Children with Severe Malnutrition: Can Those at Highest Risk of Death Be Identified with the WHO Protocol?
Open Access
- 26 December 2006
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLoS Medicine
- Vol. 3 (12) , e500
- https://doi.org/10.1371/journal.pmed.0030500
Abstract
With strict adherence to international recommended treatment guidelines, the case fatality for severe malnutrition ought to be less than 5%. In African hospitals, fatality rates of 20% are common and are often attributed to poor training and faulty case management. Improving outcome will depend upon the identification of those at greatest risk and targeting limited health resources. We retrospectively examined the major risk factors associated with early (p < 0.0001). Conversely, the group of children without any of these seven features, or signs of dehydration, severe acidosis, or electrolyte derangements, had a low fatality (7%). Formal assessment of these features as emergency signs to improve triage and to rationalize manpower resources toward the high-risk groups is required. In addition, basic clinical research is necessary to identify and test appropriate supportive treatments.Keywords
This publication has 32 references indexed in Scilit:
- WHO guidelines for severe malnutrition: are they feasible in rural African hospitals?Archives of Disease in Childhood, 2007
- Intravenous Fluids — Getting the Balance RightNew England Journal of Medicine, 2005
- Extended-Interval Gentamicin Administration in Malnourished ChildrenJournal of Tropical Pediatrics, 2005
- Use of clinical syndromes to target antibiotic prescribing in seriously ill children in malaria endemic area: observational studyBMJ, 2005
- Bacteremia among Children Admitted to a Rural Hospital in KenyaNew England Journal of Medicine, 2005
- Iron Deficiency and Malaria among Children Living on the Coast of KenyaThe Journal of Infectious Diseases, 2004
- Understanding of informed consent in a low-income setting: three case studies from the Kenyan coastSocial Science & Medicine, 2004
- Improving the hospital management of malnourished children by participatory researchInternational Journal for Quality in Health Care, 2004
- Description of cause of serious illness and outcome in patients identified using ETAT guidelines in urban MalawiArchives of Disease in Childhood, 2001
- Sepsis syndrome and septic shock in pediatrics: Current concepts of terminology, pathophysiology, and managementThe Journal of Pediatrics, 1993