Using Mid-Upper Arm Circumference to End Treatment of Severe Acute Malnutrition Leads to Higher Weight Gains in the Most Malnourished Children
Using Mid-Upper Arm Circumference to End Treatment of Severe Acute Malnutrition Leads to Higher Weight Gains in the Most Malnourished Children
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DOI：
10.1371/journal.pone.0055404
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发表时间：
2013-02-13
期刊：
影响因子：
3.7
通讯作者：
Briend, Andre
中科院分区：
文献类型：
--
作者：
Dale, Nancy M.;Myatt, Mark;Briend, Andre
目的：世界卫生组织建议接受营养计划治疗严重急性营养不良的儿童出院，这些儿童的中上臂周长较低(MUAC 15%)。如果遵循这一建议，与营养不良程度较轻的儿童相比，最严重营养不良的儿童接受的治疗时间更短。这项研究评估了使用MUAC>；125 mm作为出院标准是否可以消除这种影响。方法和结果：分析了在北苏丹Gedaref的Medecins Sans Frontieres门诊营养计划中治愈的753名儿童的数据。以MUAC>；125 mm作为出院标准。比较入院时儿童的住院时间和体重增加百分比与营养状况的关系。入院时MUAC低的儿童与MUAC高的儿童相比，治疗持续时间更长(p=0.000)，体重增加百分比也更高(p=0.000)。在治疗持续时间(p=0.000)和体重增加百分比(p=0.000)上也显示了类似的结果。结论：这项研究表明，与体重增加百分比相比，使用MUAC作为出院标准消除了最严重营养不良儿童较轻营养不良较短治疗的影响。这些发现直接解决了目前世卫组织建议使用体重增加百分比的主要问题。MUAC可以作为出院标准，而不是体重增加的百分比，因为对于最营养不良的人来说，拥有更长的疗程和更高的体重增加百分比是非常可取的。
Objective: The World Health Organization recommends discharging children admitted to nutrition programs treating severe acute malnutrition, with a low mid-upper arm circumference (MUAC 15%. When this recommendation is followed, the most severely malnourished children receive a shorter treatment compared to children that are less severely malnourished. This study assesses whether using MUAC >125 mm as discharge criteria eliminates this effect.Methods and Findings: Data from 753 children cured from a Medecins Sans Frontieres outpatient nutrition program in Gedaref, North Sudan were analyzed. MUAC >125 mm was used as discharge criteria. Length of stay and percent weight gain of children were compared in relation to nutritional status on admission. Children with low MUAC on admission had a longer duration of treatment (p = 0.000) and also a higher percent weight gain (p = 0.000) than children with higher MUAC. Similar results with weight-for-height z-scores categories were shown with both duration of treatment (p = 0.000) and percent weight gain (p = 0.000).Conclusion: This study shows that using MUAC as the discharge criteria eliminates the effect of shorter treatment in most severely malnourished children compared to least severely malnourished, as is observed with percent weight gain. The findings directly address the main concern that has been identified with the current WHO recommendation of using percent weight gain. MUAC could be used as discharge criteria, instead of percent weight gain, as having a longer duration of treatment and a higher percent weight gain for the most malnourished is highly desirable.