Hospital based nutrition rehabilitation of severely undernourished children using energy dense local foods

Mamidi, Raja Sriswan; Kulkarni, Bharati; Radhakrishna, K. V.; Shatrugna, Veena

doi:10.1007/s13312-010-0101-7

Cited by 39 publications

(42 citation statements)

References 10 publications

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“…High defaulter rates have been reported in India by other facility-based interventions for children with SAM, where only one out of five children admitted stayed for the prescribed duration of treatment (15) . The proportion of children who reached the programme discharge criteria (81?0 %) compares favourably with national and international standards of care (.75 %) (12,13) ; however, only 39?4 % of the discharged children gained 15 % or more of their initial weight, the minimum weight gain recommended globally by WHO to discharge children as recovered (14) .…”

Section: Betweenmentioning

confidence: 94%

Providing care for children with severe acute malnutrition in India: new evidence from Jharkhand

Aguayo

Jacob

Badgaiyan

et al. 2012

Public Health Nutr.

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Objective: To assess the effectiveness of facility-based care for children with severe acute malnutrition (SAM) in malnutrition treatment centres (MTC). Design: Early detection and treatment of SAM using locally adapted protocols; assessment of programme outcomes, including survival, default, discharge and recovery rates. Setting: All forty-eight MTC in Jharkhand, India. Subjects: Children (n 3595) with SAM admitted to MTC (1 July 2009-30 June 2011). Results: Of children admitted, 55?0 % were girls, 77?7 % were 6-23 months old and 68?6 % belonged to scheduled tribes or castes; 34?4 % had oedema or medical complications. Of the 3418 programme exits, the proportion of children who died was 0?6 % (n 20), the proportion of children who defaulted was 18?4 % (n 628) and the proportion of children discharged was 81?0 % (n 2770). Children's average weight gain was 9?6 (SD 8?4) g/kg body weight per d and their average length of stay was 16?0 (SD 5?7) d. Among the 2770 children who were discharged from the programme, 39?4 % (n 1090) gained 15 % or more of their initial weight while 60?6 % (n 1680) gained less than 15 % of their initial weight. Conclusions: MTC provide live-saving care for children with SAM as demonstrated by high survival rates. However, the protocols and therapeutic foods currently used need to improve to ensure the recovery of all discharged children. MTC should be reserved for children with complicated SAM; children with uncomplicated SAM should be admitted to a community-based programme for the management of SAM, at a lesser risk to children and a lesser cost to families and the health system.

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Section: Betweenmentioning

confidence: 94%

Providing care for children with severe acute malnutrition in India: new evidence from Jharkhand

Aguayo

Jacob

Badgaiyan

et al. 2012

Public Health Nutr.

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“…Mean weight gain of patients during admission in MTC was 12.12±7.67gm/kg/day. Mamidi et al 6 also reported in their study that mean duration of stay of non-oedematous patients was 26 ± 20 days and mean weight gain of admitted patients was 5gm/kg/day. Eight percent children did not gain weight, 44% children had poor catch up growth (<5g/kg/day), 35% children had moderate catch up growth (5-10g/kg/day) and 12% had rapid catch-up growth (>10g/kg/day).…”

Section: Discussionmentioning

confidence: 81%

“…Such pattern is expected since growth rates are much higher in the first two to three years of life compared to the next two years. 6 Apart from the age factor, the severity of wasting is known to influence the rate of weight gain. In our study, overall weight gain of those patients who had weight for height Z score (WHZ) >-4 SD was more as compared to patients who had WHZ >-3SD to <-4SD but the difference was not statistically significant (p>0.05).…”

Section: Discussionmentioning

confidence: 99%

Treatment outcome in patients with severe acute malnutrition managed with protocolised care at malnutrition treatment corner in Rajasthan, India: a prospective observational study (quasi-experimental)

Nagar¹,

Nagar²,

Bd³

2016

Int J Res Med Sci

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“…A retrospective study at NIN analyzed hospital records of children admitted to nutrition ward during the period of January 2001 to December 2005 (Mamidi et al, 2010). Data was available on 309 children, who stayed in the nutrition ward for > 7 days.…”

Section: Nin Experience Of Hospital-based Management Of Children Withmentioning

confidence: 99%

“…Another study from this centre on the children treated with the local foods assessed the composition of weight gain (i.e. fat and lean mass) in these children (Radhakrishna et al, 2010). The study was carried out to address the concerns that rapid catch up growth during nutrition rehabilitation of severely malnourished children may be associated with disproportionately higher amounts of body fat deposition.…”

Section: Nin Experience Of Hospital-based Management Of Children Withmentioning

confidence: 99%

Management of SAM and MAM

Kulkarni¹

2016

Proceedings of the Indian National Science Academy

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Moderate acute malnutrition (MAM) i.e. weight for height z-score (WHZ) between -2 and -3 and severe acute malnutrition (SAM) i.e. WHZ score <-3 in children have serious consequences, contributing to increased morbidity and mortality, and require targeted interventions. Children with SAM and associated medical complications are at high risk of mortality and need facility-based management. The paper describes the guidelines by World Health Organization (WHO) and Indian Academy of Paediatrics (IAP) for inpatient and community based management of SAM. Experience of nutrition rehabilitation at National Institute of Nutrition, Hyderabad, has shown that it is possible to treat SAM children using local foods. A few studies that have also assessed the effectiveness of the Ready to Use Therapeutic Foods (RUTF) for the management of SAM in Indian settings have shown low mortality and high cure rates in non-defaulting children. More evidence on the costeffectiveness and sustainability of this intervention is, however, required. The prevalence of MAM is much larger than that of SAM and children with MAM are also vulnerable to enhanced risk of mortality and morbidity. WHO has recommended that children with MAM should receive nutrient-dense foods to meet their extra needs for weight gain, height gain and functional recovery; however, there is no definitive consensus on the most effective way to treat children with MAM. Finally, prevention of acute malnutrition requires a far wider spectrum of interventions beyond clinical management and need to focus on multi-sectoral actions.

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Hospital based nutrition rehabilitation of severely undernourished children using energy dense local foods

Cited by 39 publications

References 10 publications

Providing care for children with severe acute malnutrition in India: new evidence from Jharkhand

Providing care for children with severe acute malnutrition in India: new evidence from Jharkhand

Treatment outcome in patients with severe acute malnutrition managed with protocolised care at malnutrition treatment corner in Rajasthan, India: a prospective observational study (quasi-experimental)

Management of SAM and MAM

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