Malnutrition Forum

The IMTF and Faculty of Medicine University of Southampton have developed an eLearning course titled "Caring for Infants and young children with severe malnutrition" based on the WHO recommended guidelines for the management of severe malnutrition. The course aims at providing a standardised and accessible resource that will facilitate the acquisition by health professionals of core competencies in the care and management young children with severe acute malnutrition.

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Indian Pediatrics has brought out a Special Issue (August 2010) on Severe Acute Malnutrition, which deliberates in detail on the global and national evidence relating to pertinent issues on this subject.

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A Workshop on Management of SAM Children through Medical Nutrition Therapy is being jointly organised in India by:

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The International Malnutrition Task Force (IMTF) for the prevention and control of malnutrition was launched in September 2005 in Durban at the 18th International Congress of Nutrition

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"India has asked UNICEF to stop distributing millions of dollars worth of nutrition aid to children, saying it had been done without permission and at the expense of local food to fight hunger," Reuters reports. Since August 2008, UNICEF has invested about $2.4 million importing "a high energy relief treatment known as 'Ready to Use Therapeutic Food' (RUTF)" for children with severe acute malnutrition in the states of Bihar and Madhya Pradesh, according to the news service (Williams, 8/4).

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UMESH KAPIL

This editorial discusses the issues surrounding Home-based management of Severe Acute Malnutrition with Ready-to-Use Therapeutic Food. It also outlines advantages of Home-Based against hospital-based management of SAM.

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Rahman A, Chowdhury S, Hossain

This study revealed that the prevalence of severe and moderate wasting were more common among children in Bangladesh, and the overall prevalence of acute malnutrition was about 10%, indicating that it is one of the major public health problems in the country.

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This study sought to compare the acceptability and energy intake of Ready-to-Use Therapeutic Food (RUTF) with cereal legume based khichri among malnourished children in urban low to middle socioeconomic neighborhoods in Delhi and concluded that RUTF and khichri were both well accepted by study children. The energy intake from RUTF was however higher due to its extra energy density.

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In India, 48% of children under five years of age are stunted and 43% are underweight: almost 8 million children suffer from Severe Acute Malnutrition.

Dr Prasad and colleagues are of the view that "the current thinking - that a centrally produced and processed Ready to use Therapeutic Foods should supplant the locally prepared indigenous foods in treating SAM - ignores the multiple causes of malnutrition and destroys the diversity of potential solutions based on locally available foods".

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ANN ASHWORTH Emeritus Professor of Community Nutrition

This editorial was on the paper by Hossain and colleagues regarding the effectiveness of treatment of severe malnutrition with locally adapted ICMH protocol using locally available foods.

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MM Hossain, MQ Hassan, MH Rahman, A KABIR, AH Hannan AND AKMF Rahman

In Bangladesh, Treatment of severe malnutrition with locally adapted ICMH protocol using locally available foods is as efficacious as the WHO protocol.

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Hossain MI, Dodd NS, Ahmed T, Miah GM, Jamil KM, Nahar B, Alam B, Mahmood CB. Journal of Health Popul Nutr. 2009 Feb;27(1):72-9

Experience in managing severe malnutrition in a government tertiary treatment facility in Bangladesh has demonstrated the potential of addressing severe acute malnutrition (with complications) effectively with minimum incremental expenditure in Bangladesh.

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In Bangladesh national guidelines for the case-management of severe acute malnutrition have been finalised.

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A review has taken place of the impact of the WHO inpatient guidelines on severely malnourished children in Asia.

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