Post discharge morbidities and mortalities among children with severe acute malnutrition who did not undergo nutrition rehabilitation

Research snapshot¹

A prospective study evaluated post-discharge morbidities among children with severe acute malnutrition (SAM), including diarrhoea and other acute illnesses, who did not undergo the nutrition rehabilitation (NR) phase of SAM management at Dhaka Hospital of International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b). NR follows the initial ‘stabilisation phase’ of World Health Organization (WHO)-recommended SAM treatment and provides energy-dense food to rebuild body tissues and achieve catch-up growth. The probable causes of not undergoing NR were family and other unavoidable commitments. Follow-up was undertaken between May and August 2014 of 90 children aged 6-59 months of both sexes suffering from SAM with associated morbidities who undertook the stabilisation phase of management but not NR. Three follow-up schedules were planned at two-week intervals (the second at the follow-up unit and the first and third over the phone). During the first follow-up, 37 of 70 (53%) reported various morbidities. Only seven children came for the second follow-up; all required hospitalisation for different morbidities. On third follow-up, 23 of 58 (40%) children reported morbidity. The odds of morbidities were 7.7 times higher (95% CI: 2.33–26.58, p<0.0001) among the children who came from a poor family (monthly income < USD127). Children with SAM and diarrhoea bypassing NR frequently suffered from different types of morbidities. The authors conclude that NR is an important component of the management of SAM and nutrition programmes in Bangladesh should consider including community-based management of acute malnutrition (CMAM) for the complete management of SAM in young children.