scholarly journals A comparison of the programme coverage of two therapeutic feeding interventions implemented in neighbouring districts of Malawi

2007 ◽  
Vol 10 (9) ◽  
pp. 907-913 ◽  
Author(s):  
Kate Sadler ◽  
Mark Myatt ◽  
Teshome Feleke ◽  
Steve Collins
Keyword(s):  
Severe Malnutrition ◽  
Point Estimate ◽  
Recent Period ◽  
Community Based ◽  
Malnourished Children ◽  
Period Estimate ◽  
Sample Method ◽  
Feeding Interventions ◽  
Programme Coverage ◽  
Exact Point

AbstractObjectiveTo compare therapeutic feeding programme coverage for severely malnourished children achieved by a community-based therapeutic care (CTC) programme and a therapeutic feeding centre (TFC) programme operating in neighbouring districts in Malawi.DesignTwo surveys were implemented simultaneously one in each of the two programme areas. Each survey used a stratified design with strata defined using the centric systematic area sample method. Thirty 100 km2 quadrats were sampled. The community or communities located closest to the centre of each quadrat were sampled using a case-finding approach. Cases were defined as children aged under 5 years with ≤ 70% of the weight-for-height median or bilateral pitting oedema. Receipt of treatment was ascertained by the child's presence in a therapeutic feeding programme or by documentary evidence. Coverage in each quadrat was estimated in two ways, a period estimate that provides an estimation of coverage for the recent period preceding the survey and a point estimate that provides an estimation of coverage at the exact point in time of the survey.ResultsOverall the period coverage was 24.55% (95% confidence interval (CI) = 17.8–31.4%) in the TFC programme and 73.64% (95% CI = 66.0–81.3%) in the CTC programme. The point coverage was 20.04% (95% CI = 13.8–26.3%) in the TFC programme and 59.95% (95% CI = 51.4–68.5%) in the CTC programme.ConclusionsIn this context, CTC gave substantially higher programme coverage than a TFC programme. Given effective treatment, this enabled higher impact of CTC on severe malnutrition in this population.

scholarly journals Community-based Management of Micronutrient deficiency in Malnourished Children in Ghana

2014 ◽  
Vol 13 (4) ◽  
pp. 383-387
Author(s):  
O Ayokunle ◽  
OA Odusoga
Keyword(s):  
Developing Countries ◽  
Growth And Development ◽  
Patient Management ◽  
Medical Science ◽  
Micronutrient Deficiency ◽  
Severe Malnutrition ◽  
Significant Morbidity ◽  
Community Based ◽  
Malnourished Children ◽  
The Relationship

The relationship between undernutrition and ill health is complex. It is complicated by growth retardation, impaired mental development, and significant morbidity from malaria, diarrhoeal diseases, pneumonia etc. and mortality. Several micronutrients are required for adequate growth and development especially in young children. They also account for three of the four most important forms of malnutrition worldwide. This review attempts to evaluate the community-based management of malnutrition in developing countries while comparing it to the in-patient management of malnourished children. Parameters evaluated include cost, coverage, choice, nosocomial infection acquisition and effect on productivity. The community-based management of severe malnutrition has many benefits that should be harnessed by healthcare givers so as to reduce the burden of malnutrition in low resource settings.DOI: http://dx.doi.org/10.3329/bjms.v13i4.20552Bangladesh Journal of Medical Science Vol.13(4) 2014 p.383-387

USE OF CORTISONE IN MALNOURISHED CHILDREN

PEDIATRICS ◽  
1954 ◽  
Vol 13 (5) ◽  
pp. 439-446
Author(s):  
KURT GLASER ◽  
EMIL FREUNDLICH
Keyword(s):  
Experimental Study ◽  
Case Reports ◽  
Severe Malnutrition ◽  
Malnourished Children

Twenty-five case reports of infants with severe malnutrition treated with cortisone are presented and the results of this clinical experimental study are discussed.

