Management of acute moderate and severe childhood malnutrition.

Anthropometric data of 2466 children in Haryana revealed low sensitivity (6.9%) and positive predictive value (14.3%) of Mid-upper Arm Circumference (MUAC) at 115 mm cut-off for identifying Severe acute malnutrition (SAM). This raises concerns regarding the reliability of MUAC as a screening tool to identify SAM at the community-level.

Home-based management has many advantages as the children have reduced exposure to hospitalacquired infections and receive continuity of care after discharge. It also benefits by increasing the time available to mothers to spend with family and reduces the risk of possible neglect of siblings. Also, mothers are able to look after other family responsibilities simultaneously(1,2). An essential c...

INTRODUCTION Hypothermia is a risk factor for increased mortality in children with severe acute malnutrition (SAM). Yet frequent temperature measurement remains unfeasible in under-resourced units in developing countries. ThermoSpot is a continuous temperature monitoring sticker designed originally for neonates. When applied to skin, its liquid crystals are designed to turn black with hypotherm...

The World Health Organization (WHO) recommends the assessment of nutritional recovery using the same anthropometric indicator that was used to diagnose severe acute malnutrition (SAM) in children. However, related empirical evidence from low-income countries is lacking. Non-oedematous children (n = 661) aged 6-59 months admitted to a community-based outpatient therapeutic program for SAM in rur...

BACKGROUND Previous studies have shown the benefits of ready-to-use supplementary food (RUSF) distribution in reducing the incidence and prevalence of severe acute malnutrition. METHODS AND FINDINGS To compare the incidence of wasting, stunting and mortality between children aged 6 to 23 mo participating and not participating in distributions of RUSF, we implemented two exhaustive prospective...

OBJECTIVE One of the many challenges faced by epidemiologists is to adequately plan and optimize subject selection procedures in terms of effectiveness and efficiency. In the context of a case-control study involving severe acute malnutrition, a two-step subject selection procedure is used. The aim of the article is to establish an appropriate cut-off point for the screening phase and to achiev...

When an emergency occurs, and large numbers of children with severe acute malnutrition (SAM) are to be treated, programme managers have to know, usually within a short period of time, the number of SAM children they will have to treat in the next few months (usually in the next 12 months). This is needed in particular for funding requests, as the number of patients to be treated has a direct im...

BACKGROUND Malnutrition is common in the developing world and associated with disease and mortality. Because malnutrition frequently occurs among children in the community as well as those with acute illness, and because anthropometric indicators of nutritional status are continuous variables that preclude a single definition of malnutrition, malnutrition-attributable fractions of admissions an...

Trial design Three feeding regimens-centrally produced ready-to-use therapeutic food, locally produced ready-to-use therapeutic food, and augmented, energy-dense, home-prepared food-were provided in a community setting for children with severe acute malnutrition (SAM) in the age group of 6-59 months in an individually randomised multicentre trial that enrolled 906 children. Foods, counselling, ...