Screening for wasting and underweight in children aged 6-59 months presenting to the outpatients’ clinic of a Tertiary Hospital: a retrospective study.

Abstract

Background: Malnutrition is a major underlying factor in under five mortality and morbidity. Early detection and management are key in preventing the associated complications. The use of weight for height Z score is often difficult in busy outpatients’ clinics. Therefore, a simple tool like the mid upper arm circumference (MUAC) measurement will be more effective.

Methodology: We conducted 5 - month retrospective chart review at the Pediatric outpatients’ clinic of Tamale Teaching Hospital. Children (6-59 months) who presented to the clinic after implementation of routine measurement of MUAC measurement were recruited. Data collected included age, gender, mother’s educational status, marital status and occupation. Weight and MUAC measurements were taken. Descriptive analysis was performed and univariate associations were determined using cross-tabulation and compared using Chi-square test. P values < 0.05 was statistically significant.

Results: Of the 199 children aged 6 to 59 months included in the study,113(56.8%) were male, median age was 24 months and 189 (96%) of the mothers were married. Using the MUAC measurement, 8 (4%) had moderate malnutrition, 8(4%) had severe malnutrition and 22 (11%) were at risk of malnutrition. When the weight for age Z score was considered, 31 (16%) and 18 (9.3%) were moderately and severely underweight respectively. Young age (≤ 24 months) (p-0.01) and low or no maternal formal education (p=0.002) were factors significantly associated with children being malnourished.

Conclusions: The MUAC is a simple tool that can be used in the early detection of children with wasting. The outpatient’s clinic offers a unique opportunity for this screening.