OptiDiag: Improvements in the diagnosis of child undernutrition through assessment of emerging biomarkers of deprived metabolic status and vulnerability

Organisation: Action contre la Faim (ACF) - France

Partners: Duke University, USA; AgroParisTech, France; Institute of Tropical Medicine of Antwerp, Belgium; Co-funded by ECHO

Location: Paris

Type of grant: Core – development

Status: Ongoing

  • Measuring Mid-Upper Arm Circumference (MUAC) in Bangladesh, photo by Trenton Dailey-Chwalibóg

  • Trenton Dailey-Chwalibóg, a Ph.D. student and Research Project Manager, prepares serum samples during a field test at Redemption Hospital in Monrovia, Liberia.

  • Trenton Dailey-Chwalibóg and Issa Kemokai enter Redemption Hospital in Monrovia, Liberia.

  • A mother and her child from the out-patient OptiDiag project at the Redemption Hopsital in Monrovia, Liberia.

  • Issa Kemokai examines the assay using a portable microscope.

  • OptiDiag research staff image the D4 assay using the smartphone detector at Redemption Hospital in Monrovia, Liberia.

  • Jay Gupta watches as Trenton Dailey-Chwalibóg prepares a sample for the D4 assays.

  • Trenton Dailey-Chwalibóg and Issa Kemokai export frozen serum samples from Liberia to Germany and the United States for analysis.

  • Trenton Dailey-Chwalibóg and Issa Kemokai clean the database and organize patient dockets.

  • Rayhan Mostak, Trenton Dailey-Chwalibóg and Mubarak Hossain export frozen serum samples from Bangladesh to Germany and the United States for analysis.


Weight for Height z-score (WHZ) and mid-upper arm circumference (MUAC) have been acknowledged as criteria for the diagnosis severe acute malnutrition (SAM) and the targeting of humanitarian nutrition programmes. However, in the absence of a gold standard allowing to understanding their respective diagnosis performances and limits, the statement of their inconsistencies is triggering the urgent need for relevant and practical diagnosis tools to improve the accuracy of SAM diagnosis in humanitarian settings. The project is co-funded by EU Humanitarian Aid.

 What humanitarian need is being addressed?

The diagnosis of children suffering from Severe Acute Malnutrition (SAM): to increase the sensitivity and specificity of diagnostic measures for SAM and identify children who are at highest risk for life-threatening acute and chronic complications.

What is the innovative solution and how will it improve existing humanitarian practice?

The solution we want to put in place can be described as novel diagnostic and screening tools relying on the assessment of emerging biomarkers of metabolic deprivation and vulnerability, as a complement or an alternative to anthropometric indicators, for identification, classification, and management of malnourished children in the developing world.

 What materials or research outputs are likely to be produced?

The project is part of a PhD leading to several scientific publications on:

  • Validated anthropometric indicators and confirmation of possible misdiagnosis of SAM made by MUAC or WHZ criteria.
  • Identification of high risk groups within the SAM children based on admission characteristics and treatment response.
  • Documented underlying heterogeneity of the pathophysiology.
  • Generation of new algorithms for the assessment and classification of malnourished children, based on the combined use of emerging biomarkers and anthropometric measures, or on the modification of anthropometric criteria (modified cut-offs for specific categories of children for instance, combination of wasting and stunting, etc…).

Elrha is a registered charity in England and Wales (1177110).

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