PERSPECTIVE
Management of severe malnutrition
The management of severe malnutrition: taking a broader view
1 The School of Medicine, Swansea University, Swansea, UK
2 College of Medicine, University of Ibadan, Ibadan, Nigeria
Correspondence to:
Correspondence to:
Dr S Allen
The School of Medicine, Swansea University, Swansea, SA2 8PP, UK; s.j.allen@swansea.ac.uk
Perspective on the paper by Karaolis et al(see page 198)
| The first 150 words of the full text of this article appear below. |
The preventable, malnutrition-associated deaths of 5.6 million children each year is "a humanitarian disaster that cannot be allowed to continue".1 A recent update using data from 2001 and the disability-adjusted life year approach confirmed that undernutrition remains the single leading cause of health loss in the world today.2 Child underweight for age accounts for 8.7% of the total disease burden in people living in low- and middle-income countries, mainly countries in South Asia and sub-Saharan Africa. Specific micronutrient deficiencies are responsible for additional disease burdens.
Severe malnutrition is common in hospitals in economically poor countries. In a large study of children admitted to a rural district hospital in Kenya between 1999 and 2002, 16% (1282/8190) of children had severe wasting (weight-for-height z score 
–3), kwashiorkor or both. Children with severe wasting had a mortality rate of 19.9% compared with 4.4% among all admissions.3 Comparable data has
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