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Severe malnutrition children

Hayley K Hutton, Heather J Zar, Andrew C Argent
Aim: Severe acute lower respiratory tract infection (ALRTI) remains an important cause of childhood morbidity and mortality. Methods: This is a 12-month retrospective cohort study of children (0-12 years) admitted to a pediatric intensive care unit (PICU) with ALRTI to investigate risk factors, clinical course and in-hospital survival. Results: In total, 265 patients (median age = 4 months [2-12 months]) were identified. In all,102 (38...
March 9, 2018: Journal of Tropical Pediatrics
Joe D Piper, Salim Mwarumba, Moses Ngari, Benedict Mvera, Susan Morpeth, James A Berkley
For children with acute malnutrition, ready-to-use therapeutic foods (RUTF) are lifesaving treatments. In 2012, detailed testing detected Enterobacteriaceae including Cronobacter species at low levels in RUTF from all UNICEF-approved producers. Cronobacter in milk feeds has previously been associated with severe neonatal infections. Thus, given the susceptibility of severely malnourished children to invasive bacterial infections, concerns arose about the potential for Cronobacter infections from RUTF. This led to widespread production and supply problems in emergency feeding programmes...
March 13, 2018: Paediatrics and International Child Health
Aparna Ruia, Rajul Kumar Gupta, Gargi Bandyopadhyay, Rajshree R Gupta
Background: Good economic growth is considered synonymous with good nutrition. In recent past, some states (like Bihar and Gujarat) have seen unprecedented economic growth. Despite this and introducing plethora of programs (including integrated child development scheme [ICDS]) to reduce malnutrition, one state might be performing well in reducing malnutrition whereas other with equally high economic growth rate might lag behind. Is mere economic growth good enough to alleviate malnutrition? Objectives: The aim of the article is to document a critical comparative analysis of malnutrition with special emphasis on ICDS (with respect to finances, infrastructure, training, performance) in the two economically resurgent states of Gujarat and Bihar...
January 2018: Indian Journal of Community Medicine
Charu C Garg, Sarmila Mazumder, Sunita Taneja, Medha Shekhar, Sanjana Brahmawar Mohan, Anuradha Bose, Sharad D Iyengar, Rajiv Bahl, Jose Martines, Nita Bhandari
Trial design: Three feeding regimens-centrally produced ready-to-use therapeutic food, locally produced ready-to-use therapeutic food, and augmented, energy-dense, home-prepared food-were provided in a community setting for children with severe acute malnutrition (SAM) in the age group of 6-59 months in an individually randomised multicentre trial that enrolled 906 children. Foods, counselling, feeding support and treatment for mild illnesses were provided until recovery or 16 weeks. Methods: Costs were estimated for 371 children enrolled in Delhi in a semiurban location after active survey and identification, enrolment, diagnosis and treatment for mild illnesses, and finally treatment with one of the three regimens, both under the research and government setting...
2018: BMJ Global Health
Catherine E Oldenburg, Philippe J Guerin, Fatou Berthé, Rebecca F Grais, Sheila Isanaka
Background: The relationship between malaria infection and nutritional status is complex and previous studies suggest malaria may increase the incidence and severity of malnutrition while malnutrition may increase the risk of malaria infection. Here, we report bi-directional associations between malaria and nutritional status among children with uncomplicated severe acute malnutrition (SAM). Methods: The present study is a secondary analysis of a randomized controlled trial for the treatment of uncomplicated SAM in Niger...
March 7, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Anija Orel, Matjaz Homan, Rok Blagus, Evgen Benedik, Rok Orel, Natasa Fidler Mis
Background: Commercial enteral formulas are generally recommended for gastrostomy feeding in patients with severe neurologic impairment. However, pureed food diets are still widely used and even gaining popularity among certain groups. We tried to compare the effectiveness of gastrostomy feeding for treatment of severe malnutrition with either enteral formulas or pureed feeds. Patients and methods: A 6-month nutritional intervention was made with 37 malnourished children, adolescents and young adults (2-26 years old) with severe neurologic impairment (Gross Motor Function Classification system [GMFCS] grade V)...
March 2018: Radiology and Oncology
Lisa Frigati, Moherdran Archary, Helena Rabie, Martina Penazzato, Nathan Ford
Early mortality and morbidity remain high in children initiating antiretroviral therapy (ART), especially in sub-Saharan Africa. Many children still present with advanced human immunodeficiency virus (HIV) disease. Tuberculosis, pneumonia, and severe bacterial infections are the main causes of hospital admission in HIV-infected children. In contrast to adults with advanced HIV disease, cryptococcal disease is not common in childhood, although there is a peak in infancy and adolescence. Interventions such as TB screening in symptomatic children, and isoniazid and cotrimoxazole prophylaxis should be implemented...
