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Why have mortality rates for severe malnutrition remained so high?
1Centre for Human Nutrition, London School of Hygiene and Tropical Medicine, England.
Bulletin of the World Health Organization
|January 1, 1996
Summary
Severe malnutrition case fatality remains high at 20-30% due to flawed case management and inappropriate diets. Updated, practical treatment guidelines and training are crucial for reducing mortality in malnutrition cases.
Area of Science:
- Nutrition
- Pediatrics
- Public Health
Background:
- Severe malnutrition continues to have a high case fatality rate (20-30%) over the past five decades.
- Oedematous malnutrition presents the highest mortality risk (50-60%).
Purpose of the Study:
- To identify the causes of persistent high mortality in severe malnutrition.
- To evaluate current case-management practices in treatment centers worldwide.
Main Methods:
- Literature review spanning five decades.
- Survey of 79 malnutrition treatment centers globally.
Main Results:
- Inappropriate diets (high protein, energy, sodium; low micronutrients) are common for acutely ill children.
- Fatal practices, such as diuretic use for edema, are widespread.
- Outmoded and conflicting teaching manuals contribute to poor practices.
Conclusions:
- Faulty case management is a primary driver of high malnutrition mortality.
- Implementing updated, prescriptive treatment guidelines within comprehensive training programs is essential.
- Achieving lower mortality rates is possible with appropriate treatment regimens.