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

Abstract

To 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. Social, 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. In 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. Short-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.