scholarly journals An Experience at a Tertiary Level Hospital NRC in Management of Severe Acute Malnutrition in Children Aged between 6-59 Months Adopting World Health Organization Recommendations

2016 ◽  
Vol 1 (1) ◽  
pp. 41 ◽  
Author(s):  
S. Bharathi ◽  
K. Anuradha ◽  
J. Venkateshwar Rao
Keyword(s):  
World Health Organization ◽  
Severe Acute Malnutrition ◽  
Case Fatality ◽  
Acute Malnutrition ◽  
World Health ◽  
Severe Malnutrition ◽  
Rehabilitation Center ◽  
Nutritional Rehabilitation ◽  
Retrospective Case ◽  
Health Organization

<p><em>Objectives:<strong> </strong></em><em>To study the outcome indicators of a nutritional rehabilitation center and to assess its performance.</em></p><p><em>Design: </em><em>Retrospective case study.</em></p><p><em>Period:</em><em> One year period from Jan 2014 to Dec 2014.</em></p><p><em>Methods:<strong> </strong></em><em>Data of 254 children aged between 6-59</em><em> </em><em>months with severe acute malnutrition admitted in nutritional rehabilitation center at department of pediatrics, Gandhi hospital, was</em><em> </em><em>analyzed retrospectively. Identification and treatment of severe acute malnutrition was done according to world health organization recommendations.</em></p><p><em>Results:<strong> </strong></em><em>The recovery rate, death rate, defaulter rate, mean (SD) weight gain &amp; mean (SD) duration of stay in the nutritional rehabilitation center were 51.42%, 3.54%, 28.57%, 8g/kg/day, 14.2 days respectively.</em></p><p><em>Conclusions:<strong> </strong></em><em>Nutritional rehabilitation centers are effective in management of severe malnutrition and also in decreasing the case fatality rates.</em></p>

scholarly journals Modifying Intestinal Integrity and MicroBiome in Severe Malnutrition with Legume-Based Feeds (MIMBLE 2.0): protocol for a phase II refined feed and intervention trial

2018 ◽  
Vol 3 ◽  
pp. 95
Author(s):  
Kevin Walsh ◽  
Nuala Calder ◽  
Peter Olupot-Olupot ◽  
Tonny Ssenyondo ◽  
William Okiror ◽  
...  
Keyword(s):  
Lactose Intolerance ◽  
Severe Acute Malnutrition ◽  
Case Fatality ◽  
Acute Malnutrition ◽  
World Health ◽  
Severe Malnutrition ◽  
Epithelial Barrier ◽  
Nutritional Rehabilitation ◽  
Mucosal Integrity ◽  
Fermentable Carbohydrates

Background: Changes in intestinal mucosal integrity and gut microbial balance occur in severe acute malnutrition (SAM), resulting in treatment failure and adverse clinical outcomes (gram-negative sepsis, diarrhoea and high case-fatality). Transient lactose intolerance, due to loss of intestinal brush border lactase, also complicates SAM, thus milk based feeds may not be optimal for nutritional rehabilitation. Since the gut epithelial barrier can be supported by short chain fatty acids, derived from microbiota fermentation by particular fermentable carbohydrates, we postulated that an energy-dense nutritional feed comprising of legume-based fermentable carbohydrates, incorporated with lactose-free versions of standard World Health Organization (WHO) F75/F100 nutritional feeds will enhance epithelial barrier function in malnourished children, reduce and promote resolution of diarrhoea and improve overall outcome. Methods: We will investigate in an open-label trial in 160 Ugandan children with SAM, defined by mid-upper arm circumference <11.5cm and/or presence of kwashiorkor. Children will be randomised to a lactose-free, chickpea-enriched feed containing 2 kcal/ml, provided in quantities to match usual energy provision (experimental) or WHO standard treatment F75 (0.75 kcal/ml) and F100 (1 kcal/ml) feeds on a 1:1 basis, conducted at Mbale Regional Referral Hospital nutritional rehabilitation unit. The primary outcomes are change in MUAC at day 90 and survival to day 90. Secondary outcomes include: i) moderate to good weight gain (>5 g/kg/day), ii) de novo development of diarrhoea (>3 loose stools/day), iii) time to diarrhoea resolution (if >3 loose stools/day), and iv) time to oedema resolution (if kwashiorkor) and change in intestinal biomarkers (faecal calprotectin). Discussion: We hypothesize that, if introduced early in the management of malnutrition, such lactose-free, fermentable carbohydrate-based feeds, could safely and cheaply improve global outcome by reducing lactose intolerance-related diarrhoea, improving mucosal integrity and enhancing immunity, and limiting the risk of systemic infection and associated broad-spectrum antibiotic resistance. Registration: ISRCTN 10309022.

scholarly journals Children Living with Disabilities Are Absent From Severe Malnutrition Guidelines

2021 ◽  
Author(s):  
Magdalena Engl ◽  
Paul Binns ◽  
Indi Trehan ◽  
Natasha Lelijveld ◽  
Chloe Angood ◽  
...  
Keyword(s):  
Resource Constraints ◽  
Severe Acute Malnutrition ◽  
Guideline Development ◽  
Acute Malnutrition ◽  
World Health ◽  
Severe Malnutrition ◽  
General Terms ◽  
Or Practice ◽  
Health Organization ◽  
Specific Section

