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Background: Malnutrition is a major underlying factor in under five mortality and morbidity. Early detection and management are key in preventing the associated complications. The use of weight for height Z score is often difficult in busy outpatients’ clinics. Therefore, a simple tool like the mid upper arm circumference (MUAC) measurement will be more effective.
Methodology: We conducted 5 - month retrospective chart review at the Pediatric outpatients’ clinic of Tamale Teaching Hospital. Children (6-59 months) who presented to the clinic after implementation of routine measurement of MUAC measurement were recruited. Data collected included age, gender, mother’s educational status, marital status and occupation. Weight and MUAC measurements were taken. Descriptive analysis was performed and univariate associations were determined using cross-tabulation and compared using Chi-square test. P values < 0.05 was statistically significant.
Results: Of the 199 children aged 6 to 59 months included in the study,113(56.8%) were male, median age was 24 months and 189 (96%) of the mothers were married. Using the MUAC measurement, 8 (4%) had moderate malnutrition, 8(4%) had severe malnutrition and 22 (11%) were at risk of malnutrition. When the weight for age Z score was considered, 31 (16%) and 18 (9.3%) were moderately and severely underweight respectively. Young age (≤ 24 months) (p-0.01) and low or no maternal formal education (p=0.002) were factors significantly associated with children being malnourished.
Conclusions: The MUAC is a simple tool that can be used in the early detection of children with wasting. The outpatient’s clinic offers a unique opportunity for this screening.
2. Pelletier DL, Frongillo EA (2003) Changes in child survival are strongly associated with changes in malnutrition in developing countries. J Nutr 133:107–119. https://doi.org/10.1093/jn/133.1.107
3. Liu L, Oza S, Hogan D, Chu Y, Perin J, Zhu J, Lawn JE, Cousens S, Mathers C, Black RE (2016) Global, regional, and national causes of under-5 mortality in 2000–15: an updated systematic analysis with implications for the Sustainable Development Goals. Lancet 388:3027–3035. https://doi.org/10.1016/S0140-6736(16)31593-8Caulfield 4. LE, Richard SA, Black RE (2004) Undernutrition as an underlying cause of malaria morbidity and mortality in children less than five years old. In: American Journal of Tropical Medicine and Hygiene. pp 55–63
5. Ghana Statistical Service (2018) Ghana Multiple Indicator Cluster Survey. http://ghdx.healthdata.org/record/ghana-multiple-indicator-cluster-survey-2017-2018. Accessed 9 Oct 2021
6. Bejon P, Mohammed S, Mwangi I, Atkinson SH, Osier F, Peshu N, Newton CR, Maitland K, Berkley JA (2008) Fraction of all hospital admissions and deaths attributable to malnutrition among children in rural Kenya. Am J Clin Nutr 88:1626–1631. https://doi.org/10.3945/ajcn.2008.26510
7. Antwi S (2009) Malnutrition: Missed opportunities for diagnosis. Ghana Med J 42:101–104. https://doi.org/10.4314/gmj.v42i3.43627
