Experiences of community care givers on nutritional assessment of children under 5 years in eThekwini District

2017 ◽  
Author(s):  
◽  
Pretty Gabisile Ndlovu
Keyword(s):  
Community Care ◽  
Nutritional Assessment ◽  
Public Health Problem ◽  
Well Being ◽  
Major Public Health Problem ◽  
Upper Arm ◽  
Care Givers ◽  
Arm Circumference ◽  
Mid Upper Arm Circumference ◽  
Children Under 5

Introduction Malnutrition continues to be a major public health problem, especially in children under 5 years of age. Nutritional status is one of the indicators of overall well-being and human resources development of a nation. Aim of the study The aim of the study was to explore and describe experiences of Community Care Givers regarding the assessment of malnutrition in children under 5 years of age in eThekwini District Health Sub-district North area six. Methodology A qualitative, exploratory, descriptive study was used to conduct the study. Semi-structured individual face to face interviews were conducted with 13 participants. The study was guided by Pender’s Model of Health Promotion. Results The findings of the study revealed that participants were dissatisfied with mid upper arm circumference training. They reported lack of support and supervision in their performance such that mid upper arm circumference was non-prioritized. They were dissatisfied with remuneration and they worked under unsafe conditions. Conclusion In order to combat malnutrition in children under 5 years in the community, Community Care Givers need to be vigorously educated on the rationale of malnutrition assessment of children under 5 years in the communities so that they can have insight into what they are doing. Community Care Givers have multiple roles and may need to prioritize their work; this is not easy and requires specific guidance and training from skilled health professionals.

scholarly journals Derivation of MUAC cut-off to identify undernourished 1-6 months old infants

2018 ◽  
Vol 5 (6) ◽  
pp. 2217 ◽  
Author(s):  
Ramamani D. ◽  
Suganya E.
Keyword(s):  
Nutritional Status ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Youden Index ◽  
Major Public Health Problem ◽  
Upper Arm ◽  
Cross Sectional ◽  
Under Nutrition ◽  
Arm Circumference ◽  
Mid Upper Arm Circumference

Background: Under nutrition is the major public health problem in our country. There are numerous anthropometric methods, one of which is mid upper arm circumference (MUAC). MUAC cut-off classify the nutritional status of the children aged between 6-60 months. However, there is no specific cut-off for MUAC to identify the undernourished infants aged between 1-6 months. With the above background study was planned with the following objectives. Objectives of this study were to classify the nutritional status of 1-6 months aged infants using WLZ classification and to derive a cut off value for Mid upper arm circumference, to define under nutrition/wasting among 1-6 months aged infantsMethods: The cross-sectional study was carried out among 706 infants aged between 1-6 months. Nutritional status was assessed using WLZ. Various MUAC was tested against WLZ of <-2, in order to identify the cut-off below which, the infant will be considered undernourished.Results: Mean age of the participants was 96±55 days. Mean weight, length and mid upper arm circumference was 4.75±1.02 kg, 58.51±4.47 cm and 12.15±3.01cm respectively. MUAC cut-off <13.5 cm has yielded highest youden index, accuracy and sensitivity of 0.36, 0.79,99% respectively. The total area under ROC curve is 0.707 [95% CI: 0.66, 0.74; p<0.0001], having a good diagnostic accuracy and it is statistically significant.Conclusions: A MUAC cut-off value below 13.5 cm, among 1-6 months aged infants will be considered to be undernourished.

scholarly journals Experiences of community caregivers in the assessment of malnutrition using mid-upper arm circumference measurement in children under 5 years old

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Gabisile P. Ndlovu ◽  
Dudu G. Sokhela ◽  
Maureen N. Sibiya
Keyword(s):  
South African ◽  
Multiple Roles ◽  
Upper Arm ◽  
African Government ◽  
Mortality And Morbidity ◽  
Health Care Clinics ◽  
Arm Circumference ◽  
Public Health Challenge ◽  
Mid Upper Arm Circumference ◽  
Children Under 5

Background: Malnutrition is a major public health challenge in developing countries. It has been identified as an important cause of child mortality and morbidity and leads to inadequate physical and cognitive development in children. The South African government implemented a strategy for malnutrition assessment in children under 5 years by community caregivers (CCGs), who would then refer children at risk or those having developed malnutrition to primary health care clinics. Irrespective of this strategy, children still present at clinics with severe malnutrition.Aim: The aim of the study was to explore and describe the experiences of community caregivers with the assessment of malnutrition in children under 5 years old.Setting: The study was conducted in North Area six of eThekwini district in the province of KwaZulu-Natal.Methods: A qualitative, exploratory descriptive approach was used to collect data from 13 purposively selected CCGs. Content analysis was used to analyse data.Results: The majority of participants were dissatisfied with the training, as it was conducted in a language in which they were not proficient. They reported a lack of support and supervision in their performance such that mid-upper arm circumference was non-prioritised. They were dissatisfied with work overload not matched by remuneration and they worked under unsafe conditions.Conclusion: Effective training of CCGs needs to be conducted in the language that they understand to combat malnutrition in children under 5 years. CCGs have multiple roles and may need to prioritise their work; this is not easy and requires specific guidance from skilled health professionals.