ABSTRACTPurposeChildren living with disabilities (CLWD) are at high risk of malnutrition but have long been marginalised in malnutrition treatment programmes and research. The 2013 World Health Organization (WHO) guidelines for Severe Acute Malnutrition (SAM) mention disability but do not contain specific details for treatment or support. This study assesses inclusion of CLWD in national and international SAM guidelines.MethodsNational and international SAM guidelines were sourced online and via direct enquiries. Eight scoping key informant interviews were conducted with experts involved in guideline development to help understand possible barriers to formalising malnutrition guidance for CLWD.Results71 malnutrition guidelines were reviewed (63 national, 8 international). Only 4% (3/71) had a specific section for CLWD, while the remaining lacked guidance on consistently including CLWD in programmes or practice. Only one guideline mentioned strategies to include CLWD during a nutritional emergency. Most (99%,70/71) did not link to other disability-specific guidelines. Of the guidelines that included CLWD, most only discussed disability in general terms despite the fact that different interventions are often needed for children with different conditions. Interviews pointed towards barriers related to medical complexity, resource constraints, epidemiology (e.g., unrecognised burden), lack of evidence, and difficulty of integration into existing guidelines.ConclusionChildren living with disability are not recognised in most SAM guidelines. Where they are, recommendations are very limited. Better evidence is urgently needed to identify and manage CLWD in malnutrition programmes. More inclusion in the 2022 update of the WHO malnutrition guidelines could support this vulnerable group.

Acute severe malnutrition treatment outcomes in children ages 6–59 months admitted to Singa Hospital, Sudan

2020 ◽  
Vol 114 (8) ◽  
pp. 612-617
Author(s):  
Jalal Ali Bilal ◽  
Hatim G Eltahir ◽  
Abdullah Al-Nafeesah ◽  
Osama Al-Wutayd ◽  
Ishag Adam
Keyword(s):  
Case Fatality Rate ◽  
Intestinal Parasites ◽  
Case Fatality ◽  
Clinical Information ◽  
Acute Malnutrition ◽  
World Health ◽  
Severe Malnutrition ◽  
Fatality Rate ◽  
Z Scores ◽  
Acute Severe Malnutrition

Abstract Background Acute malnutrition threatens the lives of 50.5 million children &lt;5 y of age. Consequences of malnutrition include death, among other short-term sequelae. This study was conducted from April to October 2018 to determine the outcomes of children 6–59 months of age with acute severe malnutrition admitted to Singa Hospital in central Sudan. Methods Clinical information for children with a mid-upper arm circumference (MUAC) &lt;115 mm were collected. We measured children's weight and height and calculated weight-for-height z-scores. Treatment was offered according to World Health Organization (WHO) guidelines. Outcomes were recorded as recovered, discharged against medical advice or died. Results This study included 376 malnourished children. The median age was 18 months (interquartile range [IQR] 12−24). The male:female ratio was 1:1. Among children with weight-for-height Z-scores of −4 and −3, 103 (27.3%) had oedematous malnutrition. There were 131 (34.8%) children with malaria parasites, 33 (8.7%) with pyuria and 24 (6.3%) with intestinal parasites. The recovery rate was 89.1%. The case fatality rate was 3.7%. Mortality was significantly increased with diarrhoea and dermatoses. There were no significant differences in the median of age (17.5 months [IQR 6−24] vs 18 [6−24], p = 0.595), MUAC (110 mm [IQR 104–111] vs 110 [100–111], p = 0.741) or sex (p = 0.991) between children who died and those who recovered. Conclusions The case fatality rate was 3.7% and it was associated with diarrhoea and dermatoses.

scholarly journals Dietary determinant of severe acute malnutrition among infants: Evidence from a case controlled study at a Central Indian district

2016 ◽  
Vol 6 (1) ◽  
pp. 32-39 ◽  
Author(s):  
Pavan Pandey ◽  
Shivendra Kumar Singh
Keyword(s):  
Complementary Feeding ◽  
Severe Acute Malnutrition ◽  
Sampling Strategy ◽  
Feeding Practices ◽  
Acute Malnutrition ◽  
World Health ◽  
Controlled Study ◽  
P Value ◽  
Health Organization ◽  
And Control

Breast feeding and complementary feeding practices ultimately determine the nutritional status of newborn at the end of infancy. The objective of the present study was to find the possible causes of malnutrition in context of breastfeeding and complementary feeding practices adopted by families of infants aged 6-12 month old. A community-based, unmatched, case-controlled study was conducted involving 78 cases and 156 controls in the Raisen district of Madhya Pradesh, India. The study included infants aged 6- 12 months who were enrolled in the Integrated Child Development Scheme. Cases and controls were selected through a multi-staged sampling strategy. Cases were those with severe acute malnutrition and controls were those with no malnutrition as per the World Health Organization criteria. Data related to the breastfeeding, pre-lacteal feeding and complementary feeding practices were collected using a pre-tested questionnaire. Descriptive and bivariate analyses were carried out. P-value and Odds ratios were calculated. The proportion of exclusive breastfeeding among cases and control was 10.3% and 24.4% respectively. The high odds of malnutrition were related to lack of exclusively breastfeeding [COR(95% CI) = 4.69(2.50- 6.53)], lack of feeding semisolid food, less frequent complementary feedings [COR(95% CI) = 5.69(3.01- 8.93)], lack of hand washing by caregivers [COR(95% CI) =2.44 (1.10-3.19)], and lack of use of disinfected drinking water for infants. Proper health education should be imparted not only to mothers but also other family members involved in the child’s care.South East Asia Journal of Public Health Vol.6(1) 2016: 32-39

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