Caregivers’ Ability to Assess for Wasting Status of Their Under Five Children: A Cross Sectional Study at Mwanamugimu Nutrition Unit, Mulago National Referral Hospital, Kampala, Uganda

Authors

  • Ainomugisha Prudence School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda. Author https://orcid.org/0009-0003-9260-0651 (unauthenticated)
  • Hanifa Bachou Author
  • Kasendwa Martin Maternal Child Health and Nutrition Activity, Family Health International, Uganda Office. Author
  • Murungi Amanda Mwanamugimu Nutrition Unit, Mulago National Referral Hospital, Kampala, Uganda Author
  • Owori Benard Clinical Epidemiology Unit, School of Medicine, Makerere University, Kampala, Uganda Author
  • Akriat Susan Mwanamugimu Nutrition Unit, Mulago National Referral Hospital, Kampala, Uganda Author
  • Kajjura Richard School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda Author
  • Garamoi Christopher School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda Author

DOI:

https://doi.org/10.70851/jfines.2025.2(1).63.70

Keywords:

Childhood wasting, MUAC Measurement, Caregivers, Children aged 6-59 months

Abstract

Wasting, a form of malnutrition, continues to be a major childhood health challenge affecting over 50 million children annually. It remains more pronounced in the middle- and low-income countries and continues to pose a great threat to child survival; approximately 800,000 deaths due to wasting worldwide per year. Caregivers may play key roles in early identification and referral of wasted children for care. This study aimed to assess caregivers’ ability to measure wasting status of their children aged 6-59 months. A cross sectional study was conducted in September 2022; included caregivers of children 6-59 months while children with cerebral palsy, critical illness and bilateral oedema were excluded; 73 participants were enrolled, oriented on importance and use of Mid Upper Arm Circumference (MUAC), interviewed using pre-coded questionnaire and observational checklist. Reference MUAC measurements were conducted for respective children by a nutritionist. MS Excel 2018 and STATA 15 were used to analyze data. It was observed that caregivers could measure and categorize wasting status of their children using MUAC if supported. Overall, 72 (98.6%) of participants were able to measure MUAC and categorize the wasting status of their children with high sensitivity (100%, 97.5 Positive Predictive Value) and specificity (97.1% 100% Negative Predictive Value). High level of agreement was observed between participant’s and Nutritionist’s measurement and categorization of MUAC (k = 0.82).

References

Alé, F. G., Phelan, K. P., Issa, H., Defourny, I., Le Duc, G., Harczi, G., Issaley, K., Sayadi, S., Ousmane, N., & Yahaya, I. (2016). Mothers screening for malnutrition by mid-upper arm circumference is non-inferior to community health workers: results from a large-scale pragmatic trial in rural Niger. Archives of Public Health, 74, 1-12.

Ancira-Moreno, M., & Hernández-Cordero, S. (2024). Will it be possible to achieve the global nutrition targets in Mexico by 2030? International Journal for Equity in Health, 23(1), 60.

Blackwell, N., Myatt, M., Allafort-Duverger, T., Balogoun, A., Ibrahim, A., & Briend, A. (2015). Mothers Understand And Can do it (MUAC): a comparison of mothers and community health workers determining mid-upper arm circumference in 103 children aged from 6 months to 5 years. Archives of Public Health, 73, 1-7.

Bliss, J., Lelijveld, N., Briend, A., Kerac, M., Manary, M., McGrath, M., Prinzo, Z. W., Shepherd, S., Zagre, N. M., & Woodhead, S. (2018). Use of mid-upper arm circumference by novel community platforms to detect, diagnose, and treat severe acute malnutrition in children: a systematic review. Global Health: Science and Practice, 6(3), 552-564.

Boulebatt, S., Belmejdoub, N., Aslaou, F., Al-Aizari, H., Abdellahi, N., Feil, A., & Belghyti, D. (2023). Assessment of the Efficiency of Application of the National Protocol for Integrated Management of Severe Acute Malnutrition in National Hospital Center of Nouakchott-Mauritania. Tropical Journal of Natural Product Research, 7(9).

Buttarelli, E., Woodhead, S., & Rio, D. (2021). Family MUAC: a review of evidence and practice.

Chitekwe, S., Biadgilign, S., Tolla, A., & Myatt, M. (2018). Mid-upper-arm circumference based case-detection, admission, and discharging of under five children in a large-scale community-based management of acute malnutrition program in Nigeria. Archives of Public Health, 76, 1-10.

De Pee, S., Grais, R., Fenn, B., Brown, R., Briend, A., Frize, J., Shoham, J., & Kiess, L. (2015). Prevention of acute malnutrition: distribution of special nutritious foods and cash, and addressing underlying causes—what to recommend when, where, for whom, and how. Food and nutrition bulletin, 36(1_suppl1), S24-S29.

Di Cesare, M., Ghosh, S., Osendarp, S., & Mozaffarian, D. (2021). A world free from malnutrition: An assessment of progress towards the global nutrition targets. Global Nutrition Report: The state of global nutrition, 20-34.

