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PHM Focus

Schedule at a Glance

Managing Childhood Severe Acute Malnutrition - Globally and in Your Own Backyard

Primary Leader:
Sarah White

Co-Leaders:
Mark Corden
Parminder Suchdev

Objective 1:
1. State the criteria for admission to a therapeutic feeding center including outpatient management with ready-to-use therapeutic food (i.e. Plumpy-Nut).

Objective 2:
2. Describe the phases of treatment as well as recognition and prevention of refeeding syndrome.

Objective 3:
3. Compare and contrast the approach to fluid management in children with severe acute malnutrition versus well-nourished children.

Summary:
It is estimated that 13 million children around the globe suffer from severe acute malnutrition (SAM), as defined by weight-for-height z-score below -3, a mid-upper arm circumference of <115mm or the presence of nutritional edema. SAM is responsible for 1-2 million preventable deaths per year and contributes to an estimated 30% of deaths in children under five-years-old. Given its prevalence globally, familiarity with SAM treatment is important because standard management has been shown to reduce mortality. With the implementation of World Health Organization (WHO) guidelines for the treatment of malnutrition, the mortality rate of SAM has decreased from 30% of cases in 1999 to as low as 5% by some estimates. Using a case-based and interactive approach, this topic presentation will summarize the updated 2013 WHO guidelines, focusing on management in the inpatient setting. Our discussion will include caloric advancement, fluid management, recognition and prevention of refeeding syndrome, the role of antibiotics in treating malnutrition and micronutrient deficiencies commonly seen with SAM.