Development of Severely Malnourished Children Who Received Psychosocial Stimulation: Six-Year Follow-up

PEDIATRICS ◽  
1987 ◽  
Vol 79 (2) ◽  
pp. 247-254 ◽  
Author(s):  
Sally Grantham-McGregor ◽  
William Schofield ◽  
Christine Powell
Keyword(s):  
Home Visiting ◽  
Intervention Group ◽  
Severe Malnutrition ◽  
The Third ◽  
Malnourished Children ◽  
Catching Up ◽  
Psychosocial Stimulation ◽  
Catch Up ◽  
Home Visiting Program

The development of 16 children who were hospitalized for severe malnutrition and participated in a home-visiting program of psychosocial stimulation was compared with that of two other groups who were also hospitalized but received standard medical care only: severely malnourished group (n = 18) and an adequately nourished one (n = 20). All groups were assessed regularly on the Griffiths Mental Development Scales and the Stanford-Binet test. Both groups of malnourished children were markedly behind the adequately nourished group on admission to the hospital and the group that received no intervention showed little sign of catching up. The intervention group caught up to the adequately nourished group in 2 years. This report covers the third year of home-visiting and the 3 years following its cessation. The intervention group showed a decline in three of the five Griffiths subscales. However, they retained a marked advantage over the nonintervention group of malnourished children on the Stanford-Binet test until the end of follow-up, showing no further decline in the last year. For height, both malnourished groups failed to catch up to the adequately nourished group. It was concluded that a relatively simple intervention can benefit the development of severely malnourished children.

scholarly journals A short-term intervention for the treatment of severe malnutrition in a post-conflict country: results of a survey in Guinea Bissau

2008 ◽  
Vol 11 (12) ◽  
pp. 1357-1364 ◽  
Author(s):  
Raffaella Colombatti ◽  
Alessandra Coin ◽  
Piero Bestagini ◽  
Cesaltina Silva Vieira ◽  
Laura Schiavon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Day Care ◽  
Health Indicators ◽  
Complete Recovery ◽  
Severe Malnutrition ◽  
Short Term ◽  
Guinea Bissau ◽  
Malnourished Children ◽  
Post Conflict ◽  
Weight For Age

AbstractObjectivesTo determine (i) the extent of malnutrition and the risk factors for severe malnutrition in Guinea Bissau, a post-conflict country experiencing long-term consequences of civil war; and (ii) the feasibility and effectiveness of a short-term intervention characterized by outpatient treatment with locally produced food for the treatment of severe malnutrition during the rainy season.Design and settingSocial, clinical, nutritional information were collected for children reaching the paediatric outpatient clinic of the Hospital ‘Comunità di Sant’Egidio’ in Bissau, Guinea Bissau, from 1 July to 12 August 2003. Severely malnourished children (weight-for-age <−3sd) in poor health status were admitted for daily nutritional and pharmacological treatment until complete recovery. Social and health indicators were analysed to define risk factors of severe malnutrition.ResultsIn total, 2642 children were visited (age range: 1 month–17 years). Fever, cough and dermatological problems were the main reasons for access. Social data outlined poor housing conditions: 86·4 % used water from unprotected wells, 97·3 % did not have a bathroom at home, 78·2 % lived in a mud house. Weight-for-age was <−2sd in 23·0 % of the children and <−3sd in 10·3 %; thirty-seven children (1·4 %) were severely malnourished and admitted for day care. All recovered with a weight gain of 4·45 g/kg per d, none died or relapsed after 1 year. Severely malnourished children were mainly infants, part of large families and had illiterate mothers.ConclusionShort-term interventions performed in post-conflict countries during seasons of high burden of disease and malnutrition are feasible and successful at low cost; day-care treatment of severe malnutrition with locally produced food is an option that can be tested in other settings.

scholarly journals The effects of malnutrition on cardiac function in African children

2015 ◽  
Vol 101 (2) ◽  
pp. 166-171 ◽  
Author(s):  
Jonathan A Silverman ◽  
Yamikani Chimalizeni ◽  
Stephen E Hawes ◽  
Elizabeth R Wolf ◽  
Maneesh Batra ◽  
...  
Keyword(s):  
Heart Rate ◽  
Cardiac Function ◽  
Severe Acute Malnutrition ◽  
Resistance Index ◽  
Stroke Volume Index ◽  
Acute Malnutrition ◽  
Volume Index ◽  
Severe Malnutrition ◽  
Systemic Vascular Resistance Index ◽  
Malnourished Children

