Document Detail

Management of severe acute malnutrition in children.
MedLine Citation:
PMID:  17141707     Owner:  NLM     Status:  MEDLINE    
Severe acute malnutrition (SAM) is defined as a weight-for-height measurement of 70% or less below the median, or three SD or more below the mean National Centre for Health Statistics reference values, the presence of bilateral pitting oedema of nutritional origin, or a mid-upper-arm circumference of less than 110 mm in children age 1-5 years. 13 million children under age 5 years have SAM, and the disorder is associated with 1 million to 2 million preventable child deaths each year. Despite this global importance, child-survival programmes have ignored SAM, and WHO does not recognise the term "acute malnutrition". Inpatient treatment is resource intensive and requires many skilled and motivated staff. Where SAM is common, the number of cases exceeds available inpatient capacity, which limits the effect of treatment; case-fatality rates are 20-30% and coverage is commonly under 10%. Programmes of community-based therapeutic care substantially reduce case-fatality rates and increase coverage rates. These programmes use new, ready-to-use, therapeutic foods and are designed to increase access to services, reduce opportunity costs, encourage early presentation and compliance, and thereby increase coverage and recovery rates. In community-based therapeutic care, all patients with SAM without complications are treated as outpatients. This approach promises to be a successful and cost-effective treatment strategy.
Steve Collins; Nicky Dent; Paul Binns; Paluku Bahwere; Kate Sadler; Alistair Hallam
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Lancet     Volume:  368     ISSN:  1474-547X     ISO Abbreviation:  Lancet     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2006-12-04     Completed Date:  2006-12-19     Revised Date:  2007-03-29    
Medline Journal Info:
Nlm Unique ID:  2985213R     Medline TA:  Lancet     Country:  England    
Other Details:
Languages:  eng     Pagination:  1992-2000     Citation Subset:  AIM; IM    
Valid International Ltd, Oxford, UK.
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MeSH Terms
Child, Preschool
Community Health Services / economics,  organization & administration*
HIV Infections / complications,  drug therapy
Malnutrition* / epidemiology,  mortality,  therapy
Severity of Illness Index
World Health*
Comment In:
Lancet. 2007 Mar 3;369(9563):740; author reply 741   [PMID:  17336646 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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