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Assessing nutrition status of children in emergency

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The nutritional indices commonly calculated for children are:
1. Weight-for-height – a measure of wasting or acute malnutrition
2. MUAC – a measure of wasting or acute malnutrition
3. Oedema
a) Weight for height
Weight for height uses weight of a child and compares it with the weight of a standard child of
the same height and sex using internationally accepted reference values. Weight for height
measures wasting or acute malnutrition and it indicates current inadequate dietary intake. This is because body weight is sensitive to rapid changes in food supply or disease, while height
changes very slowly. This is the most useful tool for screening and targeting vulnerable groups in emergency.
b) Mid-upper arm circumference (MUAC)
Mid-upper arm circumference is the measurement around the middle of the upper arm. These
measurements are a good predictor of immediate risk of death.
c) Oedema
Oedema is an abnormal accumulation of fluid in the intercellular tissue. It is a key clinical
feature of severe malnutrition and is associated with high mortality rates in children. Oedema
tend to increase the weight of a child it hides the true picture of the child’s nutrition status and
thus all cases of oedema should be separated from all other measurements and treated as severe
acute malnutrition. Oedema should be used as major inclusion criteria to a therapeutic feeding
program.
The prevalence (rate) of malnutrition is frequently assessed in emergencies and used to
determine response and to identify target groups and geographical areas at risk. Malnutrition can be assessed through anthropometry (body measurements). Body measurements include: age, sex,
weight (or length in children under 24 months or under 85 cm in height), oedema (fluid
retention) and MUAC. In emergencies, acute malnutrition (wasting) in children aged 6 to 59
months is frequently measured as it reflects recent changes in dietary intake and infection and
acts as a ‘proxy’ for the nutritional status of the entire population.
Weight-for-height is widely used in nutrition surveys and as the selection criteria for selective feeding programmes. MUAC is commonly used to initially screen individuals for admission to feeding programmes but should not be used as a single measure in anthropometric surveys.
Oedema is a clinical sign of severe acute malnutrition though individuals with oedema can’t be
anthropometrically assessed.
Cut-off points used to classify the severity of malnutrition are either presented as Z scores orstandard deviation (SD) scores or as a percentage of the median. The term ‘global acute
malnutrition’ or GAM refers to moderate and severe acute malnutrition (weight-for-height SD
less than -2). Severe acute malnutrition (SAM) refers to severe acute malnutrition (weight-for-
height SD less than -3). Individuals with oedema are always classified as SAM.

Titany answered the question on November 11, 2021 at 12:24

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