Standard reference

WHO/UNICEF Joint Statement: WHO child growth standards and the identification of severe acute malnutrition in infants and children (2009) (https://www.who.int/publications/i/item/9789241598163)

The 2009 WHO/UNICEF joint statement is the normative source for the MUAC < 115mm SAM cutoff in children 6-59 months. It supersedes the earlier 2007 WHO/WFP/SCN/UNICEF Joint Statement on Community-based Management of Severe Acute Malnutrition, which originally specified MUAC < 110mm and addressed only SAM. The three-band classification (adequate / MAM / SAM) used by this vocabulary is operationalized by subsequent consolidated guidance rather than by either joint statement. Reference cutoffs by age group: children 6-59 months, MUAC with SAM < 115mm, MAM 115-124mm, adequate >= 125mm, or WHZ bands SAM < -3 SD, MAM -3 to < -2 SD (WHO Child Growth Standards 2006); school-age / adolescents, BMI-for-age z-score thresholds from WHO 2007 Growth Reference; adults, BMI < 16 severe, 16-18.4 moderate, >= 18.5 adequate; pregnant and lactating women, MUAC cutoff (commonly < 210mm or < 230mm per protocol). Programs choose the rule appropriate to the subject and cite it on the AnthropometricProfile.

Values

Code Label Standard code Definition
adequate Adequate No acute malnutrition detected under the cutoff rule applied. Reference thresholds by age: MUAC >= 125mm for children 6-59 months; WHZ >= -2 SD for under-5s; BMI-for-age z-score >= -2 SD for school-age and adolescents; BMI >= 18.5 for adults.
moderate_acute_malnutrition Moderate acute malnutrition (MAM) Moderate acute malnutrition under the cutoff rule applied. Reference thresholds by age: MUAC 115-124mm for children 6-59 months; WHZ -3 to <-2 SD for under-5s; BMI-for-age z-score -3 to <-2 SD for school-age and adolescents; BMI 16-18.4 for adults. Typically requires supplementary feeding.
severe_acute_malnutrition Severe acute malnutrition (SAM) Severe acute malnutrition under the cutoff rule applied, or presence of bilateral pitting oedema. Reference thresholds by age: MUAC < 115mm for children 6-59 months; WHZ < -3 SD for under-5s; BMI-for-age z-score < -3 SD for school-age and adolescents; BMI < 16 for adults. Requires therapeutic treatment.

Referenced by this vocabulary