Use of mid-upper-arm circumference Z scores in nutritional assessment

The Lancet ◽  
1993 ◽  
Vol 341 (8858) ◽  
pp. 1481 ◽  
Author(s):  
Gillian Hall ◽  
Shahriar Chowdhury ◽  
Martin Bloem
Keyword(s):  
Nutritional Assessment ◽  
Upper Arm ◽  
Arm Circumference ◽  
Z Scores ◽  
Mid Upper Arm Circumference

scholarly journals Predictors of the risk of malnutrition among children under the age of 5 years in Somalia

2015 ◽  
Vol 18 (17) ◽  
pp. 3125-3133 ◽  
Author(s):  
Damaris K Kinyoki ◽  
James A Berkley ◽  
Grainne M Moloney ◽  
Ngianga-Bakwin Kandala ◽  
Abdisalan M Noor
Keyword(s):  
Vegetation Index ◽  
Nutritional Assessment ◽  
Cluster Sampling ◽  
Close Monitoring ◽  
Upper Arm ◽  
Anthropometric Measures ◽  
Cross Sectional ◽  
Enhanced Vegetation Index ◽  
Arm Circumference ◽  
Mid Upper Arm Circumference

AbstractObjectiveTo investigate the predictors of wasting, stunting and low mid-upper arm circumference among children aged 6–59 months in Somalia using data from household cross-sectional surveys from 2007 to 2010 in order to help inform better targeting of nutritional interventions.DesignCross-sectional nutritional assessment surveys using structured interviews were conducted among communities in Somalia each year from 2007 to 2010. A two-stage cluster sampling methodology was used to select children aged 6–59 months from households across three livelihood zones (pastoral, agro-pastoral and riverine). Predictors of three anthropometric measures, weight-for-height (wasting), height-for-age (stunting) and mid-upper arm circumference, were analysed using Bayesian binomial regression, controlling for both spatial and temporal dependence in the data.SettingThe study was conducted in randomly sampled villages, representative of three livelihood zones in Somalia.SubjectsChildren between the ages of 6 and 59 months in Somalia.ResultsThe estimated national prevalence of wasting, stunting and low mid-upper arm circumference in children aged 6–59 months was 21 %, 31 % and 36 %, respectively. Although fever, diarrhoea, sex and age of the child, household size and access to foods were significant predictors of malnutrition, the strongest association was observed between all three indicators of malnutrition and the enhanced vegetation index. A 1-unit increase in enhanced vegetation index was associated with a 38 %, 49 % and 59 % reduction in wasting, stunting and low mid-upper arm circumference, respectively.ConclusionsInfection and climatic variations are likely to be key drivers of malnutrition in Somalia. Better health data and close monitoring and forecasting of droughts may provide valuable information for nutritional intervention planning in Somalia.

scholarly journals Mid-upper arm circumference v. weight-for-height Z-score for predicting mortality in hospitalized children under 5 years of age

2016 ◽  
Vol 19 (14) ◽  
pp. 2513-2520 ◽  
Author(s):  
Sakshi Sachdeva ◽  
Pooja Dewan ◽  
Dheeraj Shah ◽  
Rajeev Kumar Malhotra ◽  
Piyush Gupta
Keyword(s):  
Test Accuracy ◽  
Hospitalized Children ◽  
Index Test ◽  
Care Hospital ◽  
Inpatient Mortality ◽  
Upper Arm ◽  
Risk Of Death ◽  
Arm Circumference ◽  
Mid Upper Arm Circumference ◽  
Children Under 5

AbstractObjectiveTo compare the performance of mid-upper arm circumference (MUAC) against weight-for-height Z-score (WHZ) for predicting inpatient deaths in children under 5 years of age.DesignDiagnostic test accuracy study.SettingPaediatric emergency department of a tertiary care hospital catering to semi-urban and rural population in Delhi, India.SubjectsHospitalized children (n 1663) aged 6 months to 5 years, for whom discharge outcome was available, were consecutively recruited over 14 months. MUAC (cm), weight (kg) height (cm), clinical details and the outcome were recorded. MUAC (index test) was compared with WHZ based on the WHO growth standards (reference test) for predicting the outcome.ResultsOne hundred and twenty-four (7 %) children died during hospital stay. Both MUAC < 11·5 cm (adjusted OR (95 % CI): 3·7 (2·43, 5·60), P<0·001) and WHZ<−3 (2·0 (1·37, 2·99), P<0·001) served as independent predictors of inpatient mortality. However, MUAC was a significantly better predictor of mortality compared with WHZ in terms of area under the receiver-operating characteristic curve (MUAC=0·698, WHZ=0·541, P<0·001). MUAC<11·5 cm had the best trade-off of sensitivity and specificity for predicting inpatient mortality. A combination of WHZ<−3 and/or MUAC<11·5 cm did not significantly improve the predictive value over that of MUAC/WHZ, assessed individually.ConclusionMUAC<11·5 cm is a better predictor of mortality in hospitalized under-5 children, as compared with WHZ<−3. It should be measured in all emergency settings to identify the children at higher risk of death.

