Mid-Upper Arm Circumference as a Screening tool for indentifying over weight and obesity among adolescences in Addis Abeba, Ethiopia.
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Date
2019-10
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Addis Abeba University
Abstract
Background- Adolescent overweight and obesity is a global public health problem and
associated with increased risk of metabolic syndrome. Recently, mid-upper arm circumference
has been suggested as a screening tool for overweight and obesity among school age children
and early adolescent. However, little is known about the potential use of mid-upper arm
circumference in late adolescents (15-19 years).
Objective- The aim of the study was to evaluate the ability of mid-upper arm circumference to
correctly identify BMI-for-age z-score defined overweight and obesity among adolescents in
selected high schools of Addis Ababa, Ethiopia, 2019.
Methods- A school-based cross-sectional study was conducted among 851 late adolescents in
Addis Ababa. A stratified multi-stage sampling procedure was followed. A pre-tested
interviewer-administered questionnaire was used. Anthropometric measurements including
weight, height, and mid-upper arm circumference were measured. Receiver operating
characteristic curve analysis was done to determine the ability of MUAC to detect overweight
and obesity. Sensitivity, specificity, predictive values and likelihood ratio of MUAC were
calculated for the optimal cutoff points.
Result - MUAC had strong positive correlation with BMI-for-age z-score (r = 0.84). The
diagnostic performance of MUAC as assessed by area under the curve (AUC) for identifying
overweight and obesity was 0.96 for both genders. The optimal mid upper arm circumference
cut off point was ≥ 27.9 cm with sensitivity of 90.28%, specificity of 90.71%, positive
likelihood ratio of 9.72 and negative likelihood ratio of 0.11 for girls. Similarly, for boys
optimal mid upper arm circumference cut off point was ≥ 27.75 cm with sensitivity of 94.1%,
specificity of 89.1%, positive likelihood ratio of 8.7 and negative likelihood ratio of 0.07.
Conclusion - This study provide evidence that MUAC have high specificity and sensitivity to
identify overweight/obese among late adolescences as evaluated against body mass index for
age z-score. The optimal mid upper arm circumference cut off point for girls was ≥ 27.9 cm
and for boys was ≥ 27.75 cm. MUAC have potential for screening and surveillance applications
as simple and widely available indicator of overweight/obesity in late adolescents.
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Keywords
Mid-Upper Arm,over weigh, obesity