Guidelines for management of acute malnutrition through communitybased. Training course on impatient management of severe acute. When thinking about severe acute malnutrition you should have in mind all the vital organs in the body such as the heart, the kidneys and the liver. Dietary counselling, breastfeeding counselling, and positive feeding and caring practices should always be part of the management of moderate malnutrition, even when food supplements are given. To fulfill criteria to identify children with severe or acute malnutrition for treatment, there must be trained community and health workers available. Severe acute malnutrition sam evaluation of associated. Antibiotics as part of the management of severe acute.
Communicable diseasesin infancy and childhooddiagnosistherapy 3. Severe acute malnutrition is defined in these guidelines as the presence of oedema of both feet or severe wasting weightforheightlength pdf available in the lancet 3689551. Who management of severe acute malnutrition in infants. Federal bureau of prisons medical management of malnutrition undernutrition clinical guidance september 2014 1 1. Nutritional status directly impacts the vulnerability for and the severity of infectious diseases that affect children in emergency settings. Infants and children who are 659 months of age and have a midupper arm circumference bilateral oedema should be immediately referred for full assessment at a treatment centre for the management of severe acute malnutrition. A typical timeframe for the management of a child with severe malnutrition is shown in table 1. The addition of antibiotics to therapeutic regimens for uncomplicated severe acute malnutrition was associated with a significant improvement in recovery and mortality rates.
Management of severe acute malnutrition, orgpublications files. Where to manage children with severe acute malnutrition who have oedema 23 3. Purpose and terminology the federal bureau of prisons bop clinical guidance for the medical management of malnutrition undernutrition provides recommendations for the assessment and nutritional augmentation of inmates who are in a malnourished state. Introduction management of severe acute malnutrition in. Treatment outcomes of severe acute malnutrition in. Management of acute severe malnutrition pimam version 1, november 2011. Maternal depression and child severe acute malnutrition. Antibiotics as part of the management of severe acute malnutrition. Severe malnutrition, also known as severe acute malnutrition, is a condition that is brought on by starvation. Management of severe acute malnutrition in children under five years. Severe malnutrition in children under 5 years of age is the end result of chronic nutritional and, frequently, emotional deprivation by carers. Management of severe and moderate acute malnutrition in. Guidelines for management of acute malnutrition through communitybased therapeutic care ctc iii this protocol has been put together by the national communitybased therapeutic care programme taskforce, cofacilitated by the ministry of health and child welfare and unicef. This technical brief is one of three commissioned by the communitybased management of acute malnutrition cmam forum.
Acknowledgements this inpatient management of children with severe acute malnutrition sam training course is the practical application of the 1999 world health organisation who publication management of severe malnutrition. Malnutrition occurs when the body does not get the nutrients it needs. Pdf on apr 5, 2016, lindsey lenters and others published management of severe and moderate acute malnutrition in children find, read and cite all the research you need on researchgate. This manual is based on the treatment and management of severe protein energy malnutrition, which was published by who in 1981. Community mobilisation, emotional wellbeing and stimulation. This is an extract from relevant guidelines and guidance documents as listed in references. Protocol for the management of severe acute malnutrition. That is, the medical problems of the child result, in part, from the social problems of the home in which the child lives. Malnutrition treatment and management hexagon nutrition. Management of the child with a serious infection or severe malnutrition. Use of antibiotics in the management of children with severe acute malnutrition in outpatient care 26 4.
Management of the seriously ill patient it is important to recognize dehydration and specific infections, such as pneumonia and septicaemia, which often accompany pem and contribute to. These health workers then must assess the children for certain health risks and infections before beginning treatment with rutf and therapeutic milk. The treatment and management of these three forms of severe malnutrition are the same. The world health organization who recently published a manual of the management of severe malnutrition. More details on outpatient treatment of sam are included in this document. Malnutritionmoderate acute malnutrition mam, severe acute malnutrition sam, and global acute malnutrition gam its risk factors and causes of undernutrition are discussed in this chapter, as well as the consequences of acute malnutrition. A manual for physicians and other senior health workers, and the who is grateful to all those involved in the production of this fundamental training course. Malnutrition is directly responsible for 300,000 deaths per year in children younger than 5 years in developing countries and contributes indirectly to more than half of all deaths in children worldwide. Management of severe acute malnutrition, orgpublicationsfiles. Vitamin a supplementation in the treatment of children with severe acute malnutrition 31 5. Poolresourcesmammanagementcmamforumtechnicalbriefsept2014. Causes include limited food supply and some mental and physical health conditions. Malnutrition is a worldwide problem that can result from environmental, economic and medical conditions.