March 4, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Deepak Dwivedi, Surendra Singh, Jyoti Singh, Naresh Bajaj, Harendra Pratap Singh
OBJECTIVE: This cross sectional study was done to assess the developmental status in children (6-30 mo old) with severe acute malutrition (SAM). METHODS: Study subjects were enrolled from children in SAM therapeutic unit, and controls were selected from well-baby clinic of the institute. Neurodevelopment of both groups was assessed using the Developmental assessment scale of Indian infants (DASII). Developmental quotient (DQ) ≤70 was considered delayed. RESULTS: Mean (SE) motor DQ 59...
February 15, 2018: Indian Pediatrics
Marta Farràs, Kanta Chandwe, Jordi Mayneris-Perxachs, Beatrice Amadi, John Louis-Auguste, Ellen Besa, Kanekwa Zyambo, Richard Guerrant, Paul Kelly, Jonathan Richard Swann
BACKGROUND: Environmental enteric dysfunction (EED) is widespread throughout the tropics and in children is associated with stunting and other adverse health outcomes. One of the hallmarks of EED is villus damage. In children with severe acute malnutrition (SAM) the severity of enteropathy is greater and short term mortality is high, but the metabolic consequences of enteropathy are unknown. Here, we characterize the urinary metabolic alterations associated with villus health, classic enteropathy biomarkers and anthropometric measurements in severely malnourished children in Zambia...
2018: PloS One
Bishwajit Ghose, Sanni Yaya
Background: Anemia is the most widely prevalent form of micronutrient deficiency that affects over a quarter of the global population. Evidence suggests that the burden of anemia is higher in the developing countries with women of reproductive age and children being the most at-risk groups. The most common causes are believed to be malnutrition and low bioavailability of micronutrients, which usually result from poor dietary habits and inadequate intake of food rich in micronutrients such as fresh fruits and vegetables...
2018: PeerJ
Misbah Anjum, Khemchand N Moorani, Bilquis Naeem, Shazia Kulsoom, Ashfaq Ahmed Memon
Objectives: First objective was to compare eGFR by Updated Schwartz (US) and Simple Height Independent (SHID) formula with Original Schwartz (OS) in children with Severe Acute Malnutrition (SAM). The second objective was to compare eGFR in children below and above two years. Methods: This analytic study on estimation of GFR was based on retrospective data collected from 78 children with SAM at Nutritional Rehabilitation Unit from October 2014 - March 2015. Glomerular filtration rate was calculated using serum creatinine (S...
November 2017: Pakistan Journal of Medical Sciences Quarterly
Mathias Altmann, Chiara Altare, Nanette van der Spek, Jean-Christophe Barbiche, Jovana Dodos, Mahamat Bechir, Myriam Ait Aissa, Patrick Kolsteren
Water, sanitation and hygiene (WASH) interventions have a small but measurable benefit on stunting, but not on wasting. Our objective was to assess the effectiveness of a household WASH package on the performance of an Outpatient Therapeutic feeding Program (OTP) for severe acute malnutrition (SAM). We conducted a cluster-randomized controlled trial embedded in a routine OTP. The study population included 20 health centers (clusters) from Mao and Mondo districts in Chad. Both arms received the OTP. The intervention arm received an additional household WASH package (chlorine, soap, water storage container, and promotion on its use)...
February 26, 2018: American Journal of Tropical Medicine and Hygiene
Angeline Grant, James Njiru, Edgar Okoth, Imelda Awino, André Briend, Samuel Murage, Saida Abdirahman, Mark Myatt
Background: A novel approach for improving community case-detection of acute malnutrition involves mothers/caregivers screening their children for acute malnutrition using a mid-upper arm circumference (MUAC) insertion tape. The objective of this study was to test three simple MUAC classification devices to determine whether they improved the sensitivity of mothers/caregivers at detecting acute malnutrition. Methods: Prospective, non-randomised, partially-blinded, clinical diagnostic trial describing and comparing the performance of three "Click-MUAC" devices and a MUAC insertion tape...
2018: Archives of Public Health, Archives Belges de Santé Publique
Heitor Pons Leite, Lúcio Flávio Peixoto de Lima, José Augusto de A C Taddei, Ângela Tavares Paes
OBJECTIVE: To test the hypothesis that low blood thiamine concentrations in malnourished critically ill children are associated with higher risk of 30-d mortality. METHODS: Prospective cohort study in 202 consecutively admitted children who had whole blood thiamine concentrations assessed on admission and on days 5 and 10 of intensive care unit (ICU) stay. The primary outcome variable was 30-d mortality. Mean blood thiamine concentrations within the first 10 d of ICU stay, age, sex, malnutrition, C-reactive protein concentration, Pediatric Index of Mortality 2 score, and severe sepsis/septic shock were the main potential exposure variables for outcome...
