WHO recommends 11.5 cm as a cut-off point of Mid-Upper Arm Circumference (MUAC) to detect and/or diagnose severe acute malnutrition (SAM) in under-five. MUAC is practical and useful, especially in area with limited facilities which has no standardized scale and infantometer. However, several studies showed that this cut-off need to be evaluated as it has modest detection rate for SAM. This study aims to evaluate diagnostic value of MUAC with 11.5 cm cut-off compared to WHZ as gold standard to identify SAM. The sensitivity, specificity, positive and negative predictive value of MUAC with 11.5 cm as a standard cut-off will be evaluated.

This study also aim to find new cut-off value that may offer better diagnostic performance. The main research questions were:

What is the diagnostic accuracy of Mid-Upper Arm Circumference (MUAC) compared to the Weight for Height Z Score (WHZ) in identifying SAM in children, and what is the optimal MUAC cut-off value for enhanced diagnostic performance?

Inclusion Criteria:

• under-fives that 6-59 months-old

Exclusion Criteria:

• ascites
• edema
• hydrocephalus
• tumor or oncologic diseases
• organomegaly
• uncooperative during measurement

This study was conducted in the largest primary community health care facility in Cengkareng Jakarta and have 29.110 registered under-fives in its service area.