Department of Nutrition and Dietetics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia.
Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
J Nutr Sci. 2022 Mar 21;11:e23. doi: 10.1017/jns.2022.21. eCollection 2022.
Mid-upper arm circumference (MUAC) is an age-sensitive anthropometric measurement in infants. However, exact age is difficult to know, particularly in low-income countries. We evaluated the diagnostic accuracy of an age-independent mid-upper arm circumference-to-length (MUAC/L) ratio measurement in detecting wasting among infants aged 1-6 months in Ethiopia. A facility-based diagnostic accuracy study was conducted on 467 in-patient infants aged 1-6 months from March to May 2019. The receiver operating characteristic (ROC) curve was used to evaluate the ability of MUAC/L to detect wasting. Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and positive and negative predictive values were calculated. The magnitude of severe wasting was 21⋅6 % and moderate wasting was 13⋅0 %. The area under the ROC curve (AUC) of MUAC/L was 0⋅77 (95 % CI 0⋅73, 0⋅81) for detecting moderate wasting and 0⋅92 (95 % CI 0⋅89, 0⋅94) for detecting severe wasting. MUAC/L had a sensitivity of 91⋅1 % (95 % CI 81⋅3, 94⋅4), a specificity of 84⋅7 % (95 % CI 80⋅6, 88⋅2), a positive likelihood ratio of 5⋅82 (95 % CI 4⋅53, 7⋅48) and a negative likelihood ratio of 0⋅13 (95 % CI 0⋅07, 0⋅22) in total infants. The optimal MUAC/L cut-off was <0⋅190 for boys and <0⋅185 for girls. MUAC/L had an AUC of 0⋅77 and 0⋅92 in predicting moderate and severe wasting in infants aged 1-6 months, respectively. Using MUAC/L to treat Ethiopian infants with severe wasting and infants with similar characteristics in other countries could improve treatment coverage.
中上臂围（MUAC）是婴儿年龄敏感的人体测量指标。然而，确切的年龄很难确定，尤其是在低收入国家。我们评估了一种与年龄无关的中上臂围与长度（MUAC/L）比值测量在检测埃塞俄比亚 1-6 个月婴儿消瘦中的诊断准确性。2019 年 3 月至 5 月，在一家医疗机构进行了一项基于设施的诊断准确性研究，共纳入了 467 名 1-6 个月的住院婴儿。使用受试者工作特征（ROC）曲线评估 MUAC/L 检测消瘦的能力。计算了灵敏度、特异性、阳性似然比、阴性似然比以及阳性和阴性预测值。严重消瘦的发生率为 21.6%，中度消瘦的发生率为 13.0%。MUAC/L 对中度消瘦的 ROC 曲线下面积（AUC）为 0.77（95%CI 0.73，0.81），对重度消瘦的 AUC 为 0.92（95%CI 0.89，0.94）。MUAC/L 的灵敏度为 91.1%（95%CI 81.3%，94.4%），特异性为 84.7%（95%CI 80.6%，88.2%），阳性似然比为 5.82（95%CI 4.53，7.48），阴性似然比为 0.13（95%CI 0.07，0.22）。总婴儿的最佳 MUAC/L 截断值为男孩<0.190，女孩<0.185。MUAC/L 在预测 1-6 个月婴儿中度和重度消瘦时的 AUC 分别为 0.77 和 0.92。在埃塞俄比亚使用 MUAC/L 治疗重度消瘦婴儿和其他国家具有类似特征的婴儿，可以提高治疗覆盖率。
