UPSC-CMS 2017 — Pediatrics

Q: Which of the following criteria are used for detecting a child with severe acute malnutrition according to WHO guidelines? 1. Bilateral pitting oedema 2. Weight for height Z-score less than minus three SD 3. Mid upper arm circumference of less than 11.5 cm (115 mm) Select the correct answer using the code given below:

1, 2 and 3. ***1, 2 and 3*** - According to **WHO guidelines**, Severe Acute Malnutrition (SAM) in children aged 6-59 months is diagnosed by the presence of **ANY ONE** of these three criteria: - **Bilateral pitting oedema** (nutritional edema) - indicates kwashiorkor - **Weight-for-height Z-score (WHZ) < -3 SD** - indicates severe wasting - **Mid-Upper Arm Circumference (MUAC) < 11.5 cm (115 mm)** - indicates severe wasting - All three are **independent diagnostic criteria** for SAM, meaning any single criterion is sufficient for diagnosis - These criteria are used in **community screening**, **facility-based assessment**, and **nutritional rehabilitation programs** *1 and 2 only* - This incorrectly excludes **MUAC < 11.5 cm**, which is a valid and widely used WHO criterion for SAM diagnosis - MUAC is particularly useful for **community-based screening** as it's simple and doesn't require complex equipment *2 and 3 only* - This incorrectly excludes **bilateral pitting oedema**, which is a critical criterion for diagnosing **kwashiorkor** (edematous malnutrition) - Oedema can occur even when weight-for-height appears normal due to fluid retention masking tissue wasting *1 and 3 only* - This incorrectly excludes **weight-for-height Z-score < -3 SD**, which is the **gold standard anthropometric measure** for severe wasting - WHZ is essential for facility-based diagnosis and monitoring treatment response [Practice more Pediatrics PYQs on OnCourse]

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Which of the following criteria are used for detecting a child with severe acute malnutrition according to WHO guidelines? 1. Bilateral pitting oedema 2. Weight for height Z-score less than minus three SD 3. Mid upper arm circumference of less than 11.5 cm (115 mm) Select the correct answer using the code given below: