SAM Diagnostic Criteria for Children Under 5 Years

Severe Acute Malnutrition (SAM) in children under 5 years is typically diagnosed using specific anthropometric measurements. The key indicators provided in the question are weight-for-height and Mid-Upper Arm Circumference (MUAC).

Identifying Correct Diagnostic Criteria

The standard diagnostic criteria for SAM include:

• Weight-for-Height Z-score (WHZ): A WHZ below -3 Standard Deviations (SD) indicates severe wasting.
• Mid-Upper Arm Circumference (MUAC): A MUAC measurement less than 115 mm (or 11.5 cm) indicates severe malnutrition.
• Bilateral pitting edema: Presence of edema is also a criterion.

Analyzing the given options based on established SAM criteria:

• (i) Weight for Height - 3 SD: This aligns with the WHZ criterion for severe wasting. This is a correct indicator for SAM.
• (ii) Weight for Height - 2 SD: This indicates moderate wasting (WHZ below -2 SD), not severe wasting.
• (iii) MUAC less than 115 mm: This is a standard threshold for diagnosing SAM. This is a correct indicator for SAM.
• (iv) MUAC less than 125 mm: This threshold is generally used for identifying children at risk or for screening, but the diagnostic cut-off for SAM is lower (115 mm).

Conclusion on Criteria

Based on the analysis, the criteria that correctly diagnose SAM in children $\le$ 5 years are:

• (i) Weight for Height - 3 SD
• (iii) MUAC less than 115 mm

Therefore, the combination representing the diagnostic criteria for SAM is (i) and (iii).