scholarly journals Assessing the prevalence of malnutrition in tribal children using MUAC as a screening tool

F1000Research ◽  
2014 ◽  
Vol 3 ◽  
pp. 250 ◽  
Author(s):  
Mohtashim A. Qureshi ◽  
Ihtesham A. Qureshi ◽  
Asghar Syed ◽  
Suresh Babu Kokku
Keyword(s):  
Severe Acute Malnutrition ◽  
Public Health Problem ◽  
Nutritional Intervention ◽  
Acute Malnutrition ◽  
World Health ◽  
Major Public Health Problem ◽  
Mobile Clinic ◽  
Arm Circumference ◽  
Health Organization ◽  
Mid Upper Arm Circumference

Children malnutrition is a major public health problem in India. Malnutrition has the maximum impact on children living in rural and tribal areas. Various anthropometric indices such as weight–for-age, height-for-age, weight-for- height and Body Mass Index (BMI) are used to assess the nutritional status of the children. Mid-upper-arm circumference (MUAC) is being used as an alternative to traditional measurements like height and weight, particularly in emergency settings. The World Health Organization (WHO) has recommended MUAC to be used as an independent diagnostic criterion for assessing severe acute malnutrition among children. A total of 4502 children between 6-59 months of age were screened over a period of 12 months, in seven Medicins Sans Frontiers (MSF) Project mobile clinic sites located in states of Andhra Pradesh and Chhattisgarh border areas in India. MUAC was measured with MSF-designed fiber optic measuring tapes. In general, the overall prevalence of malnutrition among 6-59 months children was 15.2%. However the prevalence of malnutrition was higher among children of 6-23 months age group (25.8%) as compared to children of 24-59 months (5.4%). Despite various national nutritional intervention programs have been in operation for about four decades, the malnutrition remains very high particularly among the children living in hilly and remote tribal villages.

scholarly journals OUTCOME AND NUTRITIONAL ASSESSMENT OF CHRONIC LIVER DISEASE PATIENTS USING ANTHROPOMETRY AND SUBJECTIVE GLOBAL ASSESSMENT

2017 ◽  
Vol 54 (3) ◽  
pp. 225-231 ◽  
Author(s):  
Gonçalo NUNES ◽  
Carla Adriana SANTOS ◽  
Rita BAROSA ◽  
Cristina FONSECA ◽  
Ana Teresa BARATA ◽  
...  
Keyword(s):  
Liver Disease ◽  
Global Assessment ◽  
Nutritional Assessment ◽  
Handgrip Strength ◽  
Subjective Global Assessment ◽  
Upper Arm ◽  
Protein Calorie Malnutrition ◽  
Arm Circumference ◽  
Hospitalised Patients ◽  
Mid Upper Arm Circumference

ABSTRACT BACKGROUND: Protein-calorie malnutrition is common in chronic liver disease (CLD) but adequate clinical tools for nutritional assessment are not defined. OBJECTIVE: In CLD patients, it was aimed: 1. Characterize protein-calorie malnutrition; 2. Compare several clinical, anthropometric and functional tools; 3. Study the association malnutrition/CLD severity and malnutrition/outcome. METHODS: Observational, prospective study. Consecutive CLD ambulatory/hospitalised patients were recruited from 01-03-2012 to 31-08-2012, studied according with age, gender, etiology, alcohol consumption and CLD severity defined by Child-Turcotte-Pugh. Nutritional assessment used subjective global assessment, anthropometry, namely body-mass index (BMI), triceps skinfold, mid upper arm circumference, mid arm muscular circumference and handgrip strength. Patients were followed during two years and survival data was recorded. RESULTS: A total of 130 CLD patients (80 men), aged 22-89 years (mean 60 years) were included. Most suffered from alcoholic cirrhosis (45%). Hospitalised patients presented more severe disease ( P <0.001) and worst nutritional status defined by BMI ( P =0.002), mid upper arm circumference ( P <0.001), mid arm muscular circumference ( P <0.001), triceps skinfold ( P =0.07) and subjective global assessment ( P <0.001). A third presented deficient/low handgrip strength. Alcohol consumption ( P =0.03) and malnutrition detected by BMI ( P =0.03), mid upper arm circumference ( P =0.001), triceps skinfold ( P =0.06), mid arm muscular circumference ( P =0.02) and subjective global assessment ( P <0.001) were associated with CLD severity. From 25 patients deceased during follow-up, 17 patients were severely malnourished according with triceps skinfold. Malnutrition defined by triceps skinfold predicted mortality ( P <0.001). CONCLUSION: Protein-calorie malnutrition is common in CLD patients and alcohol plays an important role. Triceps skinfold is the most efficient anthropometric parameter and is associated with mortality. Nutritional assessment should be considered mandatory in the routine care of CLD patients.

