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. 2017 Oct;13(4):e12417.
doi: 10.1111/mcn.12417. Epub 2017 Feb 10.

Severe acute malnutrition in children aged under 5 years can be successfully managed in a non-emergency routine community healthcare setting in Ghana

Robert Akparibo  1 , Janet Harris  1 , Lindsay Blank  1 , Mike J Campbell  1 , Michelle Holdsworth  1
Affiliations

Severe acute malnutrition in children aged under 5 years can be successfully managed in a non-emergency routine community healthcare setting in Ghana

Robert Akparibo et al. Matern Child Nutr. 2017 Oct.

Abstract

This study investigated the performance of community-based management of severe acute malnutrition (CMAM) within routine healthcare services in Ghana. This was a retrospective cohort study of n = 488 children (6-59 months) who had received CMAM. Data for recovery, default, and mortality rates were obtained from enrolment cards in 56 outpatient centres in Upper East region, Ghana. Satisfactory rates of recovery of 71.8% were reported. Children who were enrolled with higher mid-upper arm circumference (MUAC) ≥11.5 cm had seven times greater chance of recovery compared with children who were enrolled with lower MUAC <11.5 cm, OR = 7.35, 95% CI [2.56, 21.15], p < .001. Children who were diagnosed without malaria at baseline were 30 times, OR = 30.39, 95% CI [10.02, 92.13], p < .001, more likely to recover compared with those with malaria (p < .001). The average weight gain was 4.7 g-1 ·kg-1 ·day-1 , which was influenced by MUAC status at baseline, β = .78, 95% CI [0.46, 1.00], p < .001, presence of malaria, β = -1.25, 95% CI [-1.58, 0.92], p < .001, and length of stay, β = 0.13, 95% CI [0.08, 0.18], p < .001. The default rate (28.5%) was higher than international standards recommendations by Sphere. Mortality rate (1.6%) was lower than international standards. Our findings suggest that community-based management of SAM can achieve similar success when delivered in routine non-emergency settings. However, this success can be diluted by a high default rate, and the factors contributing to this need to be explored to improve programme effectiveness within communities.

Keywords: Ghana; children; malnutrition; management; non-emergency; severe-acute.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
MUAC = mid‐upper arm circumference
See this image and copyright information in PMC

References

    1. Akparibo, R. (2013). Scaling up nutrition in Ghana. The Lancet global blog. October 14, 2013. Internet: http://globalhealth.thelancet.com/bloggers/robert-akparibo. (Accessed 4th May 2016).
    1. Amthor, R. E. , Cole, S. M. , & Manary, M. J. (2009). The use of home‐based therapy with ready‐to‐use therapeutic food to treat malnutrition in a rural area during a food crisis. Journal of the American Dietetic Association, 109(3), 464–467. - PubMed
    1. Barry, C. (2012). Regression analysis: Using stepwise regression to explain plan energy usage. Internet:http://blog.minitab.com/blog/real-world-quality-improvement/using-minita.... (Accessed 10 April, 2016).
    1. Black, R. E. , Allen, L. H. , Bhutta, Z. A. , Caulfield, L. E. , de Onis, M. , Ezzati, M. , … Rivera, J. (2008). Maternal and child undernutrition: Global and regional exposures and health consequences. Lancet, 371(9608), 243–260. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(07)61690-... - PubMed
    1. Black, R. E. , Victora, C. G. , Walker, S. P. , Bhutta, Z. A. , de Onis, M. , Ezzati, M. , … Uauy, R. (2013). Maternal and child nutrition study group. Maternal and child undernutrition and overweight in low‐oncome and middle‐income countries. Lancet, 382(9890), 427–451 .http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(13)60937-X.pdf - PubMed

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