ObjectiveCardiac dysfunction may contribute to high mortality in severely malnourished children. Our objective was to assess the effect of malnutrition on cardiac function in hospitalised African children.DesignProspective cross-sectional study.SettingPublic referral hospital in Blantyre, Malawi.PatientsWe enrolled 272 stable, hospitalised children ages 6–59 months, with and without WHO-defined severe acute malnutrition.Main outcome measuresCardiac index, heart rate, mean arterial pressure, stroke volume index and systemic vascular resistance index were measured by the ultrasound cardiac output monitor (USCOM, New South Wales, Australia). We used linear regression with generalised estimating equations controlling for age, sex and anaemia.ResultsOur primary outcome, cardiac index, was similar between those with and without severe malnutrition: difference=0.22 L/min/m2 (95% CI −0.08 to 0.51). No difference was found in heart rate or stroke volume index. However, mean arterial pressure and systemic vascular resistance index were lower in children with severe malnutrition: difference=−8.6 mm Hg (95% CI −12.7 to −4.6) and difference=−200 dyne s/cm5/m2 (95% CI −320 to −80), respectively.ConclusionsIn this largest study to date, we found no significant difference in cardiac function between hospitalised children with and without severe acute malnutrition. Further study is needed to determine if cardiac function is diminished in unstable malnourished children.

Proposed Recommended Nutrient Densities for Moderately Malnourished Children

2009 ◽  
Vol 30 (3_suppl3) ◽  
pp. S267-S342 ◽  
Author(s):  
Michael H. Golden
Keyword(s):  
Dietary Intake ◽  
Severe Malnutrition ◽  
Type I ◽  
Type Ii ◽  
Healthy Individuals ◽  
Malnourished Children ◽  
Factorial Approach ◽  
Accelerated Growth ◽  
Moderate Malnutrition ◽  
Definition Of

Recommended Nutrient Intakes (RNIs) are set for healthy individuals living in clean environments. There are no generally accepted RNIs for those with moderate malnutrition, wasting, and stunting, who live in poor environments. Two sets of recommendations are made for the dietary intake of 30 essential nutrients in children with moderate malnutrition who require accelerated growth to regain normality: first, for those moderately malnourished children who will receive specially formulated foods and diets; and second, for those who are to take mixtures of locally available foods over a longer term to treat or prevent moderate stunting and wasting. Because of the change in definition of severe malnutrition, much of the older literature is pertinent to the moderately wasted or stunted child. A factorial approach has been used in deriving the recommendations for both functional, protective nutrients (type I) and growth nutrients (type II).

scholarly journals Improving screening for malnourished children at high risk of death: a study of children aged 6–59 months in rural Senegal

2018 ◽  
Vol 22 (5) ◽  
pp. 862-871 ◽  
Author(s):  
Mark Myatt ◽  
Tanya Khara ◽  
Carmel Dolan ◽  
Michel Garenne ◽  
André Briend
Keyword(s):  
High Risk ◽  
Community Based ◽  
Risk Of Death ◽  
Malnourished Children ◽  
Arm Circumference ◽  
Near Term ◽  
Mid Upper Arm Circumference ◽  
Risk Ratios ◽  
System Operating ◽  
Weight For Age

AbstractObjectiveTo investigate whether children with concurrent wasting and stunting require therapeutic feeding and to better understand whether multiple diagnostic criteria are needed to identify children with a high risk of death and in need of treatment.DesignCommunity-based cohort study, following 5751 children through time. Each child was visited up to four times at 6-month intervals. Anthropometric measurements were taken at each visit. Survival was monitored using a demographic surveillance system operating in the study villages.SettingNiakhar, a rural area of the Fatick region of central Senegal.ParticipantsChildren aged 6–59 months living in thirty villages in the study area.ResultsWeight-for-age Z-score (WAZ) and mid-upper arm circumference (MUAC) were independently associated with near-term mortality. The lowest WAZ threshold that, in combination with MUAC, detected all deaths associated with severe wasting or concurrent wasting and stunting was WAZ <−2·8. Performance for detecting deaths was best when only WAZ and MUAC were used. Additional criteria did not improve performance. Risk ratios for near-term death in children identified using WAZ and MUAC suggest that children identified by WAZ <−2·8 but with MUAC≥115 mm may require lower-intensity treatment than children identified using MUAC <115 mm.ConclusionsA combination of MUAC and WAZ detected all near-term deaths associated with severe anthropometric deficits including concurrent wasting and stunting. Therapeutic feeding programmes may achieve higher impact if WAZ and MUAC admission criteria are used.