December 7, 2017: Nutrition
Etienne Nel
PURPOSE OF REVIEW: Advances in our understanding of the treatment of severe acute malnutrition (SAM) in a resource-limited environment are needed to improve outcome. RECENT FINDINGS: Ready-to-use therapeutic foods (RUTFs) made from local products and with reduced milk content lower costs and may be effective in older children. None of the therapeutic foods used to treat severely malnourished children correct long chain polyunsaturated fatty acid deficiencies.Routine short-term antibiotic (amoxicillin) treatment, in the context of adequate healthcare supervision, does not improve the recovery rate...
February 15, 2018: Current Opinion in Clinical Nutrition and Metabolic Care
Eleanor Rogers, Karen Martínez, Jose Luis Alvarez Morán, Franck G B Alé, Pilar Charle, Saul Guerrero, Chloe Puett
BACKGROUND: The Malian Nutrition Division of the Ministry of Health and Action Against Hunger tested the feasibility of integrating treatment of severe acute malnutrition (SAM) into the existing Integrated Community Case Management package delivered by community health workers (CHWs). This study assessed costs and cost-effectiveness of CHW-delivered care compared to outpatient facility-based care. METHODS: Activity-based costing methods were used, and a societal perspective employed to include all relevant costs incurred by institutions, beneficiaries and communities...
February 20, 2018: Human Resources for Health
Andrea L Conroy, Michael T Hawkes, Robyn Elphinstone, Robert O Opoka, Sophie Namasopo, Christopher Miller, Chandy C John, Kevin C Kain
BACKGROUND: Chitinase-3-like 1 (CHI3L1) is a glycoprotein elevated in paediatric severe malaria, and an emerging urinary biomarker of acute kidney injury (AKI). Based on the hypothesis that elevated CHI3L1 levels in malaria are associated with disease severity, the relationship between plasma CHI3L1 levels, AKI and mortality was investigated in Ugandan children enrolled in a clinical trial evaluating inhaled nitric oxide (iNO) as an adjunctive therapy for severe malaria. METHODS: Plasma CHI3L1 levels were measured daily for 4 days in children admitted to hospital with severe malaria and at day 14 follow up...
February 15, 2018: Malaria Journal
Mulugeta Yohannis Kabalo, Bereket Yohannes
OBJECTIVES: Severely undernourished young children clinically present with a typical nutritional oedema or none-oedematous. However, research evidence is limited on how these types predict treatment outcomes in Ethiopia. This study was aimed to compare oedematous and none-oedematous children for their treatment outcomes in Boloso Sore district in Southwest Ethiopia. RESULTS: The overall recovery rate was 396 (68%). From oedematous children; 235 (79.9%) recovered, 18 (6...
February 9, 2018: BMC Research Notes
Moise Muzigaba, Brian Van Wyk, Thandi Puoane
BACKGROUND: Despite the widespread implementation of the World Health Organization (WHO) guidelines for the management of severe malnutrition in South Africa, poor treatment outcomes for children under 5 years are still observed in some hospitals, particularly in rural areas. OBJECTIVE: To explore health care workers' perceptions about upstream and proximal factors contributing to poor treatment outcomes for severe acute malnutrition in two district hospitals in South Africa...
January 30, 2018: African Journal of Primary Health Care & Family Medicine
Julie Jesson, Désiré L Dahourou, Madeleine Amorissani Folquet, Karen Malateste, Caroline Yonaba, Marie-Sylvie N'Gbeche, Sylvie Ouédraogo, Véronique Mea-Assande, Clarisse Amani-Bossé, Stéphane Blanche, Marguerite Timité-Konan, Valériane Leroy
BACKGROUND: There is limited information about malnutrition, growth evolution and metabolic changes among children initiated early on lopinavir-based antiretroviral therapy (ART) in Africa. METHODS: HIV-1-infected children, age <2 years were initiated on ART, as part of the MONOD ANRS 12206 project, conducted in Burkina Faso and Côte d'Ivoire. Weight-for-age, height-for-age and weight-for-height Z-scores (WAZ, HAZ, WHZ) defined malnutrition (Z-score <-2 standard deviations [SD]) using WHO growth references...
February 3, 2018: Pediatric Infectious Disease Journal
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