Abstract
BackgroundSevere acute malnutrition (SAM) is a major global health problem affecting some 16.9 million children under five. Little is known about what happens to children 6–24 months post-discharge as this window often falls through the gap between studies on SFPs and those focusing on longer-term effects.MethodsA protocol was registered on PROSPERO (PROSPERO 2017:CRD42017065650). Embase, Global Health and MEDLINE In-Process and Non-Indexed Citations were systematically searched with terms related to SAM, nutritional intervention and follow-up between June and August 2017. Studies were selected if they included children who experienced an episode of SAM, received a therapeutic feeding intervention, were discharged as cured and presented any outcome from follow-up between 6–24 months later.Results3,691 articles were retrieved from the search, 55 full-texts were screened and seven met the inclusion criteria. Loss-to-follow-up, mortality, relapse, morbidity and anthropometry were outcomes reported. Between 0.0% and 45.1% of cohorts were lost-to-follow-up. Of those discharged as nutritionally cured, mortality ranged from 0.06% to 10.4% at an average of 12 months post-discharge. Relapse was inconsistently defined, measured, and reported, ranging from 0% to 6.3%. Two studies reported improved weight-for-height z-scores, whilst three studies that reported height-for-age z-scores found either limited or no improvement.ConclusionsOverall, there is a scarcity of studies that follow-up children 6–24 months post-discharge from SAM treatment. Limited data that exists suggest that children may exhibit sustained vulnerability even after achieving nutritional cure, including heightened mortality and morbidity risk and persistent stunting. Prospective cohort studies assessing a wider range of outcomes in children post-SAM treatment are a priority, as are intervention studies exploring how to improve post-SAM outcomes and identify high-risk children.
Highlights
Severe acute malnutrition (SAM) is a major public health problem, estimated to affect 16.9 million children under 5 across the globe in 2017, causing over 516,000 child deaths per year [1, 2]
There is a scarcity of studies that follow-up children 6–24 months post-discharge from SAM treatment
Prospective cohort studies assessing a wider range of outcomes in children post-SAM treatment are a priority, as are intervention studies exploring how to improve post-SAM outcomes and identify high-risk children
Summary
Severe acute malnutrition (SAM) is a major public health problem, estimated to affect 16.9 million children under 5 across the globe in 2017, causing over 516,000 child deaths per year [1, 2]. ‘uncomplicated’ SAM) to be managed as outpatients using Ready-to-Use Therapeutic Food (RUTF); and inpatient care for the much smaller number of children with additional medical complications [5, 6]. This ‘Community-Management of Acute Malnutrition’ (CMAM) model of care is cost-effective, allows for increased caseloads, and is supported by substantial evidence of having contributed to lower mortality rates from SAM [6,7,8,9]. Little is known about what happens to children 6–24 months postdischarge as this window often falls through the gap between studies on SFPs and those focusing on longer-term effects
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
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.
