1Center for Surgery and Public Health,Harvard School of Public Health,Harvard Medical School,Brigham and Women's Hospital,One Brigham Circle,1620 Tremont Street,4-020,Boston,MA 02120,USA.
2Department of Global Health,Milken Institute School of Public Health,George Washington University,Washington,DC,USA.
Public Health Nutr. 2018 Aug;21(12):2230-2237. doi: 10.1017/S1368980018000940. Epub 2018 Apr 18.
To assess ethnicity- and age-modified associations between mid-upper arm circumference (MUAC) and mortality in Nepalese children and whether sociodemographic factors explain these associations.
Secondary data analysis of children followed until 3 years of age. Estimated mortality hazard ratios (HR) for MUAC<11·5cm (recommended cut-off for identifying severe acute malnutrition among children ≥6 months old) compared with ≥11·5cm in younger (<6 months) and older children (≥6 months) of Pahadi and Madhesi ethnicity, adjusting for sex, socio-economic status (SES) and mother's education using Cox proportional hazard models.
Sarlahi, Nepal (21 October 2001-2 February 2006).
Children (n 48 492) enrolled in the Nepal Nutrition Intervention Project, Sarlahi-4.
Among children aged ≥6 months, MUAC<11·5 cm was associated with increased risk of mortality in both Pahadis (HR=4·01; 95 % CI 1·42, 11·76) and Madhesis (HR=5·60; 95 % CI 3·87, 8·11) compared with those with MUAC≥11·5 cm, after adjusting for sex, SES and maternal literacy. Among children <6 months old, MUAC<11·5 cm was not associated with mortality in Pahadis with (HR=1·12; 95 % CI 0·72, 1·73) or without adjusting (HR=1·17; 95 % CI 0·75, 1·18) as compared with Madeshis (adjusted HR=1·76; 95 % CI 1·35, 2·28).
Among older children, MUAC<11·5 cm is associated with subsequent mortality in both ethnicities regardless of other characteristics. However, among children aged <6 months, it predicted mortality only among Madhesis, while sociodemographic factors were more strongly associated with mortality than MUAC<11·5cm among Pahadis.
评估中上臂围（MUAC）与尼泊尔儿童死亡率之间的种族和年龄修正关联，以及社会人口因素是否可以解释这些关联。
对随访至 3 岁的儿童进行二次数据分析。使用 Cox 比例风险模型，调整性别、社会经济地位（SES）和母亲教育后，比较 MUAC<11.5cm（识别≥6 个月大儿童严重急性营养不良的推荐临界值）与 Pahadi 和 Madhesi 族裔的<6 个月和≥6 个月儿童 MUAC≥11.5cm 的估计死亡率风险比（HR）。
尼泊尔萨拉里（2001 年 10 月 21 日至 2006 年 2 月 2 日）。
参加尼泊尔营养干预项目（萨拉里希 4 号）的儿童（n=48492）。
在≥6 个月的儿童中，与 MUAC≥11.5cm 的儿童相比，Pahadi 族（HR=4.01；95%CI 1.42，11.76）和 Madhesi 族（HR=5.60；95%CI 3.87，8.11）中 MUAC<11.5cm 与死亡率风险增加相关，调整性别、SES 和母亲识字率后。在<6 个月的儿童中，与不调整（HR=1.17；95%CI 0.75，1.18）相比，调整后（HR=1.12；95%CI 0.72，1.13），MUAC<11.5cm 与 Pahadi 族的死亡率无关，但与 Madhesi 族的死亡率有关（调整后 HR=1.76；95%CI 1.35，2.28）。
在年龄较大的儿童中，无论其他特征如何，MUAC<11.5cm 与随后的死亡率相关。然而，在<6 个月的儿童中，它仅在 Madhesi 族中预测死亡率，而社会人口因素与死亡率的相关性强于 Pahadi 族中 MUAC<11.5cm。
