Assessment of malnutrition in preschool-aged children by mid-upper arm circumference in the Gaza Strip (January, 2024–August, 2025): a longitudinal, cross-sectional, surveillance study

The Lancet Pub Date : 2025-10-08 DOI:10.1016/s0140-6736(25)01820-3

Masako Horino, Sanaa Al Najjar, Amro Tabaza, Haya Alkhammash, Reham Jaffal, Jiaxin Chen, Ghada Al-Jadba, Keith P West, Akihiro Seita

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引用次数: 0

Abstract

Background

Since October, 2023, Palestinian children in the Gaza Strip have suffered war-induced displacement, food insecurity, malnutrition, and elevated risks of famine and mortality. In this study, we aimed to document the extent of, and patterns in, wasting malnutrition in children aged 6–59 months across the Gaza Strip between January, 2024, and August, 2025.

Methods

This longitudinal, cross-sectional, surveillance study was conducted across a total of 16 UN Relief and Works Agency for Palestine Refugees in the Near East health centres and 78 medical points established within school shelters and tent encampments across the five governorates of Gaza. Children aged 6–59 months were screened for wasting malnutrition by mid-upper arm circumference (MUAC) measurement. Children with a MUAC of less than 125 mm were enrolled into therapeutic feeding regimens. MUAC Z scores were derived from published WHO age-specific and sex-specific arm circumferential growth curves. Monthly prevalence of acute wasting (MUAC Z scores less than –2) and severe wasting (MUAC Z scores less than –3) were described by age, sex, type of screening facility, and governorate.

Findings

Between Jan 1, 2024, and Aug 15, 2025, 265 974 measurements were obtained from 219 783 uniquely identified children, with two-thirds of children screened in Khan Younis and Middle Governorates. The monthly prevalence of acute wasting ranged from 5% (34 of 722 children) to 7% (794 of 10 907) between January and June, 2024. After approximately 4 months of severe aid restrictions between September, 2024, and mid-January, 2025, the prevalence of wasting increased from 8·8% (1601 of 18 225 children) to 14·3% (1661 of 11 619), with the highest prevalence observed in Rafah (32·2%; 95 of 295) and among children aged 24–59 months (21·0%; 1366 of 6518). After a 6-week ceasefire, marked by a substantial increase in the number of aid trucks entering through territory borders, by March, 2025, the prevalence of wasting had declined to 5·5% (831 of 15 165). However, after an 11-week blockade from March to May, 2025, and continued severely restricted entry of food, water, medicines, fuel, and other essentials thereafter, by early August, 2025, 15·8% (1213 of 7668) of screened children were acutely wasted, including 3·7% (280 of 7668) severely wasted, equating to more than 54 600 children in need of therapeutic care.

Interpretation

After nearly 2 years of war and severe restrictions in humanitarian aid, tens of thousands of preschool-aged children in the Gaza Strip are suffering from preventable acute malnutrition and facing an increased risk of mortality.

Funding

UN Relief and Works Agency for Palestine Refugees in the Near East.

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加沙地带学龄前儿童中上臂围的营养不良评估（2024年1月- 2025年8月）：一项纵向、横断面、监测研究

自2023年10月以来，加沙地带的巴勒斯坦儿童遭受了战争导致的流离失所、粮食不安全、营养不良以及饥荒和死亡风险上升的困扰。在这项研究中，我们旨在记录2024年1月至2025年8月期间加沙地带6-59个月儿童消瘦性营养不良的程度和模式。方法这项纵向、横断面的监测研究是在加沙五个省的16个联合国巴勒斯坦难民救济和工程处近东保健中心和78个设在学校庇护所和帐篷营地内的医疗点进行的。通过测量中上臂围（MUAC）对6-59月龄儿童进行消瘦性营养不良筛查。MUAC小于125 mm的儿童被纳入治疗性喂养方案。MUAC Z评分来源于WHO公布的年龄特异性和性别特异性手臂周向生长曲线。急性消瘦（MUAC Z评分小于-2）和严重消瘦（MUAC Z评分小于-3）的月患病率按年龄、性别、筛查设施类型和省份描述。在2024年1月1日至2025年8月15日期间，对219 783名经过独特鉴定的儿童进行了265 974次测量，其中三分之二的儿童在汗尤尼斯和中部省份进行了筛查。2024年1月至6月，急性消瘦的月患病率从5%（722名儿童中34名）到7%（10907名儿童中794名）不等。在2024年9月至2025年1月中旬的大约4个月的严格援助限制之后，消瘦患病率从8.8%（18225名儿童中的1601名）上升到14.3%（11619名儿童中的1661名），其中Rafah的患病率最高（32.2%，295名儿童中的95名），24-59个月的儿童中患病率最高（21.0%，6518名儿童中的1366名）。经过6周的停火，通过领土边界进入的援助卡车数量大幅增加，到2025年3月，浪费的发生率下降到5.5%（15165辆中的831辆）。然而，在2025年3月至5月的11周封锁之后，食品、水、药品、燃料和其他必需品的进入继续受到严格限制，到2025年8月初，15.8%（7668人中1213人）的筛查儿童严重浪费，包括3.7%（7668人中280人）严重浪费，相当于超过54 600名儿童需要治疗护理。经过近两年的战争和对人道主义援助的严格限制，加沙地带数以万计的学龄前儿童正遭受可预防的急性营养不良，并面临着日益增加的死亡风险。资助联合国近东巴勒斯坦难民救济和工程处。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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The Lancet

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