scholarly journals Nutritional Assessment in Preterm Infants: A Practical Approach in the NICU

Nutrients ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 1999 ◽  
Author(s):  
Luis Pereira-da-Silva ◽  
Daniel Virella ◽  
Christoph Fusch
Keyword(s):  
Preterm Infants ◽  
Head Circumference ◽  
Nutritional Assessment ◽  
Fat Free Mass ◽  
Retinol Binding Protein ◽  
Practical Approach ◽  
Serum Phosphate Level ◽  
Upper Arm ◽  
Arm Circumference ◽  
Mid Upper Arm Circumference

A practical approach for nutritional assessment in preterm infants under intensive care, based on anthropometric measurements and commonly used biochemical markers, is suggested. The choice of anthropometric charts depends on the purpose: Fenton 2013 charts to assess intrauterine growth, an online growth calculator to monitor intra-hospital weight gain, and Intergrowth-21st standards to monitor growth after discharge. Body weight, though largely used, does not inform on body compartment sizes. Mid-upper arm circumference estimates body adiposity and is easy to measure. Body length reflects skeletal growth and fat-free mass, provided it is accurately measured. Head circumference indicates brain growth. Skinfolds estimate reasonably body fat. Weight-to-length ratio, body mass index, and ponderal index can assess body proportionality at birth. These and other derived indices, such as the mid-upper arm circumference to head circumference ratio, could be proxies of body composition but need validation. Low blood urea nitrogen may indicate insufficient protein intake. Prealbumin and retinol binding protein are good markers of current protein status, but they may be affected by non-nutritional factors. The combination of a high serum alkaline phosphatase level and a low serum phosphate level is the best biochemical marker for the early detection of metabolic bone disease.

Mid upper arm circumference as an alternative measure to assess the nutritional status of adolescents: a study in India based on NFHS-4 data

2021 ◽  
pp. 1-12
Author(s):  
Aparna Roy ◽  
T. V. Sekher
Keyword(s):  
Nutritional Status ◽  
Sensitivity And Specificity ◽  
Measurement Data ◽  
Anthropometric Measurement ◽  
Alternative Measure ◽  
Upper Arm ◽  
Male Adolescents ◽  
Arm Circumference ◽  
Mid Upper Arm Circumference ◽  
The Relationship

Abstract Use of body mass index (BMI) to assess the nutritional status of adolescents requires many resources, especially for country-level assessment. This study aimed to determine the relationship between BMI and mid upper arm circumference (MUAC) among adolescent males and females in India and to examine whether MUAC effectively represents the nutritional status of adolescents. The study utilized anthropometric measurement data collected by India’s National Family Health Survey-4 (2015–16). The weighted sample for analysis included 91,315 female and 14,893 male adolescents. The BMI and MUAC measurements showed a positive correlation in both female and male adolescents. Using BMI-for-age Z-score classifications, 12.7% of the adolescents were undernourished. Using MUAC (in cm) as per NACS (Nutrition Assessment, Counselling, and Support) guidelines and Mramba et al. (2017) classified 22.9% and 3.7% of the adolescents as undernourished respectively. Finally, using the MUAC-for-age Z-score classification, 98.4% of adolescents were determined to be normal and 1.7% undernourished. Sensitivity and specificity tests of the MUAC cut-offs, in comparison with BMI cut-offs, showed that all three MUAC cut-off classifications had high specificity (NACS cut-off: 81.3%; Mramba et al. cut-off (cm): 97.7%; Mramba et al. cut-off (Z-score): 99.1%). The NACS cut-off had moderately high sensitivity (52.2%) but the Mramba et al. cut-offs had low sensitivity (13.3% for the centimetre cut-off and 6.6% for the Z-score cut-off). Sensitivity and specificity tests proved the relationship between BMI and MUAC, and that MUAC represents adolescent nutritional status with considerable efficiency. With further research, it may be established that MUAC is a better and promising measure of adolescent nutrition, having the advantage of needing fewer resources for data collection. The MUAC has the potential to offer a simple and low-resource alternative to BMI to assess nutritional status among adolescents in poor countries.

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