scholarly journals Severe malnutrition is associated with decreased levels of plasma transferrin receptor

1997 ◽  
Vol 77 (3) ◽  
pp. 391-397 ◽  
Author(s):  
Francis O. T. Akenami ◽  
Antti Vaheri ◽  
Marjaleena Koskiniemi ◽  
Sanna-Maria Kivivuori ◽  
Emmanuel E. Ekanem ◽  
...  
Keyword(s):  
Transferrin Receptor ◽  
Plasma Concentrations ◽  
Fe Deficiency ◽  
Severe Malnutrition ◽  
Reference Ranges ◽  
Healthy Children ◽  
Plasma Albumin ◽  
Malnourished Children ◽  
The Mean ◽  
Apparently Healthy

Sixty children aged 1-3 years with protein malnutrition were involved in the present study. Measurements were made of plasma transferrin receptor (TfR), haemoglobin (Hb), ferritin, transferrin and Fe in comparison with twenty apparently healthy age- and sex-matched reference children in Nigeria. Plasma TfR was measured by an immunofluorometric assay. The mean plasma concentrations of both albumin (37 g/l) and transferrin (1·88 g/l) were within reference ranges in the ‘healthy’ children. The malnourished children had severe protein deficiency as indicated by their significantly lower mean plasma albumin (24·4-28·2 g/l; P < 0·0001) and transferrin (1·24-1·53 g/l; P < 0·0001) concentrations in comparison with the reference children. In the reference children, the traditional indicators of Fe nutrition (plasma Fe, transferrin Fe saturation and Hb) were within the reference ranges, but ferritin values were raised, indicating acute or chronic infection and/or inflammation. The mean concentrations of plasma TW (4·2-5-2 mg/l) in the malnourished group were significantly lower than the mean (6·1 mgn) of the reference children (P=0·0009). In the children with severe malnutrition, none of the indicators of Fe status except Hb (81·5-86·7 g/l; P<0·0001) showed Fe deficiency, including the serum concentration of TfR and the TfR : ferritin ratio, although the Fe status was lower than in the reference children (for Fe P = 0·009; and ferritin P=0·0004). In the absence of haemodilution, the low Hb values are a clear indication that the malnourished children were Fe deficient; none of the other indices was indicative of Fe deficiency. This is the first report of TfR levels in malnourished and healthy African children.

scholarly journals Effectiveness of home-based fortified diet in the rehabilitation of malnourished children in resource restrained country: an institution based retrospective study

2020 ◽  
Author(s):  
Saba Shahid ◽  
Marvi Mahesar ◽  
Anum Rahim ◽  
Yumna Sadiq
Keyword(s):  
Weight Gain ◽  
Chart Review ◽  
Data Extraction ◽  
Real Life ◽  
Retrospective Chart Review ◽  
Final Analysis ◽  
Nutrition Survey ◽  
Community Based ◽  
Malnourished Children ◽  
Home Based

Abstract Background: Globally, it is estimated that 50 million children under five are wasted. National nutrition survey-2018 has shown that 23.3% and 45.5% of children are wasted and stunted in Pakistan. Many studies have shown that hospital-based management of malnutrition is not practical due to high cost and iatrogenic infections, and currently, WHO recommends community-based management of malnutrition with the provision of therapeutic food. There is limited evidence of community rehabilitation of malnourished children by using the home-fortified diet in Pakistan. This study evaluated the effectiveness of using the home-fortified diet in achieving recovered from malnutrition through a retrospective chart review.Methods: A retrospective chart review of pediatric patients (aged six months –5 years) seen in Indus Hospital between January 2017 to June 2018 was conducted. A predesigned data extraction form was used to record detailed information about demographic characteristics, feeding, anthropometric, micronutrient, and nutritional details at enrollment and on follow-up.Results: A total of 361 patients were included in the final analysis. The median age of children was 14 months. 102 children were recovered from malnutrition with a median length of stay in the program of 28 days. The median for weight gain was 4.8 (0-10.3) g/Kg/day, 226 children defaulted and 10 died.Conclusion: This study revealed adequate weight gain and recovered from malnutrition in children by using the home-fortified diet in real-life situations. Home-fortified diets may serve as an effective strategy in community-based rehabilitation of malnourished children, especially in resource constraint contexts.

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