These nutrients aid weight gain after illness, repair damaged tissues and help replace the rapid turnover of cells intestine and immune cells. Managing severe acute malnutrition study session 10 managing severe acute malnutrition introduction. Management of severe acute malnutrition in children. Acutely malnourished children lack growth nutrients that are required to build new tissues. Successful management of the severely malnourished child does. The treatment and management of severe proteinenergy. Collins s, dent n, binn p, et al management of severe acute malnutrition in children. What is the right management of severe acute malnutrition. Pdf management of severe acute malnutrition researchgate. In children aged 659 months, an arm circumference less than 110 mm is also indicative of severe acute malnutrition. It is most often found in children who live in underdeveloped or poorly developed countries. Pdf severe acute malnutrition sam is defined as a weightforheight measurement of 70% or less below the median, or three sd or more below the mean. Management of severe acute malnutrition world health organization.
Successful management of the severely malnourished child requires that medical, nutritional and social problems be recognized and corrected. In the absence of standard protocols, mortality in children admitted to hospital with sam can range between 20 30% with the highest levels of 5060% among those with oedematous malnutrition. When a child or adult is severely malnourished, these organs do not function properly. Pdf management of severe acute malnutrition in children. Malnutrition is the end result of chronic nutritional and, frequently, emo. Management of severe acute malnutrition in children under. The brief focuses on current principles and approaches to moderate acute malnutrition mam management, highlighting key constraints, gaps.
Pdf management of severe and moderate acute malnutrition. Findings from this study suggest that effective management of paediatric severe acute malnutrition in the study setting is affected by a multiplicity of factors that manifest at different levels of the health system and the community. Severe acute malnutrition remains a major killer of children under five years of age. Experience from nongovernmental organizations suggests that this. The communitybased management of acute malnutrition cmam forum. Guidelines for the inpatient treatment of severely malnourished. The who estimates that over 460 million adults and 150 million children are undernourished. Severe malnutrition is both a medical and a social disorder.
Nutrition council snnc has developed national guidelines for management of severe and moderate acute malnutrition. Following this a book called caring for severely malnourished children 2003 by a. The objective of the rehabilitation phase in dietary management of severe acute. The moh recognizes that timely and effective management of acute malnutrition in. Patients with appetite and no medical complication or those completely recovered from any medical complication can be treated at home on an outpatient basis.
Imam stands for integrated management of acute malnutrition it is an integrated program to fight back against acute malnutrition. However, severe acute malnutrition sam is the most serious form in emergency settings causing high mortality and morbidity among children aged 659 months across the former 10. A verificatory study is encouraged to collaborate these findings. Sam management protocol available this time brought the approach from facilitybased to communitybased by outpatient therapeutic program otp. To begin effective management and treatment of malnutrition, certain criteria must be fulfilled to properly scope the degree of attention that an individual needs. Management of severe malnutrition world health organization. Management of severe and moderate acute malnutrition in children. The management of severe acute malnutrition sam is critical for child survival and is a key costeffective component of the scaling up nutrition framework for addressing undernutrition.
Standard procedure is to measure the midupper arm circumference. But, little was known about the treatment outcomes of the program in ethiopia. The recommended treatment protocol evolved from years of research in research departments, and its main points have circulated among nongovernmental organizations working in relief operations since 1993. These guidelines have been developed in collaboration with partners based on the who guidelines and experience within and outside the country. In the last session you learnt about the use of anthropometric indices to determine the nutritional status of women and children.
It is a nutritional program designed especially for children of 659 months of age and is a very important concept for management of malnutrition. Kzn guidelines on the integrated management of acute. Review management of severe acute malnutrition in children. Successful management of the severely malnourished patients requires that both medical and social. Severe acute malnutrition treatment usually starts with community health workers who can correctly identify samaffected children. Key messages of imam integrated management of acute. Recognition and management of malnutrition 8 daniel martinezgarcia md laurent hiffler,md teresa m. The contribution of severe acute malnutrition to the overall burden of childhood morbidity and mortality is enormous, with more than 20 million children with severe wasting worldwide, 1 an untold. Children in third world countries suffer from severe acute malnutrition sam in an extent of public health important. Additional guidance information can be found in these. Severe acute malnutrition pocket book of hospital care. The risk of mortality in acute malnutrition is directly related to severity. Help us improve the state of severe malnutrition website help us improve the state of severe malnutrition website. Management of severe acute malnutrition in lowincome and middleincome countries.
1127 96 612 1183 626 637 341 1238 633 1419 140 688 794 680 666 1298 240 38 1294 911 745 8 1463 808 598 546 132 538 165 1150 184 750 777 1008 920 885 1101