Pediatr Gastroenterol Hepatol Nutr.  2012 Dec;15(4):210-219.

Community Management of Acute Malnutrition in the Developing World

• Park SE
• Kim S
• Ouma C
• Loha M
• Wierzba TF
• Beck NS

Abstract

Globally, acute malnutrition triggers more than 50% of childhood mortality in children under 5 years old, which implies that about 3.5 million children die of malnutrition each year. Prior to the advent of ready-to-use therapeutic food (RUTF), the management of acute malnutrition was limited to hospitals, resulting in low coverage rates with high mortality, as malnourished cases were indentified at later stages often plagued with complications. However, current availability of RUTF has enabled malnourished children to be treated at communities. Further, because RUTF is dehydrated and sealed, it has the added advantage of a lower risk of bacterial contamination, thereby prolonging its storage life at room temperature. Recent data indicate that Community Management of Acute Malnutrition (CMAM) is as cost effective as other high-impact public health measures such as oral rehydration therapy for acute diarrheal diseases, vitamin A supplementation, and antibiotic treatment for acute respiratory infections. Despite the high efficacy of CMAM programs, CMAM still draws insufficient attention for global implementation, suggesting that CMAM programs should be integrated into local or regional routine health systems. Knowledge gaps requiring further research include: the definition of practical screening criteria for malnourished children at communities, the need for systematic antibiotic therapy during malnutrition treatment, and the dietary management of severe malnutrition in children below 6 months of age.

Keyword

Severe acute malnutrition; Community Management of Acute Malnutrition; Ready-to-use therapeutic food; Developing countries

MeSH Terms

Child
Child Nutrition Disorders
Developing Countries
Fluid Therapy
Humans
Imidazoles
Malnutrition
Mass Screening
Nitro Compounds
Public Health
Respiratory Tract Infections
Vitamin A
Imidazoles
Nitro Compounds
Vitamin A

Figure

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  Fig. 1 Triage of children with acute malnutrition. Cited and modified from 'Community Based Therapeutic Care, A Field Manual, First Edition,Valid International 2006 (available online at http://www.fantaproject.org/downloads/pdfs/CTC_Manual_v1_Oct06.pdf).

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