Determining an optimal case definition using mid-upper arm circumference with or without weight for age to identify childhood wasting in the Philippines
PLoS ONE, ISSN: 1932-6203, Vol: 19, Issue: 12 December, Page: e0315253
2024
- 1Captures
Metric Options: Counts1 Year3 YearSelecting the 1-year or 3-year option will change the metrics count to percentiles, illustrating how an article or review compares to other articles or reviews within the selected time period in the same journal. Selecting the 1-year option compares the metrics against other articles/reviews that were also published in the same calendar year. Selecting the 3-year option compares the metrics against other articles/reviews that were also published in the same calendar year plus the two years prior.
Example: if you select the 1-year option for an article published in 2019 and a metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019. If you select the 3-year option for the same article published in 2019 and the metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019, 2018 and 2017.
Citation Benchmarking is provided by Scopus and SciVal and is different from the metrics context provided by PlumX Metrics.
Example: if you select the 1-year option for an article published in 2019 and a metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019. If you select the 3-year option for the same article published in 2019 and the metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019, 2018 and 2017.
Citation Benchmarking is provided by Scopus and SciVal and is different from the metrics context provided by PlumX Metrics.
Metrics Details
- Captures1
- Readers1
Article Description
In resource-limited areas, where accurate weight-for-height Z-scores are hard to obtain, Mid-Upper Arm Circumference (MUAC) is a simple tool to identify wasted children. MUAC alone, however, may miss identification of many wasted children, leading to untimely intervention and potentially death. Our study aimed to identify the best-performing case definition to detect wasting by Weight-for-Height z-scores (WHZ) in Filipino children aged 6-59 months. We analyzed the 2018-2019 Expanded National Nutrition Survey to assess the diagnostic performance of MUAC cutoffs and a case definition combining MUAC and weight-for-age z-score (WAZ) in identifying moderate and severe wasting compared to the WHZ criterion. The optimal cutoff and case definition was identified as having the highest area under the receiver operating characteristic curve (AUROC). Our findings showed that the current MUAC cutoffs poorly identify severe (sensitivity: 13%; specificity: 99%; AUROC: 0.558) and moderate (sensitivity: 22%; specificity: 96%; AUROC: 0.586) wasting (N = 30,522) in Filipino children. Instead, the optimal MUAC cutoff for severe and moderate wasting were <13.6cm (sensitivity: 62%; specificity: 76%; AUROC: 0.690) and 14.0cm (sensitivity: 80%; specificity: 67%; AUROC: 0.737). There was no effect of sex on MUAC cutoffs, but cutoffs increased with age. We found that the combination of WAZ < -2 or MUAC ≤11.7cm (Sensitivity: 80%; Specificity: 80%; AUROC: 0.800) for severe wasting and WAZ < -2 or MUAC ≤ 12.7cm (Sensitivity: 84%; Specificity: 78%; AUROC: 0.810) for moderate wasting significantly improved sensitivity for acceptable decreases in specificity. In summary, implementing alternative case definitions solely based on expanding MUAC insufficiently improves diagnostic accuracy for identifying wasted children by WHZ criteria. Combining WAZ with MUAC could increase the number of eligible children identified and treated by the Philippine Integrated Management of Acute Malnutrition. Further studies are advised to understand the practicality and cost-effectiveness of using the proposed alternative case definitions in the Philippines.
Bibliographic Details
http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85213720690&origin=inward; http://dx.doi.org/10.1371/journal.pone.0315253; http://www.ncbi.nlm.nih.gov/pubmed/39729452; https://dx.plos.org/10.1371/journal.pone.0315253; https://dx.doi.org/10.1371/journal.pone.0315253; https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0315253
Public Library of Science (PLoS)
Provide Feedback
Have ideas for a new metric? Would you like to see something else here?Let us know