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Apr 5, 2016 · Each year, approximately 5.9 million children around the world die before their fifth birthday (You and others 2015). The leading killers are prematurity and pneumonia, responsible for 17.8 percent and 15.5 percent of all deaths in this age group, respectively (Liu and others 2014, 2016). Degrees of malnutrition are associated with increased risk of all-cause mortality and increased risk of ...
- Box 11.1
Box 11.1 Key Priorities for Enhancing Effectiveness of...
- Table 11.3
Child with SAM has a recent history of diarrhea, vomiting,...
- Figure 11.1
Reproductive, Maternal, Newborn, and Child Health: Disease...
- Box 11.1
Over 17 million children are affected by severe acute malnutrition (SAM) worldwide. Despite significant progress in recent years, approximately 2.9 million children accessed treatment in 65 countries in 2013 – only about 17 percent of the children needing treatment. Children with SAM are nine times more likely to die than well-nourished children.
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3 days ago · All infants under six months with SAM need to be treated in an in-patient facility. The presence of medical complications, including general danger signs, or failing the appetite test means that a severely malnourished child should be classified as severe complicated malnutrition and referred to an in-patient facility.
- Introduction
- (Outpatient Care Follow-On Sessions: Steps 1-15 [except 6] are repeated)
- Child Receives Treatment in Outpatient Care
- 4) Common Supplementary Medicines for SAM in Outpatient Care*
- PARACETAMOL DOSAGES
- EXIT CATEGORIES FOR CMAM
- STABILISATION PHASE REHABILITATION PHASE STEP Days 1-2 Days 3-7 Weeks 2-6
- Giving medications to children with SAM and medical complications
- Routine medicines for inpatient care
- De-worming
- Vitamin A
- Immunizations
- B. SFPs in the Context of CMAM
- D. Where There Is No SFP
- Children 6-59 months:
This document introduces the concept and protocols used in outpatient and inpatient care for children with severe acute malnutrition (SAM) without medical complications as well as with medical complications. It provides an overview of admission and discharge processes and criteria, medical treatment and nutrition rehabilitation in outpatient care. ...
Sugar water given Bilateral pitting oedema checked Anthropometry checked: MUAC measured Weight measured Length or height measured; WFH verified* Nutritional status recorded DECISION whether child IS ADMITTED FOR SAM or REFERRED FOR MAM OR OTHER (In outpatient care follow-on sessions: progress of nutritional status monitored) Registration ...
Routine medication given upon admission (In outpatient care
Source: Community-based Therapeutic Care (CTC): *These are recommendations based on international protocols, but all drugs and dosing must be linked to national protocols and essential drug lists where available for treatment of acute malnutrition
For severely malnourished children, use for symptomatic treatment of fever but with extreme caution. Give one-time treatment only and start an antibiotic or antimalarial immediately. Monitor the child; if the fever is 39° C or greater, refer him/her to inpatient care where possible. If inpatient care is not available, give a single dose of paraceta...
Inpatient Care for the Management of SAM with Medical Complications.
Hypoglycaemia Hypothermia Dehydration Electrolytes Infection Micronutrients Cautious feeding Catch-up growth Sensory stimulation Prepare for follow-up no iron with iron
The use of IV lines is strictly avoided except in case of septic shock or septicemia. Special care with intramuscular injections is taken as children with SAM have reduced muscle mass and the risk of nerve damage is high. Before prescribing/administering any drug it is important to: Check standard dosages with national (WHO) guidelines for SAM Ch...
On admission, routine medicines should be given to the child as per national protocols where available. Note: Children who have been transferred from outpatient care should not receive routine medications that have already been administered before
Give a single dose of Mebendazole (or Albendazole) when the child progresses from transition to rehabilitation phase. If the child is referred earlier to outpatient care, de-worming drugs should be given on arrival.
Because of its toxicity and the considerable amount available in RUTF, routine vitamin A is only given in a single dose on the day of discharge from the full therapeutic treatment. This usually happens in outpatient care, thus in inpatient care only children completing their full rehabilitation in inpatient care should receive vitamin A (unless tre...
Check immunization status of the child upon admission ac-cording to the standard immunization schedule, especially immunization for measles.
In emergencies where the population depends on external food assistance, a general ration for the whole population is a priority to reach the maximum number of children. Normally, SFPs should not be set up before a general ration is in place. Also in an emergency, SFPs (to manage MAM in children) should be prioritized over CMAM outpatient care and ...
In some situations, no SFP is available. This is likely to be the case when outpatient care is part of routine health care in non-emergency situations or in a food-secure environment. In non-emergency situations, some form of supplementary feeding for the management of MAM might be part of child survival interventions or a national programme. For e...
Routine supplementation should be given on admission except where Vitamin A has been given in the past 4 months or health campaigns have ensured good coverage. Children referred from outpatient care, inpatient care or other health facility where Vitamin A has already been given should not be given Vitamin A. Children showing clinical signs of V...
Children with SAM who do not respond to treatment by day 4 after admission require additional investigation (of case management practices, for suspect TB and HIV, etc.) In areas with outpatient treatment of SAM at health centers or hospitals, children with SAM without complications can be treated as an outpatient at the closest facility.
29 (81%) had specific sections focusing on infant <6m SAM; total page space of guidelines devoted to infants <6m ranged from 1% to 19%, mean 6%; all 29/29 guidelines recommended inpatient treatment – one distinguished between clinically complicated and uncomplicated SAM, as they do for older children;
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Dec 26, 2012 · infants aged <6 months. Of 20 million children under 5 years with SAM worldwide, 3.8 million are infants. To better manage and improve outcomes for infants aged under 6 months old (0–5.9 months) (infants <6m) SAM, a better evidence base regarding treatment for this group is needed. This review seeks to fill that evidence gap. Methods We ...
