CASE-MANAGEMENT OF SEVERE MALNUTRITION

Key words: Severe malnutrition, Hypoglycemia, Hypothermia, Sepsis, Micronutrients, Re-feeding formulas

Malnutrition contributes to almost 60% of deaths in under 5 children. Severe malnutrition can lead to death in over a third of affected children, while appropriate case-management can reduce the mortality to less than 10%. The main steps for effective case-management include: prevention, prompt recognition and treatment of hypoglycemia, hypothermia and electrolyte disturbances; cautious, preferably enteral rehydration with low-sodium high-potassium solutions when necessary; broad spectrum antibiotic therapy, micronutrient supplementation, frequent feeding with high calorie re-feeding formulas and psychosocial stimulation. The Author describes the main problems in the implementation of such a protocol in a tertiary care paediatric hospital in North-East Brazil.