验证 MUAC（中上臂围）在马哈拉施特拉邦农村地区 6-59 个月儿童严重急性营养不良检测中的切点。
Validating the MUAC (Mid-upper arm circumference) Cut-off for Detection of Severe Acute Malnutrition in Children Aged 6-59 Months in Rural Maharashtra.
机构信息
Department of Community Medicine, Dr Sushila Nayar School of Public Health, Mahatma Gandhi Institute of Medical Sciences Sewagram, Wardha, Maharashtra, India. Correspondence to: Dr Reshma Sougaijam, Wangkhei khunou, Ward no. 22, Imphal - 795001, Manipur, India.
Department of Community Medicine, Dr Sushila Nayar School of Public Health, Mahatma Gandhi Institute of Medical Sciences Sewagram, Wardha, Maharashtra, India.
出版信息
Indian Pediatr. 2019 Mar 15;56(3):209-212.
OBJECTIVE
To review the Mid-upper arm circumference (MUAC) cut-off currently being used to identify Severe Acute Malnutrition (SAM) as currently defined using Weight-for-Height.
METHODS
Cross-sectional study conducted in 24 villages of a Primary Health Centre in Wardha district of Maharashtra among 2650 children between the ages of 6 to 59 months.
RESULTS
For identifying SAM, sensitivity of MUAC was 23.5% and specificity was 99.7% for cut-off <11.5 cm. Using Youden index, best Mid-upper arm circumference cut-off point to identify SAM was <13 cm with sensitivity of 74.5% and specificity of 92.7%. Using Receiver operating characteristics curve, best MUAC cut-off point was 12.8 cm with 74.5% sensitivity and 92.7% specificity. Area under curve was 0.88 (95%CI: 0.85-0.91).
CONCLUSION
The current MUAC cut-off of <11.5 cm for detecting SAM needs to be increased to ensure that children, who need referral for management of malnutrition, are not missed.
目的
评价目前用于识别严重急性营养不良（SAM）的中上臂围（MUAC）截断值，该截断值目前是根据身高体重定义的。
方法
在马哈拉施特拉邦沃德哈区的一个初级保健中心的 24 个村庄中进行了一项横断面研究，共纳入了 2650 名 6 至 59 个月龄的儿童。
结果
对于识别 SAM，截断值<11.5cm 的 MUAC 灵敏度为 23.5%，特异性为 99.7%。使用约登指数，最佳的中上臂围截断值来识别 SAM 为<13cm，灵敏度为 74.5%，特异性为 92.7%。使用受试者工作特征曲线，最佳 MUAC 截断值为 12.8cm，灵敏度为 74.5%，特异性为 92.7%。曲线下面积为 0.88（95%CI：0.85-0.91）。
结论
目前用于检测 SAM 的 MUAC 截断值<11.5cm 需要提高，以确保不会漏诊需要转诊进行营养不良管理的儿童。
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