EC Paediatrics

Research Article Volume 15 Issue 2 - 2026

Concordance of Moderate and Severe Acute Malnutrition Diagnosis by Mid-Upper Arm Circumference and Weight-for-Height in Children Under Five Years of Age, Mérida-Venezuela

Nolis Camacho-Camargo1, Franmar Castellano 2 , Mariela Paoli-Valeri 3 , Rafael Santiago-Peña 4 , Rosanna Cicchetti 5 , Sofía Alvarado6, Ebert Rosales2 and Rossybel Fernández2*

1Pediatrician, Specialist in Nutrition and Growth, Professor, Department of Pediatrics, Universidad de Los Andes, Instituto Autónomo Hospital Universitario de los Andes (IAHULA), Venezuela

2 Pediatrician, Department of Pediatrics, Universidad de Los Andes, Instituto Autónomo Hospital Universitario de los Andes (IAHULA), Venezu- ela

3Endocrinologist, Full Professor, Universidad de los Andes, PhD in Medical Sciences, Attending Physician, Endocrinology Service, Instituto Autónomo Hospital Universitario de los Andes (IAHULA), Venezuela

4Pediatric Gastroenterologist, Attending Physician and Professor, Department of Pediatrics, Hospital Universitario de Valera “Dr. Pedro Emilio Carrillo”, Coordinator of the Childcare and Pediatrics Postgraduate Program, ULA - HUPEC, Venezuela

5BSc in Nutrition and Dietetics, Specialist in Clinical Nutrition, Nutrition and Growth Clinic, Instituto Autónomo Hospital Universitario de los Andes (IAHULA), Venezuela

6Medical Student, Universidad Nacional de La Plata, Argentina

*Corresponding Author: Rossybel Fernández, Pediatrician, Department of Pediatrics, Universidad de Los Andes, Instituto Autónomo Hospital Universitario de los Andes (IAHULA), Venezuela.
Received: January 05, 2026; Published: January 30, 2025



Objective: To evaluate the concordance between the diagnosis of moderate acute malnutrition (MAM) and severe acute malnutrition (SAM) obtained by mid-upper arm circumference (MUAC) and weight-for-height (WFH) in children under five years of age in Mérida, Venezuela.

Methodology: An observational, analytical, cross-sectional study was conducted. Variables included age, sex, weight, height, and MUAC. MUAC was assessed using UNICEF references, and WFH was based on World Health Organization (WHO) standards. ROC curves were used to establish the ideal cutoff value (CV), and the Kappa coefficient (k) was estimated to evaluate the agreement between indicators.

Results: 1,520 patients under 5 years were studied: 614 (40.3%) infants and 906 (59.7%) preschoolers. The mean age was 28.8 months. The optimal MUAC cutoff (MUAC-Mérida) was 13.55 cm for MAM and 12.95 cm for SAM. WFH diagnosed 116 children with MAM (100%). Of these, UNICEF-MUAC identified 33 children (28.4%), while Mérida-MUAC identified 91 (78.4%). For SAM, WFH classified 71 children (100%); 32 (45%) were identified by UNICEF-MUAC and 56 (78.9%) by Mérida-MUAC. Concordance between WFH and Mérida-MUAC for MAM was weak (k = 0.223) and moderate for SAM (k = 0.474).

Conclusion: These findings allow for the establishment of optimal cutoffs based on regional characteristics, suggesting an age- and sex-adjusted MUAC. We propose a community-level cutoff and a dual-indicator assessment in health centers for inclusion in feeding programs to avoid missing at-risk children.

 Keywords: Mid-Upper Arm Circumference; Weight-for-Height; Malnutrition; Children; Concordance

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Rossybel Fernández., et al. “Concordance of Moderate and Severe Acute Malnutrition Diagnosis by Mid-Upper Arm Circumference and Weight-for-Height in Children Under Five Years of Age, Mérida-Venezuela”. EC Paediatrics 15.2 (2026): 01-10.

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