@article{fdi:010066215,
  title = {{C}urrent {MUAC} cut-offs to screen for acute malnutrition need to be adapted to gender and age : the example of {C}ambodia},
  author = {{F}iorentino, {M}. and {S}ophonneary, {P}. and {L}aillou, {A}. and {W}hitney, {S}. and de {G}root, {R}. and {P}erignon, {M}arl{\`e}ne and {K}uong, {K}. and {B}erger, {J}acques and {W}ieringa, {F}ranck},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground {E}arly identification of children <5 yrs with acute malnutrition is a priority. {A}cute malnutrition is defined by the {W}orld {H}ealth {O}rganization as a mid-upper-arm circumference ({MUAC}) <12.5 cm or a weight-for-height {Z}-score ({WHZ}) <-2. {MUAC} is a simple and low-cost indicator to screen for acute malnutrition in communities, but {MUAC} cut-offs currently recommended by {WHO} do not identify the majority of children with weight-for-height {Z}-score (<-2 (moderate malnourished) or r<-3 (severe malnourished). {A}lso, no cut-offs for {MUAC} are established for children >5 yrs. {T}herefore, this study aimed at defining gender and age-specific cut-offs to improve sensitivity of {MUAC} as an indicator of acute malnutrition. {M}ethods {T}o establish new age and gender-specific {MUAC} cut-offs, pooled data was obtained for 14,173 children from 5 surveys in {C}ambodia (2011-2013). {S}ensitivity, false positive rates, and areas under receiver-operator characteristic curves ({AUC}) were calculated using wasting for children <5yrs and thinness for children >= 5yrs as gold standards. {A}mong the highest values of {AUC}, the cut-off with the highest sensitivity and a false positive rate <= 33% was selected as the optimal cut-off. {R}esults {O}ptimal cut-off values increased with age. {B}oys had higher cut-offs than girls, except in the 8-10.9 yrs age range. {I}n children <2yrs, the cut-off was lower for stunted children compared to non stunted children. {S}ensitivity of {MUAC} to identify {WHZ}<-2 and <-3 z-scores increased from 24.3% and 8.1% to >80% with the new cut-offs in comparison with the current {WHO} cut-offs. {C}onclusion {G}ender and age specific {MUAC} cut-offs drastically increased sensitivity to identify children with {WHZ}-score <-2 z-scores. {I}nternational reference of {MUAC} cut-offs by age group and gender should be established to screen for acute malnutrition at the community level.},
  keywords = {{CAMBODGE}},
  booktitle = {},
  journal = {{P}los {O}ne},
  volume = {11},
  numero = {2},
  pages = {e0146442 [11 p.]},
  ISSN = {1932-6203},
  year = {2016},
  DOI = {10.1371/journal.pone.0146442},
  URL = {https://www.documentation.ird.fr/hor/fdi:010066215},
}