First Field Test of an Innovative, Wider Tape to Measure Mid-Upper Arm Circumference in Young Laotian Children

Food Nutr Bull. 2018 Mar;39(1):28-38. doi: 10.1177/0379572117742502. Epub 2017 Dec 19.


Background: Measurements of mid-upper arm circumference (MUAC) may result in measurement error due to incorrect placement along the arm or tight pulling of tape. To reduce the risk of these measurement errors, a new wider tape was developed.

Objective: To compare the measurement agreement and precision and the ease of use of the standard and wide MUAC tapes.

Methods: Mid-upper arm circumference was measured in 814 children aged 9 to 32 months with both tapes. The midpoint of the upper arm was measured with the standard tape and estimated with the wide tape. Standardization sessions were implemented to assess intra- and interobserver precision.

Results: Mid-upper arm circumference with the wide MUAC tape was significantly larger than the standard tape (mean [standard deviation]: 14.3 [1.0] cm vs 13.9 [1.0] cm; P < .001), resulting in a consistent bias of +0.41 cm. Forty-six (5.7%) children were identified with low MUAC <12.5 cm by standard tape compared with 10 (1.2%) by the wide tape ( P <.001). Because a new tape could be reproduced by correcting for this bias, we corrected measured results by subtracting 0.41 cm and mean MUAC by tape type was no longer significantly different. Intra- and interobserver technical error of measurement suggested a better precision with the wide MUAC tape.

Conclusions: Despite simplifying the measurement by approximating the midpoint of the upper arm, the wide MUAC tape tended to have better precision than the standard MUAC tape. However, there was a consistent measurement bias of +0.41 cm in mean MUAC. This first field test yielded promising results and led to further product adjustments.

Keywords: Lao PDR; MUAC; mid-upper arm circumference; young children.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anthropometry / instrumentation*
  • Arm / anatomy & histology*
  • Child, Preschool
  • Female
  • Growth Disorders / epidemiology*
  • Humans
  • Infant
  • Male
  • Prevalence
  • Surveys and Questionnaires
  • Thinness / epidemiology*
  • Wasting Syndrome / epidemiology*