@article {Ezeofor524, author = {Ifeyinwa Obiageli Ezeofor and Ada Lizbeth Garcia and Charlotte Margaret Wright}, title = {Criteria for undernutrition screening in hospitalised infants under 6 months: a diagnostic accuracy study in a resource-poor setting}, volume = {105}, number = {6}, pages = {524--529}, year = {2020}, doi = {10.1136/archdischild-2019-318313}, publisher = {BMJ Publishing Group Ltd}, abstract = {Purpose We aimed to describe the prevalence of undernutrition in hospitalised infants aged under 6 months and test the utility of simple index measures to detect undernutrition.Design Diagnostic accuracy study: weight, length, mid-upper arm circumference (MUAC), triceps and subscapular skinfolds were measured in infants aged 2 weeks to 6 months admitted to a Teaching Hospital in Enugu, Nigeria. Index criteria : low (\<-2SD) weight-for-age Z-scores (WAZ), weight-for-length Z-scores (WLZ); MUAC \<11 cm. Reference definition: weight faltering (conditional weight gain below fifth percentile for healthy Nigerian infants) or sum of skinfolds (SSF) \<10 mm.Results Of 125 hospitalised infants, only 5\% (6) were admitted specifically for undernutrition, but low SSF were found in 33\% (41) and, 24\% (25) with known birth weight had weight faltering, giving an undernutrition prevalence of 36\%. Low WAZ was the most discriminating predictor of undernutrition (sensitivity 69\%, positive predictive value 86\%, likelihood ratio 5.5; area under receiver operator curves 0.90) followed by MUAC (73\%, 73\%, 4.9; 0.86), while WLZ performed least well (49\%, 67\%, 2.9; 0.84). Where both MUAC and WAZ were low, there was sensitivity 90\%, positive predictive value 82\% and likelihood ratio 8.7.Conclusions Infants aged under 6 months admitted to hospital in Nigeria had a high prevalence of undernutrition. In young, high-risk population, a low WAZ alone was a valuable screening criterion, while combining weight with MUAC gave even higher discrimination. Measurement of length to calculate WLZ was a less useful predictor in this population.}, issn = {0003-9888}, URL = {https://adc.bmj.com/content/105/6/524}, eprint = {https://adc.bmj.com/content/105/6/524.full.pdf}, journal = {Archives of Disease in Childhood} }