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Journal of Tropical Pediatrics 1992 38(5):240-246; doi:10.1093/tropej/38.5.240
© 1992 by Oxford University Press
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Detecting Malnutrition at Age 6–12 Months: International Comparisons of Arm Circumference v. Standard Anthropometry

R. Pust, MD*, P. Johnson, MD* and J. Lautenschlager, MD**

Department of Family ond Community Medicine, Uniwrsity of Arizona Tucson, Arizona 85724, USA
Lutheran Health Services (via) Freetown, Sierra Leone

Growth faltering, which may herald proteineoergy malnutrition (PEM) usually begins between ages 6 and 12 months. However, arm circumference (AC or MUAC) has mainly been used to screen for PEM between 12 and 60 months of age, wben AC is age-iodependent. This study of 378 infants aged 6–12 months in Pakistan, Nepal, Sierra Leone, and Papua New Guinea showed that a cut-off 12.5 cm AC selects infants <80 per cent weight-for-age (WA) witb 76 per cent sensitivity a d 90 per cent specificity. Of the 378 infants studied 131 (35 per cent) had WA <80 per cent and 126 (33 per cent) had AC < 12.5 cm. Weight-for-length agreed less well witb AC. The inter-qional prevalence range of AC < 12.5 cm was 29–40 per cent, while the WA <80 per cent range was 27-45 per cent. When AC is plotted against age, a fiat ‘plateau’ (slope = 0.04) shows age-independence between 6 and 12 month in these 378; this contrasts to the 10 per cent AC increase in European reference populations. Because this AC plateau parallels the WA plateau seeo between 6 and 12 months of age in most developing nations, AC < 125 cm may provide a simple and valid screenine, test for early PEM in this crucial age bracket. Conformatory studies elsewhere are indicated.


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