MUAC as the sole discharge criterion from community-based management of severe acute malnutrition in Burkina Faso.

Auteurs: Isanaka S Hanson KE Frison S Andersen CT Cohuet S Grais RF
Référence de l'article: Maternal & child nutrition 2018 Sep 08; (); e12688. doi: 10.1111/mcn.12688. Epub 2018 09 08
Burkina Faso community-based management of acute malnutrition discharge mid upper arm circumference proportional weight gain severe acute malnutrition


The use of mid upper arm circumference (MUAC) measurement to screen and determine eligibility for admission to therapeutic feeding programs has been established, but evidence and programmatic experience to inform guidance on the use of MUAC as a discharge criterion is limited. We present results from a large-scale nutritional program using MUAC for admission and discharge and compare program outcomes and response to treatment when determining eligibility for discharge by proportional weight gain versus discharge by MUAC. The study population included all children admitted to the Ministry of Health therapeutic feeding program supported by Médecins Sans Frontières in northern Burkina Faso from September 2007 to December 2011 (n = 50,841). Recovery was high overall using both discharge criteria, with low risks of death, nonresponse, and transfer to inpatient care and high daily gains in weight, MUAC, weight-for-height Z score, and height. When discharge was made by MUAC only, recovery increased, while all adverse program outcomes and length of stay decreased, with increasing MUAC on admission. MUAC-based programming, where MUAC is integrated into program screening, admission, and discharge, is one of several new approaches that can be used to target resources to the most at-risk malnourished children and improve program efficiency and coherency. This analysis provides additional programmatic experience on the use of MUAC-based discharge criterion, but more work may be needed to inform optimal discharge thresholds across settings.

© 2018 The Authors. Maternal and Child Nutrition Published by John Wiley & Sons, Ltd.