Timely detection of children with a high risk of death and in need of nutritional treatment is key in the success of community-based management of acute malnutrition (CMAM) programs. Whereas there has been a lot of discussions over the last 20 years over which nutritional indices should be used for nutritional screening, the need of frequent screening has been rarely mentioned, presumably due to the lack of evidence to support it.

We recently examined this issue with multiple data sets collected by many colleagues who worked in the relationship between anthropometry and mortality. The paper describing this analysis is accepted for publication in Public Health Nutrition and is now available online as preprint at: 

https://www.doi.org/10.1017/S1368980023000149

The conclusion of this work is that the prognostic value of each nutritional index declines rapidly over time. The practical implication is that to have an optimal detection of high risk children in need of rapid treatment, frequent screening, ideally monthly, is clearly needed. In contrast to what happens when combining several indices, frequent screening increases sensitivity of detection of high-risk children by up to about 50% with virtually no effect on specificity, i.e., without increasing the number of children identified as in need of treatment.

This finding highlights the need of frequent nutritional screening in CMAM programs.