Abstract:
Mid-upper arm circumference (MUAC) is an age-sensitive anthropometric measurement in infants. However, exact age is difficult to know, particularly in low-income countries. We evaluated the diagnostic accuracy of an age-independent mid-upper arm circumference-to-length (MUAC/L) ratio measurement in detecting wasting among infants aged 1-6 months in Ethiopia. A facility-based diagnostic accuracy study was conducted on 467 in-patient infants aged 1-6 months from March to May 2019. The receiver operating characteristic (ROC) curve was used to evaluate the ability of MUAC/L to detect wasting. Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and positive and negative predictive values were calculated. The magnitude of severe wasting was 21⋅6 % and moderate wasting was 13⋅0 %. The area under the ROC curve (AUC) of MUAC/L was 0⋅77 (95 % CI 0⋅73, 0⋅81) for detecting moderate wasting and 0⋅92 (95 % CI 0⋅89, 0⋅94) for detecting severe wasting. MUAC/L had a sensitivity of 91⋅1 % (95 % CI 81⋅3, 94⋅4), a specificity of 84⋅7 % (95 % CI 80⋅6, 88⋅2), a positive likelihood ratio of 5⋅82 (95 % CI 4⋅53, 7⋅48) and a negative likelihood ratio of 0⋅13 (95 % CI 0⋅07, 0⋅22) in total infants. The optimal MUAC/L cut-off was <0⋅190 for boys and <0⋅185 for girls. MUAC/L had an AUC of 0⋅77 and 0⋅92 in predicting moderate and severe wasting in infants aged 1-6 months, respectively. Using MUAC/L to treat Ethiopian infants with severe wasting and infants with similar characteristics in other countries could improve treatment coverage.
摘要:
上臂中围(MUAC)是婴儿年龄敏感的人体测量。然而,确切的年龄很难知道,特别是在低收入国家。我们评估了与年龄无关的中上臂周长与长度(MUAC/L)比率测量在检测埃塞俄比亚1-6个月婴儿的消瘦中的诊断准确性。2019年3月至5月,对467名1-6个月的住院婴儿进行了基于设施的诊断准确性研究。使用受试者工作特性(ROC)曲线来评估MUAC/L检测浪费的能力。灵敏度,特异性,正似然比,计算阴性似然比以及阳性和阴性预测值.严重消瘦的程度为21·6%,中度消瘦的程度为13·0%。MUAC/L的ROC曲线下面积(AUC)为检测中度消瘦的0·77(95%CI0·73,0·81)和检测严重消瘦的0·92(95%CI0·89,0·94)。MUAC/L的灵敏度为91·1%(95%CI81·3,94·4),特异性为84·7%(95%CI80·6,88·2),总婴儿的正似然比为5·82(95%CI4·53,7·48),负似然比为0·13(95%CI0·07,0·22)。男孩的最佳MUAC/L截止值为<0·190,女孩的最佳MUAC/L截止值为<0·185。MUAC/L在预测1-6个月婴儿的中度和重度消瘦时的AUC为0·77和0·92,分别。使用MUAC/L治疗严重消瘦的埃塞俄比亚婴儿和其他国家具有类似特征的婴儿可以提高治疗覆盖率。