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International child health

G68. DETECTION OF SEVERE PROTEIN-ENERGY MALNUTRITION BY NURSES IN THE GAMBIA
C. Hamer, K. Kvatum, D. Jeffries, S. Allen.

Royal Victoria Hospital, Banjul, the Gambia, West Africa

Aim: To test whether nurses can use the WHO Integrated Management of Childhood Illness (IMCI) nutrition algorithm to identify reliably severe protein-energy malnutrition in children.

Methods: Nurses were trained to identify severe protein-energy malnutrition using IMCI training materials. They identified visible severe wasting and bipedal oedema, and categorized weight-for-age using a growth chart, in consecutive children attending outpatient clinics. Their findings were compared with weight-for-height Z (WHZ) score, bipedal oedema assessed by a trained observer and weight-for-age Z score.

Results: 352 children were recruited of whom 34 (9.7%) were severely wasted (WHZ score <-3) and 18 (5.1%) had bipedal oedema. In the detection of severe wasting, the nurses’ assessments showed 56% sensitivity, 95% specificity and 56% positive predictive value (PPV) and for bipedal oedema 22%, 99% and 57% respectively. Overall, the nurses identified only . . . [Full text of this article]

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