PP191 - THE HIDDEN BURDEN OF WASTING: DIAGNOSTIC DISCORDANCE BETWEEN MUAC AND WHZ AMONG CHILDREN IN A HOSPITAL SETTING DURING THE WAR ON GAZA

PP191

THE HIDDEN BURDEN OF WASTING: DIAGNOSTIC DISCORDANCE BETWEEN MUAC AND WHZ AMONG CHILDREN IN A HOSPITAL SETTING DURING THE WAR ON GAZA

N. Barqawi^1,*, Z. G. Assaf², R. Zietawi³ on behalf of Amal Firwana, Rawan Firwana

¹Independent researcher, Dubai, ²RAK University, Ras Al Khaima, United Arab Emirates, ³University of Jordan, Amman, Jordan

 

Rationale:

Methods: A cross-sectional study was conducted at the Pediatric Outpatient Clinic of Nasser Hospital, Southern Gaza, during a temporary ceasefire (October–November 2025). Children with nutritional edema were clinically triaged to emergency care and therefore excluded; non-edematous GAM and SAM were assessed using MUAC and WHZ, with diagnostic discordance evaluated using Cohen’s Kappa (κ).

 

 

Results: A total of 201 children aged 6–59 months were assessed. Mean WHZ was −1.90 ± 1.23. GAM prevalence was 63.7% by MUAC and 43.8% by WHZ, while SAM prevalence was 20.9% by MUAC and 13.4% by WHZ. Diagnostic discordance between MUAC and WHZ was moderate (κ = 0.46, 95% CI: 0.35–0.57), with MUAC identifying 48 children as wasted who were classified as normal by WHZ.

 

 

Image:

 

Conclusion: The observed discordance between MUAC and WHZ may reflect underlying starvation physiology shaped by protein scarcity, chronic stress, and widespread stunting during the war on Gaza. These findings highlight a substantial risk of missed diagnoses when reliance is placed on a single anthropometric indicator in war-affected populations.

 

Disclosure of Interest: N. Barqawi Other: The authors declare that they have no competing interests., Z. Assaf Other: The authors declare that they have no competing interests., R. Zietawi Other: The authors declare that they have no competing interests.