1. Improving the Management of Severe Acute Malnutrition in an Area of High HIV Prevalence
- Author
-
Anne Nesbitt, Hilda Khengere, Kate Sadler, Steve Collins, and Marko Kerac
- Subjects
Male ,Malawi ,Pediatrics ,medicine.medical_specialty ,Referral ,Severe Acute Malnutrition ,Population ,Cohort Studies ,HIV Seroprevalence ,Risk Factors ,HIV Seropositivity ,Outpatients ,Prevalence ,Humans ,Medicine ,Community Health Services ,Prospective Studies ,Prospective cohort study ,education ,Inpatients ,education.field_of_study ,business.industry ,Mortality rate ,Malnutrition ,medicine.disease ,Treatment Outcome ,Infectious Diseases ,Clinical research ,Therapeutic food ,Child, Preschool ,Kwashiorkor ,Child Mortality ,Food, Fortified ,Pediatrics, Perinatology and Child Health ,Female ,business - 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.
- Published
- 2008
- Full Text
- View/download PDF