Gagnon-Dufresne, M.-C., Fortin, G., Bunkeddeko, K., Kalumuna, C., & Zinszer, K. (2021). Evaluating malnutrition management through an intersectional lens: A case study of a community-based child malnutrition program in rural Uganda. medRxiv, 2021.2009. 2001.21262681.

Grant, A., Njiru, J., Okoth, E., Awino, I., Briend, A., Murage, S., Abdirahman, S., & Myatt, M. (2018). Comparing performance of mothers using simplified mid-upper arm circumference (MUAC) classification devices with an improved MUAC insertion tape in Isiolo County, Kenya. Archives of Public Health, 76, 1-9.

Hawkes, C., Butt, Z., Saiful, I., & Collaborators, L. D. B. o. M. (2020). Mapping local patterns of childhood overweight and wasting in low-and middle-income countries between 2000 and 2017. Nat Med, 26(5), 750-759.

Isanaka, S., Berthe, F., Nackers, F., Tang, K., Hanson, K. E., & Grais, R. F. (2020). Feasibility of engaging caregivers in at-home surveillance of children with uncomplicated severe acute malnutrition. Matern Child Nutr, 16(1), e12876. https://doi.org/10.1111/mcn.12876

Isanaka, S., Berthé, F., Nackers, F., Tang, K., Hanson, K. E., & Grais, R. F. (2020). Feasibility of engaging caregivers in at‐home surveillance of children with uncomplicated severe acute malnutrition. Maternal & Child Nutrition, 16(1), e12876.

Laillou, A., Baye, K., Meseret, Z., Darsene, H., Rashid, A., & Chitekwe, S. (2020). Wasted children and wasted time: a challenge to meeting the nutrition sustainable development goals with a high economic impact to Ethiopia. Nutrients, 12(12), 3698.

Majiwa, P. R., Chopera, P., & Matsungo, T. M. (2024). Family-led mid-upper arm circumference (FL-MUAC) approach and the screening of acute malnutrition in children aged 6 to 59 months in Africa: a scoping review. The Pan African Medical Journal, 49, 38.

Mertens, A., Benjamin-Chung, J., Colford Jr, J. M., Hubbard, A. E., van der Laan, M. J., Coyle, J., Sofrygin, O., Cai, W., Jilek, W., & Rosete, S. (2023). Child wasting and concurrent stunting in low-and middle-income countries. Nature, 621(7979), 558-567.

Muyonga, J. (2022). Nutritional Status Research in Uganda: A Critical Review and Trend Analysis. African Journal of Food, Agriculture, Nutrition & Development, 22(8).

Ogenrwoth, B., Akumu, G., Mugisha, J., & Muyonga, J. (2022). Nutritional status research in Uganda: A critical review and trend analysis. African Journal of Food, Agriculture, Nutrition and Development, 22(8), 21243-21268.

Ray, S., & Suri, S. (2021). Global Nutrition Report 2021–India’s nutrition profile and how to meet global nutrition target. Observer Researcher Foundation.

Shreffler, J., & Huecker, M. R. (2020). Diagnostic testing accuracy: Sensitivity, specificity, predictive values and likelihood ratios.

Temel, G., & Erdogan, S. (2017a). Determining the sample size in agreement studies. Marmara Medical Journal, 30, 101-112. https://doi.org/10.5472/marumj.344822

Temel, G., & Erdogan, S. (2017b). Determining the sample size in agreement studies. Marmara Medical Journal, 30(2), 101-112.

Tickell, K. D., Achieng, C., Masheti, M., Anyango, M., Ndirangu, A., Diakhate, M. M., Yoshioka, E., Levin, C., Means, A. R., & Choo, E. M. (2023). Family MUAC supported by a two-way SMS platform for identifying children with wasting: the Mama Aweza randomised controlled trial. Eclinical medicine, 64.

UNICEF. (2023). WHO. UNICEF-WHO-The World Bank: Joint Child Malnutrition Estimates (JME)—Levels and Trends–2023 edition. In: Geneva, Switzerland.

Wali, N., Agho, K. E., & Renzaho, A. M. (2021). Wasting and associated factors among children under 5 years in five South Asian countries (2014–2018): Analysis of demographic health surveys. International Journal of Environmental Research and Public Health, 18(9), 4578.

WHO. (2021). WHO Global nutrition targets 2025: Wasting policy brief. WHO. 2014. View Article.

WHO/UNICEF/WB. (2020). Levels and trends in child malnutrition: key findings of the 2020 edition. UNICEF/WHO/World Bank Group joint child malnutrition estimates. World Health Organization.

Downloads

Published

2025-03-13 — Updated on 2025-04-15

Versions

Issue

Section

Original Research Paper

Categories

How to Cite

Ainomugisha, P., Bachou, H., Kasendwa , M., Murungi , A., Owori , B., Akriat , S., Kajjura , R., & Garamoi, C. (2025). Caregivers’ Ability to Assess for Wasting Status of Their Under Five Children: A Cross Sectional Study at Mwanamugimu Nutrition Unit, Mulago National Referral Hospital, Kampala, Uganda. Journal of Food Innovation, Nutrition, and Environmental Sciences, 2(1), 63-70. https://doi.org/10.70851/jfines.2025.2(1).63.70 (Original work published 2025)