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J Trop Pediatr. 2008 Dec;54(6):364-9. doi: 10.1093/tropej/fmn029. Epub 2008 May 1.

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

Author information

1
Valid International Ltd., Unit 9, Standingford House, 26 Cave Street, Oxford OX4 1BA, UK. kate.sadler@tufts.edu

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.

PMID:
18450820
DOI:
10.1093/tropej/fmn029
[Indexed for MEDLINE]

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