%0 Journal Article
%9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES
%A Myatt, M.
%A Khara, T.
%A Dolan, C.
%A Garenne, Michel
%A Briend, André
%T Improving screening for malnourished children at high risk of death : a study of children aged 6-59 months in rural Senegal
%D 2019
%L fdi:010075592
%G ENG
%J Public Health Nutrition
%@ 1368-9800
%K Wasting ; Stunting ; Underweight ; Mid-upper arm circumference ; Anthropometry ; Mortality ; Therapeutic feeding ; Child survival
%K SENEGAL
%M ISI:000462870200010
%N 5
%P 862-871
%R 10.1017/s136898001800318x
%U https://www.documentation.ird.fr/hor/fdi:010075592
%> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers19-04/010075592.pdf
%V 22
%W Horizon (IRD)
%X OBJECTIVE: To investigate whether children with concurrent wasting and stunting require therapeutic feeding and to better understand whether multiple diagnostic criteria are needed to identify children with a high risk of death and in need of treatment. DESIGN: Community-based cohort study, following 5751 children through time. Each child was visited up to four times at 6-month intervals. Anthropometric measurements were taken at each visit. Survival was monitored using a demographic surveillance system operating in the study villages. SETTING: Niakhar, a rural area of the Fatick region of central Senegal.ParticipantsChildren aged 6-59 months living in thirty villages in the study area. RESULTS: Weight-for-age Z-score (WAZ) and mid-upper arm circumference (MUAC) were independently associated with near-term mortality. The lowest WAZ threshold that, in combination with MUAC, detected all deaths associated with severe wasting or concurrent wasting and stunting was WAZ <-2.8. Performance for detecting deaths was best when only WAZ and MUAC were used. Additional criteria did not improve performance. Risk ratios for near-term death in children identified using WAZ and MUAC suggest that children identified by WAZ <-2.8 but with MUAC >= 115 mm may require lower-intensity treatment than children identified using MUAC<115 mm. CONCLUSIONS: A combination of MUAC and WAZ detected all near-term deaths associated with severe anthropometric deficits including concurrent wasting and stunting. Therapeutic feeding programmes may achieve higher impact if WAZ and MUAC admission criteria are used.
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