Improving the management of severe acute malnutrition in an area of high HIV prevalence.

Abstract:

AIM:To assess the clinical outcomes of a combined approach to the treatment of severe acute malnutrition in an area of high HIV prevalence using: (i) an initial inpatient phase, based on WHO guidelines and (ii) an outpatient recovery phase using ready-to-use therapeutic food. METHODS:An operational prospective cohort study implemented in a referral hospital in Southern Malawi between May 2003 and 2004. Patient outcomes were compared with international standards and with audits carried out during the year preceding the study. RESULTS:Inpatient mortality was 18% compared to 29% the previous year. Programme recovery rate was 58.1% compared to 45% the previous year. The overall programme mortality rate was 25.7%. Of the total known HIV seropositive children, 49.5% died. CONCLUSIONS:Inpatient mortality and cure rates improved compared to pre-study data but the overall mortality rate did not meet international standards. Additional interventions will be needed if these standards are to be achieved.

journal_name

J Trop Pediatr

authors

Sadler K,Kerac M,Collins S,Khengere H,Nesbitt A

doi

10.1093/tropej/fmn029

subject

Has Abstract

pub_date

2008-12-01 00:00:00

pages

364-9

issue

6

eissn

0142-6338

issn

1465-3664

pii

fmn029

journal_volume

54

pub_type

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