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

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 1, 3 and 6 months follow-up in children. DESIGN: Pooled analysis of twelve prospective studies examining survival af...

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Autores principales: Briend, André, Myatt, Mark, Berkley, James A, Black, Robert E, Boyd, Erin, Garenne, Michel, Lelijveld, Natasha, Isanaka, Sheila, McDonald, Christine M, Mwangwome, Martha, O’Brien, Kieran S, Schwinger, Catherine, Stobaugh, Heather, Taneja, Sunita, West, Keith P, Khara, Tanya
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cambridge University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10346023/
https://www.ncbi.nlm.nih.gov/pubmed/36722310
http://dx.doi.org/10.1017/S1368980023000149
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author Briend, André
Myatt, Mark
Berkley, James A
Black, Robert E
Boyd, Erin
Garenne, Michel
Lelijveld, Natasha
Isanaka, Sheila
McDonald, Christine M
Mwangwome, Martha
O’Brien, Kieran S
Schwinger, Catherine
Stobaugh, Heather
Taneja, Sunita
West, Keith P
Khara, Tanya
author_facet Briend, André
Myatt, Mark
Berkley, James A
Black, Robert E
Boyd, Erin
Garenne, Michel
Lelijveld, Natasha
Isanaka, Sheila
McDonald, Christine M
Mwangwome, Martha
O’Brien, Kieran S
Schwinger, Catherine
Stobaugh, Heather
Taneja, Sunita
West, Keith P
Khara, Tanya
author_sort Briend, André
collection PubMed
description 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 1, 3 and 6 months follow-up in children. DESIGN: Pooled analysis of twelve prospective studies examining survival after anthropometric assessment. Sensitivity and false-positive ratios to predict death within 1, 3 and 6 months were compared for three individual anthropometric indices and their combinations. SETTING: Community-based, prospective studies from twelve 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 1-month follow-up compared with 6 months by 49 % (95 % CI (30, 69)) for MUAC < 115 mm (P < 0·001), 48 % (95 % CI (9·4, 87)) for WHZ < -3 (P < 0·01) and 28 % (95 % CI (7·6, 42)) for WAZ < -3 (P < 0·005). This was accompanied by an increase in false positives of only 3 % or less. For all durations of follow-up, WAZ < -3 identified more children who died and were not identified by WHZ < -3 or by MUAC < 115 mm, 120 mm or 125 mm, but the use of WAZ < -3 led to an increased false-positive ratio up to 16·4 % (95 % CI (12·0, 20·9)) compared with 3·5 % (95 % CI (0·4, 6·5)) for MUAC < 115 mm alone. 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.
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spelling pubmed-103460232023-08-29 Prognostic value of different anthropometric indices over different measurement intervals to predict mortality in 6–59-month-old children Briend, André Myatt, Mark Berkley, James A Black, Robert E Boyd, Erin Garenne, Michel Lelijveld, Natasha Isanaka, Sheila McDonald, Christine M Mwangwome, Martha O’Brien, Kieran S Schwinger, Catherine Stobaugh, Heather Taneja, Sunita West, Keith P Khara, Tanya Public Health Nutr Research Paper 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 1, 3 and 6 months follow-up in children. DESIGN: Pooled analysis of twelve prospective studies examining survival after anthropometric assessment. Sensitivity and false-positive ratios to predict death within 1, 3 and 6 months were compared for three individual anthropometric indices and their combinations. SETTING: Community-based, prospective studies from twelve 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 1-month follow-up compared with 6 months by 49 % (95 % CI (30, 69)) for MUAC < 115 mm (P < 0·001), 48 % (95 % CI (9·4, 87)) for WHZ < -3 (P < 0·01) and 28 % (95 % CI (7·6, 42)) for WAZ < -3 (P < 0·005). This was accompanied by an increase in false positives of only 3 % or less. For all durations of follow-up, WAZ < -3 identified more children who died and were not identified by WHZ < -3 or by MUAC < 115 mm, 120 mm or 125 mm, but the use of WAZ < -3 led to an increased false-positive ratio up to 16·4 % (95 % CI (12·0, 20·9)) compared with 3·5 % (95 % CI (0·4, 6·5)) for MUAC < 115 mm alone. 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. Cambridge University Press 2023-06 2023-02-01 /pmc/articles/PMC10346023/ /pubmed/36722310 http://dx.doi.org/10.1017/S1368980023000149 Text en © The Authors 2023 https://creativecommons.org/licenses/by-nc-sa/4.0/This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike licence (http://creativecommons.org/licenses/by-nc-sa/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the same Creative Commons licence is used to distribute the re-used or adapted article and the original article is properly cited. The written permission of Cambridge University Press must be obtained prior to any commercial use.
spellingShingle Research Paper
Briend, André
Myatt, Mark
Berkley, James A
Black, Robert E
Boyd, Erin
Garenne, Michel
Lelijveld, Natasha
Isanaka, Sheila
McDonald, Christine M
Mwangwome, Martha
O’Brien, Kieran S
Schwinger, Catherine
Stobaugh, Heather
Taneja, Sunita
West, Keith P
Khara, Tanya
Prognostic value of different anthropometric indices over different measurement intervals to predict mortality in 6–59-month-old children
title Prognostic value of different anthropometric indices over different measurement intervals to predict mortality in 6–59-month-old children
title_full Prognostic value of different anthropometric indices over different measurement intervals to predict mortality in 6–59-month-old children
title_fullStr Prognostic value of different anthropometric indices over different measurement intervals to predict mortality in 6–59-month-old children
title_full_unstemmed Prognostic value of different anthropometric indices over different measurement intervals to predict mortality in 6–59-month-old children
title_short Prognostic value of different anthropometric indices over different measurement intervals to predict mortality in 6–59-month-old children
title_sort prognostic value of different anthropometric indices over different measurement intervals to predict mortality in 6–59-month-old children
topic Research Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10346023/
https://www.ncbi.nlm.nih.gov/pubmed/36722310
http://dx.doi.org/10.1017/S1368980023000149
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