@article{fdi:010073201,
  title = {{I}dentification of acute malnutrition in children in {C}ambodia requires both mid upper arm circumference and weight-for-height to offset gender bias of each indicator},
  author = {{W}ieringa, {F}ranck and {G}authier, {L}udovic and {G}reffeuille, {V}al{\'e}rie and {S}om, {S}. {V}. and {D}ijkhuizen, {M}. {A}. and {L}aillou, {A}. and {C}hamnan, {C}. and {B}erger, {J}acques and {P}oirot, {E}.},
  editor = {},
  language = {{ENG}},
  abstract = {{M}alnutrition remains a serious health problem in {C}ambodia with over 10% of children less than five years of age suffering from acute malnutrition. {I}n addition to the presence of nutritional edema, two indicators are recommended by the {W}orld {H}ealth {O}rganization for the diagnosis of acute malnutrition: weight-for-height {Z}-scores ({WHZ}; with acute malnutrition defined as {WHZ} < -2 {Z}-score) and mid-upper arm circumference ({MUAC}, with acute malnutrition defined as {MUAC} < 12.5 cm). {E}arlier, we showed that {WHZ} and {MUAC} identified different subgroups of children with acute malnutrition. {T}o explore factors associated with both indicators of acute malnutrition, we analyzed baseline data from a longitudinal study in three provinces in {C}ambodia: {P}hnom {P}enh (capital, urban environment), {K}ratie (rural province), and {R}atanakiri (hilly, rural province). {D}ata was available for 4381 children below 30 months of age. {M}alnutrition rates were higher in the two rural provinces than in the capital. {A}lthough both {MUAC} and {WHZ} showed gender bias, with {MUAC} identifying more girls, and {WHZ} identifying more boys with acute malnutrition, the gender effect was strongest for {MUAC}. {T}he gender bias of {MUAC} diminished with older age, but remained significant up to 30 months of age. {O}nly using both {MUAC} and {WHZ} as indicators resulted in gender neutral identification of acute malnutrition. {WHZ} alone always identified more children with acute malnutrition than {MUAC} alone. {I}n {P}hnom {P}enh, {MUAC} alone identified only 11% with acute malnutrition in addition to {WHZ}. {T}o conclude, both {MUAC} and {WHZ} showed gender bias in this cohort of {C}ambodian children. {I}n {C}ambodia, implementation of a {MUAC}-only or a {WHZ}-only program for the identification of acute malnutrition would be unethical as it will lead to many children remaining undiagnosed.},
  keywords = {malnutrition ; anthropometry ; weight-for-height ; mid upper arm ; circumerference ({MUAC}) ; gender ; {CAMBODGE}},
  booktitle = {},
  journal = {{N}utrients},
  volume = {10},
  numero = {6},
  pages = {art. 786 [9 p.]},
  ISSN = {2072-6643},
  year = {2018},
  DOI = {10.3390/nu10060786},
  URL = {https://www.documentation.ird.fr/hor/fdi:010073201},
}