Mid-upper arm circumference at age of routine infant vaccination to identify infants at elevated risk of death: A retrospective cohort study in the Gambia


Mwangome, MK; Fegan, G; Fulford, T; Prentice, AM; Berkley, JA; (2012) Mid-upper arm circumference at age of routine infant vaccination to identify infants at elevated risk of death: A retrospective cohort study in the Gambia. Bulletin of the World Health Organization, 90 (12). pp. 887-94. ISSN 0042-9686 DOI: 10.2471/BLT.12.109009

[img]
Preview
Text - Published Version
License:

Download (498Kb) | Preview

Abstract

: To determine the predictive value for death before 12 months of age of mid-upper arm circumference (MUAC) and weight-for-length Z score (WFLz).<br/> : A retrospective cohort analysis of infants living in Keneba, in rural Gambia, was conducted. Anthropometric measures were obtained from demographic surveillance system records for infants registered between February 1974 and July 2008 who had had MUAC and WFLz recorded at 6-14 weeks of age and vital status recorded at least once more. Hazard ratios (HRs), population attributable fractions and areas under receiver operating characteristic (ROC) curves were estimated to assess the predictive value for death in infancy of MUAC and WFLz.<br/> : Of 2876 infants included in the analysis, 40 died before the age of 12 months. The HR for death in this group versus in well-nourished infants was 5.8 (95% confidence interval, CI: 1.6-21) for a WFLz < -3. HRs for MUACs below the thresholds of 115 mm, 110 mm and 105 mm were 4.5 (95% CI: 1.4-15), 9.5 (95% CI: 2.6-35) and 23 (95% CI: 4.2-122), respectively. The attributable fractions for a MUAC < 130 mm and a WFLz < 0 were 51% and 13%, respectively. The areas under the ROC curve for death in infancy were 0.55 (95% CI: 0.46 to 0.64) for WFLz and 0.64 (95% CI: 0.55 to 0.73) for MUAC.<br/> : Among infants aged 6 to 14 weeks, unadjusted MUAC showed good performance in identifying infants at increased risk of death.<br/>

Item Type: Article
Keywords: cohort analysis, confidence interval, health risk, mortality risk, vaccination, age, anthropometry, area under the curve, arm circumference, article, body height, body weight, child death, childbirth, controlled study, Gambia, hazard ratio, human, infancy, infant, malnutrition, outcome assessment, predictive value, receiver operating characteristic, retrospective study, risk factor, season, sensitivity and specificity, Age Distribution, Arm, Body Weights and Measures, Female, Humans, Infant Mortality, Infant, Newborn, Male, Retrospective Studies, Risk Factors, ROC Curve, Age Distribution, Arm, anatomy & histology, Body Weights and Measures, Female, Gambia, epidemiology, Humans, Infant, Infant Mortality, Infant, Newborn, Male, ROC Curve, Retrospective Studies, Risk Factors, Vaccination
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Population Health (2012- ) > Dept of Nutrition and Public Health Interventions Research (2003-2012)
Faculty of Epidemiology and Population Health > Dept of Population Health (2012- )
Research Centre: Centre for Maternal, Reproductive and Child Health (MARCH)
PubMed ID: 23284194
Web of Science ID: 313389400015
URI: http://researchonline.lshtm.ac.uk/id/eprint/2064769

Statistics


Download activity - last 12 months
Downloads since deposit
157Downloads
270Hits
Accesses by country - last 12 months
Accesses by referrer - last 12 months
Impact and interest
Additional statistics for this record are available via IRStats2

Actions (login required)

Edit Item Edit Item