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Friday, February 16
PS2 Poster Session 2 and Refreshments Fri, Feb 16, 5:15 PM - 6:30 PM
Salons F-I

A Growth Reference for Mid-Upper-Arm Circumference for Age Among School-Age Children and Adolescents, with Validation for Mortality in Two Cohorts (303580)

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Evasius Bauni, KEMRI/Wellcome Trust Research Programme, Kenya 
James A. Berkley, University of Oxford, United Kingdom; and KEMRI/Wellcome Trust Research Programme, Kenya. 
Gregory Fegan, Swansea Trials Unit, Swansea University Medical School, Swansea, United Kingdom 
Diana M. Gibb, MRC Clinical Trials Unit at UCL, United Kingdom 
*Lazarus K. Mramba, University of Florida 
Lilian Muchai, KEMRI/Wellcome Trust Research Programme, Kenya 
Martha Mwangome, KEMRI/Wellcome Trust Research Programme, Kenya 
Moses Ngari, KEMRI/Wellcome Trust Research Programme, Kenya 
Sarah A. Walker, MRC Clinical Trials Unit at UCL, and University of Oxford, United Kingdom 

Keywords: Adolescent, School-aged children, Nutrition, Mortality, Anthropometry, Growth reference, Arm circumference, MBI

WHO recommends assessing acute malnutrition in school-age children using body mass index-for-age Z scores (BMIz). For under-fives, mid upper arm circumference (MUAC) is the mainstay of community diagnosis of acute malnutrition, is simple to perform and predicts survival better than weight-for-height Z scores. This study aimed to construct growth curves for MUAC-for-age Z score (MUACz) for 5-19 year olds that accord with WHO Growth Standards, and evaluate their discriminatory performance for subsequent mortality. Generalized Additive Models for Location, Scale and Shape with Box-Cox Cole Green transformation were used to construct standardised growth curves. MUACz of -2 to -3 and <-3, compared with =-2, was associated with hazard ratios for death within one year of 3.63 (95%CI 0.90 to 14.7; P=0.07) and 11.1 (95%CI 3.40 to 36.0; P<0.0001) respectively for the first cohort; and 2.22 (95%CI 1.01 to 4.9; P=0.04) and 5.15 (95%CI 2.49 to 10.7; P<0.0001) respectively for second cohort after discharge from hospital. In summary, MUACz is at least as effective as BMIz for assessing mortality risks associated with undernutrition among school-aged children and adolescents.