Mothers understand and can do it (MUAC): A comparison of mothers and community health workers determining mid-upper arm circumference in 103 children aged from 6 months to 5 years

TY - JOUR

T1 - Mothers understand and can do it (MUAC)

T2 - A comparison of mothers and community health workers determining mid-upper arm circumference in 103 children aged from 6 months to 5 years

AU - Blackwell, Nikki

AU - Myatt, Mark

AU - Allafort-Duverger, Thierry

AU - Balogoun, Amour

AU - Ibrahim, Almou

AU - Briend, André

N1 - CURIS 2015 NEXS 214

PY - 2015

Y1 - 2015

N2 - Background: Mid-upper arm circumference (MUAC) was recently endorsed and recommended for screening for acute malnutrition in the community. The objective of this study was to determine whether a colour-banded MUAC strap would allow minimally trained mothers to screen their own children for malnutrition, without locating the mid-point of the left upper arm by measurement, as currently recommended. Methods: A non-randomised non-blinded evaluation of mothers' performance when measuring MUAC after minimal training, compared with trained Community Health Workers (CHW) following current MUAC protocols. The study was conducted in 2 villages in Mirriah, Zinder region, Niger where mothers classified one of their children (n = 103) aged 6-59 months (the current age range for admission into community malnutrition programs) using the MUAC tape. Results: Mothers' had a sensitivity and specificity for classification of their child's nutritional status of > 90% and > 80% respectively for global acute malnutrition (GAM, defined by a MUAC < 125 mm) and > 73% and > 98% for severe acute malnutrition (SAM, defined by a MUAC < 115 mm). The few children misclassified as not having SAM, were classified as having moderate acute malnutrition (MAM). The choice of arm did not influence the classification results; weighted Kappa of 0.88 for mothers and 0.91 for CHW represent almost perfect agreement. Errors occurred at the class boundaries and no gross errors were made. Conclusions: Advanced SAM is associated with severe complications, which often require hospital admission or cause death. Mothers (with MUAC tapes costing $0.06) can screen their children frequently allowing early diagnosis and treatment thereby becoming the focal point in scaling-up community management of acute malnutrition. Trial registration: The trial is registered with clinicaltrials.gov (Trial number NCT01790815).

AB - Background: Mid-upper arm circumference (MUAC) was recently endorsed and recommended for screening for acute malnutrition in the community. The objective of this study was to determine whether a colour-banded MUAC strap would allow minimally trained mothers to screen their own children for malnutrition, without locating the mid-point of the left upper arm by measurement, as currently recommended. Methods: A non-randomised non-blinded evaluation of mothers' performance when measuring MUAC after minimal training, compared with trained Community Health Workers (CHW) following current MUAC protocols. The study was conducted in 2 villages in Mirriah, Zinder region, Niger where mothers classified one of their children (n = 103) aged 6-59 months (the current age range for admission into community malnutrition programs) using the MUAC tape. Results: Mothers' had a sensitivity and specificity for classification of their child's nutritional status of > 90% and > 80% respectively for global acute malnutrition (GAM, defined by a MUAC < 125 mm) and > 73% and > 98% for severe acute malnutrition (SAM, defined by a MUAC < 115 mm). The few children misclassified as not having SAM, were classified as having moderate acute malnutrition (MAM). The choice of arm did not influence the classification results; weighted Kappa of 0.88 for mothers and 0.91 for CHW represent almost perfect agreement. Errors occurred at the class boundaries and no gross errors were made. Conclusions: Advanced SAM is associated with severe complications, which often require hospital admission or cause death. Mothers (with MUAC tapes costing $0.06) can screen their children frequently allowing early diagnosis and treatment thereby becoming the focal point in scaling-up community management of acute malnutrition. Trial registration: The trial is registered with clinicaltrials.gov (Trial number NCT01790815).

U2 - 10.1186/s13690-015-0074-z

DO - 10.1186/s13690-015-0074-z

M3 - Journal article

C2 - 25992287

SN - 0778-7367

VL - 73

JO - Archives of Public Health

JF - Archives of Public Health

M1 - 26

ER -