Protein energy malnutrition other diagnostic studies

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Omodamola Aje B.Sc, M.D. [2]

Overview

There are several parameters that can be used in the assessment of a child with protein-energy malnutrition. Malnutrition can be assessed according to the WHO based on mid-upper arm circumference into moderate and severe malnutrition. Other parameters include the Z-score which assesses linear growth and weight for length.

Other Diagnostic Studies

There are several parameters that can be used in the assessment of a child with protein energy malnutrition. Malnutrition can be assessed according to the WHO as follows:^[1]^[2]

Clinical term	Clinical measure	Classification
Clinical term	Clinical measure	Moderate malnutrition	Severe malnutrition
Wasting	Mid-upper arm circumference (MUAC)	11.5 to 12.4 cm	<11.5 cm
	Weight-for-height Z-score (WHZ)	–2 to –3	<–3
Kwashiorkor		Absent	Present

*Mid-upper arm circumference(MUAC):

When time, money and experienced/ skilled personnel is in shortage such in times of flood and refugee camps, the mid-upper arm circumference (MUAC) is an accurate and efficient way to screen for malnutrition

*Z scores: The severity of wasting or stunting is defined by comparing a child’s weight and height measurements with those of a population reference standard.

Assessment of Linear Growth

Z-score	Interpretation
Z-score >-2	No stunting
Z-score >-3 and <=-2	Moderate stunting
Z-score <=-3	Severe stunting

Assessment of Weight for Length

Z-score	Interpretation
Z-score >-2	No wasting
Z-score >-3 and <=-2	Moderate wasting
Z-score <=-3	Severe wasting

References

↑ Grellety E, Krause LK, Shams Eldin M, Porten K, Isanaka S (2015). “Comparison of weight-for-height and mid-upper arm circumference (MUAC) in a therapeutic feeding programme in South Sudan: is MUAC alone a sufficient criterion for admission of children at high risk of mortality?”. Public Health Nutr. 18 (14): 2575–81. doi:10.1017/S1368980015000737. PMID 25805273.
↑ Powell-Tuck J, Hennessy EM (2003). “A comparison of mid upper arm circumference, body mass index and weight loss as indices of undernutrition in acutely hospitalized patients”. Clin Nutr. 22 (3): 307–12. PMID 12765671.

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[pmid25805273-1] Grellety E, Krause LK, Shams Eldin M, Porten K, Isanaka S (2015). “Comparison of weight-for-height and mid-upper arm circumference (MUAC) in a therapeutic feeding programme in South Sudan: is MUAC alone a sufficient criterion for admission of children at high risk of mortality?”. Public Health Nutr. 18 (14): 2575–81. doi:10.1017/S1368980015000737. PMID 25805273.

[pmid12765671-2] Powell-Tuck J, Hennessy EM (2003). “A comparison of mid upper arm circumference, body mass index and weight loss as indices of undernutrition in acutely hospitalized patients”. Clin Nutr. 22 (3): 307–12. PMID 12765671.

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