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Treatment of Severe Acute Malnutrition in Infants Aged <6 Months in Niger.
MedLine Citation:
PMID:  23092531     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: To report a nutritional rehabilitation program in Niger for the management of severe acute malnutrition in infants aged <6 months. STUDY DESIGN: This is a presentation of a case series (n = 632) of young infants who were admitted to a nutrition rehabilitation program in 2010-2011. The main characteristics of the inpatient treatment protocol where the use of diluted F-100 milk via a supplementary suckling technique until exclusive breastfeeding was reinitialized, coaching of mothers on infant feeding, and intensive antibiotic therapy as indicated during the stabilization phase. Semistructured interviews were conducted with 103 mothers. RESULTS: Rates of recovery, mortality, and default were 85% (537 of 632), 6% (37 of 632), and 9% (55 of 632), respectively. The majority of infants had an infectious disease at study entry (81%), particularly acute watery diarrhea and respiratory tract infections. Infection on admission was a predictor of death during treatment (OR, 3.9; 95% CI, 1.6-9.2). Anorexia at entry was a risk factor for treatment failure (OR, 4.4; 95% CI, 1.71-11.1). Interviews revealed a very low rate of exclusive breastfeeding (3%), with delayed initiation in 68% of cases. Traditional beliefs, perceived insufficiency of breast milk, and psychological problems played important roles in feeding choices. CONCLUSION: Severe acute malnutrition in infants aged <6 months can be successfully treated by managing cases as inpatients with an adapted protocol, intensive clinical supervision, and intensive drug treatment if indicated. Whether similar outcomes are achievable in community-based programs remains to be verified. Effective interventions for improving breastfeeding practices are needed.
Authors:
Sabine B Vygen; Dominique Roberfroid; Valérie Captier; Patrick Kolsteren
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-20
Journal Detail:
Title:  The Journal of pediatrics     Volume:  -     ISSN:  1097-6833     ISO Abbreviation:  J. Pediatr.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Mosby, Inc. All rights reserved.
Affiliation:
Institute of Tropical Medicine and International Health, Charité Medical University, Berlin, Germany; Médecins Sans Frontières, Geneva, Switzerland. Electronic address: s.vygen@yahoo.de.
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