SIMPLE AND EASY CHILDHOOD MALNUTRITION RISK ASSESSMENT.
WHAT IS MUAC?
Mid-Upper Arm Circumference is a measurement of the circumference around the middle of the upper arm. It measures muscle and fat mass in children,which is an important indicator of their nutritional status1.
The MUAC z-score tape is a simple, inexpensive, reusable plastic device that resembles a traditional measuring tape and includes customisable age indicators.
It allows healthcare professionals (HCPs) and caregivers to take these measurements in children aged 2 months to 18 years for an easy assessment of malnutrition risk.
DIFFERENCE BETWEEN Z-SCORES AND GROWTH CHARTS (CENTILES)2
A percentile indicates the percentage of observations that fall below a certain value and is usually a fixed number depending on the growth charts used i.e., 5th or 25th percentile.
A z-score is the distance and direction of an observation away from the population mean and is equivalent to standard deviation (SD) from the population mean.
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BENEFITS OF TRACKING Z-SCORES2
The use of z-scores is helpful for children who are very large or very small where it is difficult to accurately track the response to a nutrition intervention on standard growth charts.
For example, if a child with excess weight gains further weight, a percentile change from 98.9 to 99.9 is difficult to visualise on a growth chart, whereas when z-scores are used there would be an increase from 2.3 to 3.4.
Likewise, if an underweight child lost more weight, using z-scores it is easier to appreciate the change from -2.3 to -3.4, compared to the centile decreases which would be from 1.07 to 0.03, for the same difference.
Changes over time are easier to understand using z-scores with regards to a response to a nutrition intervention as they are on a linear number scale.
CHALLENGES IN MEASURING CHILDREN
Taking anthropometric measurements in children can be challenging for many reasons, including:
The child’s condition / severity of illness (i.e. if the child is in intensive care)4
Resistance of young children to being placed in the optimal measuring position5
BENEFITS OF USING MUAC TAPES
There are a number of benefits to using MUAC tapes, which can help overcome these challenges:6
- Can be used anywhere, in any setting, whether or not the HCP has the height and weight information for the child
- Can be used on any child, of any age and any weight range
- For any HCP, and parents too, to identify malnutrition
- Quick and simple to use
- Reveals immediate classification of malnutrition
- Validated in over 10,000 children
RESOURCES TO HELP YOU SCREEN
WEBINAR ON MUAC AND SCREENING
This course for HCPs describes the validity of MUAC and it’s clinical application, reviews z-score calculations and demonstrates how to take MUAC measurements in paediatric practice.
HOW TO GUIDE
This simple how to guide outlines the steps to taking measurements using the MUAC z-score tape.
To get a supply of reusable MUAC z-scope tapes for your clinic or
practice, request a meeting with your local Abbott representative
References:
1. BAPEN, 2016: Assessment and Planning. Available online: https://www.bapen.org.uk/screening-and-must/82-nutrition-support/assessment-and-planning. Last accessed June 2023.
2. Devore GR J UltrasoundMed 2017; 36:459–473.
3. Conkle J & Martorell R Adv Nutr 2019; 1;10:S10-S16.
4. Srinivasan V et al. Pediatr Qual Saf. 2017;10;2(3):e022.
5. Bilukha O et al. BMC Nutr 2020 6, 60.
6. Aydın K et al. Front Pedi 2023;11:2296-2360.
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