Prognostic value of different anthropometric indices over different measurement intervals to predict mortality in 6-59-month-old children.

Briend A Myatt M Berkley JA Black RE Boyd E Garenne M Lelijveld N Isanaka S McDonald CM Mwangwome M O'Brien KS Schwinger C Stobaugh H Taneja S West KP Khara T
Public health nutrition 2023 Feb 01; . doi: 10.1017/S1368980023000149. Epub 2023 02 01
Anthropometry Mid-upper arm circumference Mortality Stunting Underweight Wasting


OBJECTIVE: To compare the prognostic value of mid-upper arm circumference (MUAC), weight-for-height z-score (WHZ) and weight-for-age z-score (WAZ) for predicting death over periods of one, three and six months follow-up in children.

DESIGN: Pooled analysis of 12 prospective studies examining survival after anthropometric assessment. Sensitivity and false-positive ratios to predict death within one, three and six months were compared for three individual anthropometric indices and their combinations.

SETTING: Community-based, prospective studies from 12 countries in Africa and Asia.

PARTICIPANTS: Children aged 6-59 months living in the study areas.

RESULTS: For all anthropometric indices, the receiver operating characteristic curves were higher for shorter than for longer durations of follow-up. Sensitivity was higher for death with one month follow-up compared to six months by 49% (95% CI: 30-69%) for MUAC

CONCLUSIONS: Frequent anthropometric measurements significantly improve the identification of malnourished children with a high risk of death without markedly increasing false-positives. Combining two indices increases sensitivity but also increases false-positives among children meeting case definitions.