MANAGEMENT OF CHILDREN WITH SEVERE ACUTE MALNUTRITION; EXPERIENCE OF A NUTRITION REHABILITATION CENTER FROM INDORE

Dr. Sudhir Mehta*

ABSTRACT

Background: Severe acute malnutrition, defined as weight for height <-3 SD or weight for height <-2 SD with mean upper arm circumference (MUAC) of less than 11.5 cm or bilateral pedal edema as per WHO. These children presents with various complications, which are managed following the WHO guidelines for management of SAM. Material and methods: Total 200 children of SAM aged between 6 months to five years were admitted during October 2012 to December 2013 in the nutrition rehabilitation center of this medical institute. Of them majority were aged less than 18 months. All patients stayed for inpatients treatment of 14 days. Reasons for bringing children to the hospital were associated major illnesses & associated co morbidities observed were bronchopneumonia followed by acute gastroenteritis. Observed complications of SAM in our study were some and severe dehydration were (20%), hypoglycemia (10%), hypothermia (10%), hyponatremia (9%), hypokalemia (8%), hypernatremia (8%), hyperkalemia (4%), septic shock (4%), severe anemia (60%). Results: Majority of patients(60%)had good weight gain > 10g/kg/day, 20% had moderate weight gain of 5-10 gm/kg/day and 20% had poor weight gain of less than 5gm/kg/day. for height between 61-70% on admission and between 71-80% on discharge. Case fatality rate in our study was only 1%. Conclusion: In patient management of children of severe acute malnutrition with complications as per WHO’s protocol leads to overall decrease in case fatality.

Keywords: Severe acute malnutrition (SAM), WHO protocol, Nutrition rehabilitation center.