COMPARISON OF NEW WHO CRITERIA VS. FORMER WHO AND NCHS CRITERIA FOR SCREENING AND DIAGNOSIS OF MODERATE ACUTE MALNUTRITION AMONG YOUNG CHILDREN IN RURAL MALI

Acute childhood malnutrition remains a public health problem in Mali, where case detection of moderate acute malnutrition (MAM) in Ministry of Health (MOH) clinics is currently based on former WHO cutoffs for mid‐upper arm circumference (MUAC <120, >110 mm) and National Center for Health Statistics (NCHS) criteria for weight‐for‐length (W/L <80% and >70 % NCHS median). To compare the new WHO diagnostic criteria (MUAC <125, >115; W/L <−2, >−3 SD W/L) with the currently used cutoffs, we measured MUAC, weight, and length of children aged 6–35 months in villages linked to 12 Community Health Centers in Dioila Health District. Of the 2275 children screened, MAM was detected using MUAC in 110 (4.8%) and 234 (10.3%) children by MOH and WHO criteria, respectively; and in 211 (9.3%) and 297 (13.1%) of children using MOH and WHO W/L criteria. The sensitivity and specificity of MUAC for identifying children diagnosed by W/L were 0.30 and 0.98, respectively, using current MOH criteria, and were 0.42 and 0.95 using WHO criteria. The WHO criteria identify and classify more children as MAM than existing MOH‐NCHS criteria. MUAC screening identifies only 30–42% of children with MAM diagnosed by W/L regardless of which set of criteria is applied. Decisions on which diagnostic techniques and cutoffs to use depend on local resources for training, screening, and treatment of children identified as MAM. This study was funded by UNICEF and HKI, Mali. Grant Funding Source : UNICEF and Helen Keller International