8. World Health Organisation (WHO) (1995) Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee.
9. Gyamfi ABA, Adjei B (2013) Child Welfare Clinic Attendance among Children 24-59 Months in Assin North Municipality, Ghana. Int J Innov Educ Res 1:59–68. https://doi.org/10.31686/ijier.vol1.iss4.126
10. Mogeni P, Twahir H, Bandika V, Mwalekwa L, Thitiri J, Ngari M, Toromo C, Maitland K, Berkley JA (2011) Diagnostic performance of visible severe wasting for identifying severe acute malnutrition in children admitted to hospital in Kenya. Bull World Health Organ 89:900–906. https://doi.org/10.2471/BLT.11.091280
11. Abdul-Latif A-MC, Nonvignon J (2014) Economic Cost of Community-Based Management of Severe Acute Malnutrition in a Rural District in Ghana. Health (Irvine Calif) 06:886–889 https://doi.org/10.4236/health.2014.610112
12. Blackwell N, Myatt M, Allafort-Duverger T, Balogoun A, Ibrahim A, Briend A (2015) Mothers Understand And Can do it (MUAC): A comparison of mothers and community health workers determining mid-upper arm circumference in 103 children aged from 6 months to 5 years. Arch Public Heal 73:26. https://doi.org/10.1186/s13690-015-0074-z
13. WHO, WFP, United Nations System Standing Committee on Nutrition (2007) Community-based Management of Severe Acute Malnutrition. A Joint Statement by the World Health Organization, the World Food Programme, the United Nations System Standing Committee on Nutrition and the United Nations Children´s Fund. https://www.unhcr.org/publications/ operations/467a39932/community-based-management-severe
-acute-malnutrition-joint-statement-world.html. Acces sed 9 Oct 2021
14. Saaka M, Larbi A, Hoeschle-zeledon I, Appiah B (2015) Child malnutrition in northern Ghana: evidence, factors and recommendations from a new study Child malnutrition in northern Ghana: evidence, factors and recommendations from a new study. http://africa-rising.net/. Accessed 9 Oct 2021
15. The United Nations (2020) Take Action for the Sustainable Development Goals – United Nations Sustainable Development. In: United Nations Sustain. Dev. https://www.un.org/sustainabledevelopment/sustainable-development-goals/. Accessed 9 Oct 2021
16. WHO (2003) Infant and Young Child Feeding A tool for assessing national practices, policies and programmes. https://apps.who.int/iris/handle/10665/42794
17. WHO (1989) Protecting, promoting and supporting breast-feeding: A joint WHO/UNICEF Statement on the special role of maternity services. In: Wkly. epidemiol. rec. https://apps.who.int/iris/handle/10665/39679
18. WHO/UNICEF (1990) Innocenti Declaration on the Protection, Promotion and Support of Breastfeeding - healthydocuments.org. https://healthydocuments.org/children/healthydocuments-doc33.pdf
19. Hasan MT, S Soares Magalhaes RJ, Williams GM, Mamun AA (2016) The role of maternal education in the 15-year trajectory of malnutrition in children under 5 years of age in Bangladesh. Matern Child Nutr 12:929–939. https://doi.org /10.1111/mcn.12178
20. Gone T, Lemango F, Eliso E, Yohannes S, Yohannes T (2017) The association between malaria and malnutrition among under-five children in Shashogo District, Southern Ethiopia: A case-control study. Infect Dis Poverty 6:9. https://doi.org/10.1186/s40249-016-0221-y
21. Sinha R, Dua R, Bijalwan V, Rohatgi S, Kumar P (2018) Determinants of stunting, wasting, and underweight in five high-burden pockets of four Indian states. Indian J Community Med 43:279–283. https://doi.org/10.4103/ijcm.IJCM_151_18
22. Ohonba A, Ngepah N, Simo-Kengne B (2019) Maternal education and child health outcomes in South Africa: A panel data analysis. Dev South Afr 36:33–49. https://doi.org/10.1080/0376835X.2018.1456908
23. Mangrio E, Hansen K, Lindström M, Köhler M, Rosvall M (2011) Maternal educational level, parental preventive behavior, risk behavior, social support and medical care consumption in 8-month-old children in Malmö, Sweden. BMC Public Health 11:891. https://doi.org/10.1186/1471-2458-11-891
24. Balogun SA, Yusuff HA, Yusuf KQ, Al-Shenqiti AM, Balogun MT, Tettey P (2017) Maternal education and child immunization: The mediating roles of maternal literacy and socioeconomic status. Pan Afr Med J 26:217. https://doi.org/10.11604/pamj.2017.26.217.11856
25. Desmennu AT, Oluwasanu MM, John-Akinola YO, Opeyemi O, Ayo AS (2017) Maternal education and diarrhea among children aged 0-24 months in Nigeria. Afr J Reprod Health 21:27–36. https://doi.org/10.29063/ajrh2017/v21i3.2
26. Siri JG (2014) Independent associations of maternal education and household wealth with Malaria risk in Children. Ecol Soc 19:33. https://doi.org/10.5751/ES-06134-190133
27. Antwi S (2011) Evaluation et Gestion de la malnutrition chez les enfants. West Afr. J. Med. 30:11–18