Clinical trial NCT01790815: Mothers Understand And Can do it - Mid Upper Arm Circumference Screening for Malnutrition Performed by Mothers
Official title: Mothers Understand And Can do it - Mid Upper Arm Circumference Screening for Malnutrition Performed by Mothers of Children < 5 Years Old
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Marasmus
Kwashiorkor
Malnutrition; Degree, Moderate
Malnutrition
Keywords: Acute Malnutrition
Mid Upper Arm Circumference
Screening
Lead sponsor: Alliance for International Medical Action
Sponsor class: OTHER
Collaborators: name: Bien Être de La femme et de L'Enfant au Niger
First posted: 2013-02-13
Enrollment: 300
Sex: ALL
Minimum age (years): 6
Maximum age (years): 59
Standard ages: CHILD
Accepts healthy volunteers: yes
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: 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 of the Mirriah district, Niger; where the community phase of the study was conducted

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.

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

Primary outcomes:
measure: inter and intra observer variability
timeFrame: 2 years
Secondary outcomes:
measure: inter and intra observer variability
timeFrame: 2 years
measure: inter and intra observer variability
timeFrame: 2 years
Other outcomes:
Locations:
city: Mirria
country: Niger
facility: Mirriah Health District
state: Mirriah
Study officials:
affiliation: Alliance for International Medical Action
name: nikki blackwell, FCICM,FRACP
role: STUDY_DIRECTOR
References:
citation: Briend A, Maire B, Fontaine O, Garenne M. Mid-upper arm circumference and weight-for-height to identify high-risk malnourished under-five children. Matern Child Nutr. 2012 Jan;8(1):130-3. doi: 10.1111/j.1740-8709.2011.00340.x. Epub 2011 Sep 28.
citation: Briend A, Garenne M, Maire B, Fontaine O, Dieng K. Nutritional status, age and survival: the muscle mass hypothesis. Eur J Clin Nutr. 1989 Oct;43(10):715-26.
citation: Blackwell N, Myatt M, Allafort-Duverger T, Balogoun A, Ibrahim A, Briend A. 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 Health. 2015 May 18;73(1):26. doi: 10.1186/s13690-015-0074-z. eCollection 2015.