Performance of Mid-Upper Arm Circumference for Detection of Severe Acute Malnutrition in Indonesian Under-Fives

August 6, 2024 updated by: Klara Yuliarti, Indonesia University

WHO recommends 11.5 cm as a cut-off point of Mid-Upper Arm Circumference (MUAC) to detect and/or diagnose severe acute malnutrition (SAM) in under-five. MUAC is practical and useful, especially in area with limited facilities which has no standardized scale and infantometer. However, several studies showed that this cut-off need to be evaluated as it has modest detection rate for SAM. This study aims to evaluate diagnostic value of MUAC with 11.5 cm cut-off compared to WHZ as gold standard to identify SAM. The sensitivity, specificity, positive and negative predictive value of MUAC with 11.5 cm as a standard cut-off will be evaluated.

This study also aim to find new cut-off value that may offer better diagnostic performance. The main research questions were:

What is the diagnostic accuracy of Mid-Upper Arm Circumference (MUAC) compared to the Weight for Height Z Score (WHZ) in identifying SAM in children, and what is the optimal MUAC cut-off value for enhanced diagnostic performance?

Study Overview

Status

Completed

Conditions

Severe Acute Malnutrition

Intervention / Treatment

Diagnostic test: Mid-upper arm circumference

Study Type

Observational

Enrollment (Actual)

421

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

Indonesia
- DKI Jakarta
  - Jakarta, DKI Jakarta, Indonesia, 11730
    - Puskesmas Cengkareng
  - Jakarta Pusat, DKI Jakarta, Indonesia, 10440
    - RSUPN Dr Cipto Mangunkusumo

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

Child

Accepts Healthy Volunteers

Yes

Sampling Method

Non-Probability Sample

Study Population

This study was conducted in the largest primary community health care facility in Cengkareng Jakarta and have 29.110 registered under-fives in its service area.

Description

Inclusion Criteria:

under-fives that 6-59 months-old

Exclusion Criteria:

ascites
edema
hydrocephalus
tumor or oncologic diseases
organomegaly
uncooperative during measurement

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Diagnostic value of MUAC in diagnosing SAM compare to WHZ-index Time Frame: 2 months	To evaluate sensitivity, specificity, positive and negative predictive value of MUAC	2 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Finding new cut off value that offer better diagnostic performance using ROC Time Frame: 2 months	To compare sensitivity, specificity, positive and negative predictive value of MUAC with 11.5 cm as standard cut off and to new cut-off value that may offer better diagnostic performance	2 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Indonesia University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 1, 2020

Primary Completion (Actual)

February 29, 2020

Study Completion (Actual)

February 29, 2020

Study Registration Dates

First Submitted

July 31, 2024

First Submitted That Met QC Criteria

August 6, 2024

First Posted (Actual)

August 9, 2024

Study Record Updates

Last Update Posted (Actual)