Identifying children at risk of malnutrition

Excerpt

This issue of Nutrition Journal includes three papers by Grellety and Golden, which explore comparisons between the use of mid-upper arm circumference (MUAC) and the use of weight in relation to height (WH) to screen for and identify children with severe acute malnutrition at risk of death [1‐3]. This important debate is the most recent in a long history of attempts to understand the nature of a condition of varied geographical distribution with a complex aetiopathology in which the risk of mortality is high and effective care needs can appear counterintuitive. The condition is common where resources are limited and hence identification and effective care requires simple approaches that can be delivered at community level, but more complex problems need to be securely identified and manged in a facility [4, 5]. Grellety and Golden [1‐3] present data that suggest that the current balance of effort allows unacceptable mortality because groups of children at greatest risk based upon WH or the presence of oedema are not adequately identified when using MUAC, and hence, not offered appropriate care. If the authors are correct, the problem needs to be acknowledged in order for better approaches to be considered and put in place. …