Acute malnutrition in a child is clinically assessed by: September 2005

Correct Answer: Weight for height
Description: Ans. D: Weight for height An indicator known as weight-for-height is used to determine whether a child is acutely malnourished or not. The child's weight is compared to the 'normal' weight for that height. Based on this information, the World Health Organisation (WHO) has developed chas known as international standards for expected growth. If a child's weight falls within the range considered normal for his/her height, the child is found to be well-nourished. If the weight is less than the international standards, the child is considered acutely malnourished or wasted. WHO has created cut-off points to indicate the severity of the malnutrition. If a child's weight-for-height is less than -2 z-scores (or standard detions) of normal children, s/he is considered to suffer from moderate acute malnutrition or wasting. If the child's weight-for-height is less than -3 z-scores (standard detions) of normal children s/he suffers from severe acute malnutrition and is considered to be severely wasted. Another measurement used to determine a child's nutritional status is the mid-upper arm circumference (MUAC) measurement. Because MUAC measurements require a simple, colour-coded measuring band rather than weighing scales and height boards, they are often used during crisis situations. Useful for children between six months and five years of age, a MUAC measurement of less than 12.5 cm indicates that a child is suffering from moderate acute malnutrition. If the MUAC measurement is under 11.0 cm, however, the under-five child's life may be in danger as he or she is suffering from severe acute malnutrition. Although no anthropometric measure is a perfect marker of acute malnutrition, in the past, there has been a tendency to view W/H measures as the gold-standard anthropometric measure to diagnose acute malnutrition in emergencies. Discrepancies between MUAC and W/H have therefore been explained by MUAC being a poor indicator of nutritional status. A third way of diagnosing acute malnutrition is by testing for the presence of oedema. Oedema affects a child's appearance, giving him or her a puffy, swollen look in either lower limbs and feet or face. It can be detected by small pits or indentations remaining in the child's lower ankles or feet, after pressing lightly with the thumbs. The presence of oedema in both feet and lower legs is always considered a sign of severe acute malnutrition.
Category: Pediatrics
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