Mothers Understand And Can do it - Mid Upper Arm Circumference Screening for Malnutrition Performed by Mothers

Study Overview
=================
Brief Summary
-----------------
PRIMARY OBJECTIVE : To determine whether mothers, given minimal group training, are capable of using a MUAC (mid-upper arm circumference) bracelet to screen their children for malnutrition and categorise them into one of three groups : 'red' (SAM ; severe acute malnutrition), 'yellow' (MAM ; moderate acute malnutrition) or 'green' (normal nutritional status) SECONDARY OBJECTIVES : To establish whether there is a difference in the MUAC value if measured on the right arm as opposed to the left, in young children To determine whether there is a difference in the MUAC value if the mid upper arm position is determined visually as opposed to being measured in the 'classical' fashion

Detailed Description
-----------------
Severe Acute Malnutrition (SAM) and its complications are major causes of death in under 5s in the developing world. A simple, reproducible, scalable way to recognise acute malnutrition and target early intervention would be a huge advance. Can mothers with limited training reliably measure and interpret the results of Mid Upper Arm Circumference (MUAC), a measurement performed with a MUAC measuring tape costing $0.06? MUAC contrasts with Z-score (WHZ), which requires both scales and a height gauge, both health worker interventions susceptible to considerable error, sensitive to non-nutritional factors, requiring calculations and growth curves, yet much less accurate in predicting risk of death compared with MUAC.

Official Title
-----------------
Mothers Understand And Can do it - Mid Upper Arm Circumference Screening for Malnutrition Performed by Mothers of Children < 5 Years Old

Conditions
-----------------
Marasmus, Kwashiorkor, Malnutrition; Degree, Moderate, Malnutrition

Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: children present in the inpatient malnutrition treatment unit and paediatric service of the Mirriah district hospital aged between 6-59 months old children aged between 6-59 months old in the two villages where the community phase of the study was conducted Exclusion Criteria: children receiving treatment in the intensive care unit of Mirriah district hospital children with bilateral oedema children whose mothers or fathers refused consent to participate in the study

Ages Eligible for Study
-----------------
Minimum Age: 6 Months
Maximum Age: 59 Months

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------
What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| inter and intra observer variability | Variance in result of screening for malnutrition performed by mothers with minimal training compared to 'gold-standard' fully trained health care workers. Screening will be performed with a MUAC (mid-upper arm circumference) bracelet, results will be expressed by category: SAM (severe acute malnutrition), MAM (moderate acute malnutrition) or 'normal nutritional status | 2 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| inter and intra observer variability | The difference in millimetres in the MUAC value if measured on the right arm as opposed to the left ('classical method'), in young children | 2 years | 
| inter and intra observer variability | The difference in the MUAC value in millimetres if the mid upper arm position is determined visually as opposed to being measured in the 'classical' fashion | 2 years | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Acute Malnutrition, Mid Upper Arm Circumference, Screening