Sensitivity and specificity of mid-upper arm circumference for assessment of severe acute malnutrition among children ages 6 to 59 months: Systematic review and meta-analysis.

Published
December 26, 2022
Journal
Nutrition (Burbank, Los Angeles County, Calif.)
PICOID
d8da3405
DOI
Citations
0
Keywords
SAM, Sensitivity, aged <5 y, optimal cutoff point, specificity
Copyright
Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.
Patients/Population/Participants

children aged <5 y

Intervention

mid-upper arm circumference (MUAC)

Comparison

severe acute malnutrition (SAM)

Outcome

sensitivity and specificity

Abstract

P
I
C
O

Sensitivity is the proportion of people classified as diseased (i.e., no false negatives). A test with low sensitivity can be thought of as being too cautious in finding a positive result. The Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were followed for this systematic review and meta-analysis. The databases used were PubMed, Google Scholar, Jane, and African Journals Online. The search terms used were "sensitivity" and "specificity of and mid-upper arm circumference" (MUAC). A Joanna Briggs Institute meta-analysis and checklist for diagnostic test accuracy studies was used for the critical appraisal of the studies. The meta-analysis was conducted using STATA, version 14, software. The pooled sensitivity was computed to present the pooled sensitivity at a 95% confidence interval (CI). A total of 11 individual studies were included in the meta-analysis. The lowest sensitivity of MUAC with the detection of severe acute malnutrition (SAM) was 5% in Vietnam, and the highest sensitivity was at 43.2% in India. The pooled sensitivity of MUAC among children aged <5 y to determine SAM was 20.7% (range, 13.24%-28.25%; P = 0.001). Based on the pooled specificity of MUAC, the detection of SAM was 97.636% (95% CI, 96.339%-98.932%; P = 0.001), and the pooled optimal cutoff point to diagnose SAM was 13.23 cm (95% CI, 12.692-13.763 cm; P = 0.001). The sensitivity of MUAC is lower compared with the specificity to detect SAM, and varies from area to area.

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