ABSOLUTE VALUES OR Z-SCORES OF MID-UPPER ARM CIRCUMFERENCE TO IDENTIFY WASTING - EVALUATION IN A COMMUNITY AS WELL AS A CLINICAL-SAMPLE OF UNDER FIVES FROM NCHELENGE, ZAMBIA

The purpose of the study was to compare the use of absolute cut off va lues of the mid-upper arm circumference (MUAC) with age- and sex-adjus ted z scores of the MUAC in the identification of acute undernutrition (wasting) in children up to 60 months of age, In Nchelenge, northern Zambia, 275 children from the community, selected by a two-stage clust er sampling procedure, and 105 hospitalized children with protein ener gy malnutrition (PEM) individually matched for age, sex, village and u nder-five clinic attendance with 104 controls, were clinically and ant hropometrically (weight, height, MUAC) examined, z Scores for weight f or height and MUAC were calculated and PEM was classified according to a modified Wellcome scheme. For community prevalence rates of wasting in various age groups, MUAC less than or equal to -4 z scores more cl osely paralleled W/H less than or equal to -2 z scores than MUAC <125 mm. To identify individual children with wasting, MUAC less than or eq ual to -2 z scores gave a better sensitivity than MUAC <125 mm. In hos pitalized PEM children, z scores appeared to offer no advantages over absolute MUAC values in identifying the presence of wasting. Applicabi lity of the MUAC and optimal cut off values may differ according to th e setting in which the MUAC is to be applied.