Screening for overweight using mid-upper arm circumference (MUAC) among children younger than two years in the Eastern Cape, South Africa

Background: The relationship between overweight and under-nutrition, particularly in resource-poor settings, poses practical challenges for targeting nutrition interventions. Current anthropometric indicators including weight for length (WLZ) recommended by the WHO may be challenging in community settings. Objectives: The aim of this study was to assess whether MUAC can accurately identify children aged younger than two years with overweight and obesity. Method: A descriptive, cross-sectional study was used to collect data from a non-probability sample of 397 young South African children from October 2015 to February 2016. MUAC cut-off values were tested using a receiver operating characteristic and area under the curve (AUC). Results: The prevalence of overweight (WLZ > +2) and obesity (WLZ > +3) was 11% (n = 44) and 5% (21) respectively. A MUAC cut-off value for identifying male children 6 to 24 months old with overweight was determined at 16.5 cm (85% sensitivity, 71.4% specificity, AUC = 0.821) and female children at 16.5 cm (100% sensitivity, 76.6% specificity, AUC = 0.938). Conclusions: MUAC may be an appropriate tool for identifying children younger than two years old with overweight and obesity. The predicted MUAC cut-off values were able to identify infants and young children with overweight accurately.