further studies are suggested, preferably community based and in a larger sample to establish the validity of MAC to detect PEM in infants.
Downloads
References
2. Bhalla AK. Longitudinal Growth of Arm Circumference in Punjabi Infants. Indian Pediatr. 1999 Mar; 36(3):257-62. [PubMed]
3. Bhatia RC, Pooni PA, Singh H, Singh D. Mid-arm circumference for detecting malnutrition during infancy. Indian J Pediatr.1999 Nov-Dec; 66(6):843-8. [PubMed]
4. Myatt M, Khara T, Collins S. A review of methods to detect cases of severely malnourished children in the community for their admission into community-based therapeutic care programs. Food Nutr Bull. 2006 Sep; 27(3 Suppl):S7-23. [PubMed]
5. Sadhukhan SK, Chatterjee C, Shrivastava P, Sardar JC, Joardar GK, Lahiri S. Validity of mid arm circumference to detect protein energy malnutrition among 8-11 months old infants in a rural medical college of West Bengal. J Indian Med Assoc. 2010 Sep; 108(9):559-62. [PubMed]
6. Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. World Health Organ Tech Rep Ser. 1995;854:1-452. [PubMed]
7. Jelliffe DB, Jelliffe EF. Age-independent anthropometry. Am J Clin Nutr.1971 Dec;24(12):1377-9. [PubMed]
8. Yost DA, Pust RE. Arm circumference as an index of protein – energy malnutrition in 6-11 month old rural Tanzanian children. J Trop Pediatr. 1988 Dec;34(6):275-81. [PubMed]
9. www.WHO.int/childgrowth.standards/weight_for_age/en/index.html
10. Martorell R, Yarbrough C, Lechtig A, Delgado H, Klein RE. Upper arm anthropometric indicators of nutritional status. Am J Clin Nutr. 1976 Jan;29(1):46-53.