Child Health: Mid Upper Arm Circumference (MUAC)

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Mid Upper Arm Circumference (MUAC) Tape

What is MUAC?

Mid-Upper Arm Circumference (MUAC) is the circumference of the left upper arm, measured at the mid-point between the tip of the shoulder and the tip of the elbow.

What is special about the MUAC? 

Mid-Upper Arm Circumference is an essential measurement used to detect children with nutritional problems early on.

Malnutrition is still a major cause of ill-health and death among children.

By definition, acute malnutrition is a result of recent (short-term) deficiency of protein, energy together with minerals and vitamins leading to loss of body fats and muscle tissues. Acute malnutrition presents with wasting (low weight-for-height) with or without the presence of pitting oedema of both feet. It is noteworthy that terms like protein energy malnutrition, kwashiokor, merasmus and merasmic kwashiokor are no longer used.

There are other methods to evaluate acute malnutrition in children; MUAC is just one of them. MUAC of children aged 6 – 59 months gives an indication of the degree of wasting and is a good predictor of mortality. MUAC measurement is reliable, it has good reproducibility and it is useful for rapid diagnosis of nourishment status in 6-59-month-old children. Therefore for screening purposes, it is recommended to use the mid-upper arm circumference measure (MUAC) a  s a quick way of identifying children at risk.

The MUAC Tape

The MUAC-measure or (MUAC-tape) is a long strip with a series of color bands. The tape is numbered and colour-coded; this makes it easy to use even by volunteers with little medical knowledge. When measured properly against a bare upper arm, the gauge provides a number and indicates the colour range. The goal is to keep children within the green color code on the tape. Any other colour is unacceptable.

Interpretation of Mid-Upper Arm Circumference MUAC indicators

1. MUAC less than 110mm (11.0cm),

RED COLOUR

File:Mid-Upper-Arm Circumference Band.jpg

Red: Severe Malnutrition. urgent medical treatment required. Source: Wikimedia

This indicates Severe Acute Malnutrition (SAM). The child should be immediately referred to the hospital for treatment.

2. MUAC of between 110mm (11.0cm) and 125mm (12.5cm);

RED COLOUR (3-colour Tape) or ORANGE COLOUR (4-colour Tape):

MUAC ORANGE

Orange: Malnourished, supplementary treatment and follow-up required

This indicates Moderate Acute Malnutrition (MAM). The child should be immediately referred for supplementation.

3. MUAC of between 125mm (12.5cm) and 135mm (13.5cm);

YELLOW COLOUR:

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Yellow: at risk of malnutrition. Source: UNICEF

This indicates that the child is at risk for acute malnutrition and should be counseled and followed-up for Growth Promotion and Monitoring (GPM).

4. MUAC over 135mm (13.5cm);

GREEN COLOUR:

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Green: Well nourished

This indicates that the child is well nourished.

Advantages of Mid-Upper Arm Circumference (MUAC) screening

  1. It is simple and cheap. It can be used effectively used by community-based people for active case finding.
  2. It is more sensitive. MUAC is a better indicator of mortality risk associated with malnutrition, and therefore it is a better measure to identify children most in need of treatment.
  3. It is less prone to mistakes. Comparative studies have shown that MUAC is subject to fewer errors than other measures such as Weight-for-Height
  4. It increases the link with the beneficiary community; allowing the service providers to refer children with acute malnutrition to hospitals where they can receive treatment and/or supplementary feeding programs.
  5. The MUAC colour coding is easy to understand by the child’s care-taker.

Is MUAC useful for Adolescents and Adults as well?

Yes.

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Adult MUAC Tape

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