Aims The Emergency, Triage, Assessment and Treatment plus Admission (ETAT+) course has incorporated the World Health Organization’s (WHO) 10 steps for the management of malnutrition.^{1 2} The ETAT+ course was implemented in two urban Rwandan hospitals. A tertiary hospital from October 2010 and a district hospital from March 2011. The aim of this audit was to assess if the teaching and implementation of the ETAT+ course has successfully reduced mortality rates in in children (between 2 months and 5 years of age) with malnutrition.

Methods The medical records, discharge summaries, and death certificates of all the 429 children with malnutrition, admitted to these two hospitals between March 2008 and November 2011 were retrospectively reviewed and analysed using SPSS.

Results We reviewed the notes of 337 children pre ETAT+ of whom 37 died (11%) compared with 84 post-ETAT of whom 2 died (2.4%).

(Pearson Chi-squared, p = 0.03, though this has reduced power due to values of less then 5 in the boxes marked with *)

Conclusions Though these results are limited by the relatively small number of children in the post-intervention group and the lack of a control hospital (without ETAT+ intervention) they do provide evidence that the mortality rate in children with malnutrition has reduced since the implementation of the ETAT+ course.