The cross sectional study sought to determine the diagnostic value of visible severe wasting in identifying severe acute malnutrition among children aged 6 to 59.9 months admitted to one rural and one urban hospital in Kenya. On admission, mid-upper arm circumference (MUAC), weight and height were measured and the presence of visible severe wasting was assessed. The diagnostic performance of visible severe wasting was evaluated against anthropometric criteria.
Of 11 166 children admitted, 563 (5%) had kwashiorkor and 1406 (12.5%) were severely wasted (MUAC < 11.5 cm). The combined
sensitivity and specificity of visible severe wasting at the two hospitals, as assessed against a MUAC < 11.5 cm, were 54% (95% confidence
interval, CI: 51–56) and 96% (95% CI: 96–97), respectively; at one hospital, its sensitivity and specificity against a weight-for-height z-score
below −3 were 44.7% (95% CI: 42–48) and 96.5% (95% CI: 96–97) respectively.
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