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Treating severe acute malnutrition seriously


Severe acute malnutrition (SAM) affects approximately 13 million children under the age of 5 and is associated with 1–2 million preventable child deaths each year. In most developing countries, case fatality rates (CFRs) in hospitals treating SAM remain at 20–30% and few of those requiring care actually access treatment. Recently, community-based therapeutic care (CTC) programmes treating most cases of SAM solely as outpatients have dramatically reduced CFRs and increased the numbers receiving care. CTC uses ready-to-use therapeutic foods and aims to increase access to services, promoting early presentation and compliance, thereby increasing coverage and recovery rates. Initial data indicate that this combination of centre-based and community-based care is cost effective and should be integrated into mainstream child survival programmes.

  • CFR, case fatality rate
  • CTC, community-based therapeutic care
  • IMCI, Integrated Management of Childhood Illness strategy
  • MoH, Ministry of Health
  • MUAC, middle upper arm circumference
  • NGO, non-governmental organisation
  • NRU, nutrition rehabilitation unit
  • OTP, outpatient treatment programme
  • RUTF, ready-to-use therapeutic food
  • SAM, severe acute malnutrition
  • SC, stabilisation centre
  • SFP, supplementary feeding programme
  • WFH, weight-for-height
  • acute malnutrition
  • CTC
  • SAM
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    BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health