Abstract
Childhood malnutrition is a major public health concern, as it is associated with significant short- and long-term morbidity and mortality. The objective of this review was to comprehensively review the evidence for the management of severe acute malnutrition (SAM) and moderate acute malnutrition (MAM) according to the current World Health Organization (WHO) protocol using facility- and community-based approaches, as well as the effectiveness of ready-to-use therapeutic food (RUTF), ready-to-use supplementary food (RUSF), prophylactic antibiotic use, and vitamin A supplementation. We searched relevant electronic databases until 11 February 2019, and performed a meta-analysis. This review summarizes findings from a total of 42 studies (48 papers), including 35,017 children. Limited data show some benefit of integrated community-based screening, identification, and management of SAM and MAM on improving recovery rate. Facility-based screening and management of uncomplicated SAM has no effect on recovery and mortality, while the effect of therapeutic milk F100 for SAM is comparable to RUTF for weight gain and mortality. Local food and whey RUSF are comparable to standard RUSF for recovery rate and weight gain in MAM, while standard RUSF has additional benefits to CSB. Prophylactic antibiotic administration in uncomplicated SAM improves recovery rate and probably improves weight gain and reduces mortality. Limited data suggest that high-dose vitamin A supplementation is comparable with low-dose vitamin A supplementation for weight gain and mortality among children with SAM.
Highlights
Childhood undernutrition includes wasting (weight-for-height z-score (WHZ) < −2SD), stunting (height-for-age z-score (HAZ) < −2SD), underweight (weight-for-age z-score (WAZ) < −2SD), and micronutrient deficiencies or insufficiencies [1]
Findings from this review suggest that there are limited data comparing community-based management and facility-based management with other standard of care for severe acute malnutrition (SAM) or moderate acute malnutrition (MAM), suggesting some benefit of integrated community-based and outpatient management on improving recovery when compared to standard care and inpatient management
Evidence suggests that facility-based management of SAM with ready-to-use therapeutic food (RUTF) is similar to F100 on outcomes of weight gain and mortality
Summary
Childhood undernutrition includes wasting (weight-for-height z-score (WHZ) < −2SD), stunting (height-for-age z-score (HAZ) < −2SD), underweight (weight-for-age z-score (WAZ) < −2SD), and micronutrient deficiencies or insufficiencies [1]. The current World Health Organization (WHO) guidelines subsume these entities into the blanket term of childhood malnutrition, which is broadly categorized into acute and chronic malnutrition. Severe acute malnutrition (SAM) (WHZ < −3 and mid-upper arm circumference (MUAC)
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
