A growth reference for mid upper arm circumference for age among school age children and adolescents, and validation or mortality: growth curve construction and longitudinal cohortstudy

Abstract

OBJECTIVES
To construct growth curves for mid-upper-arm circumference (MUAC)-for-age z score for 5-19 year olds that accord with the World Health Organization growth standards, and to evaluate their discriminatory performance for subsequent mortality.
DESIGN
Growth curve construction and longitudinal cohort study.
SETTING
United States and international growth data, and cohorts in Kenya, Uganda, and Zimbabwe.
PARTICIPANTS
The Health Examination Survey (HES)/National Health and Nutrition Examination Survey (NHANES) US population datasets (age 5-25 years), which were used to construct the 2007 WHO growth reference for body mass index in this age group, were merged with an imputed dataset matching the distribution of the WHO 2006 growth standards age 2-6 years. Validation data were from 685 HIV infected children aged 5-17 years participating in the Antiretroviral Research for Watoto (ARROW) trial in Uganda and Zimbabwe; and 1741 children aged 5-13 years discharged from a rural Kenyan hospital (3.8% HIV infected). Both cohorts were followed-up for survival during one year.
MAIN OUTCOME MEASURES
Concordance with WHO 2006 growth standards at age 60 months and survival during one year according to MUAC-for-age and body mass index-for-age z scores.