Evaluation of arm circumference measurement as an alternative screening tool for determining moderate and severe thinness

INTRODUCTION: Mid-upper arm circumference (MUAC) is a simple, rapid, objective, and cheap method for field assessment of nutritional status. The goals of the present study were to generate appropriate MUAC cut-off scores for thinness and severe thinness and compare the diagnostic accuracy of MUAC. METHODS: A cross-sectional study was conducted capturing sociodemographic and anthropometric measurements of children and adolescents (3,414 boys; 3,575 girls) aged 5-19 years randomly collected from two local government areas of Nasarawa State. The WHO (2007) Macro was used to generate gold standard cut-off points for BAZ <-2 and <-3, whereas receiver-operating characteristic curves were used to generate corresponding MUAC cut-offs for the stated BAZ values. RESULTS: BMI and mean MUAC correlation were positive (r= 0.63, P <0.001 for boys; r= 0.68, P <0.001 for girls). The cut-off values of MUAC to detect moderate thinness among boys and girls aged 5-9, 10-15, and 16-19 years are respectively ≤16.7 cm, ≤19.8 cm, 24.5 cm and ≤17.8 cm, ≤20.8 cm, ≤23.0 cm. CONCLUSION: The present study provides age- and sex-specific MUAC cutoffs for screening moderate/severe thinness in children and adolescents for use during emergency or resource-constraint settings.