子どもにおける重度の急性栄養失調の管理
Steve Collins1, Nicky Dent, Paul Binns
1Valid International Ltd, Oxford, UK. steve@validinternational.org
Lancet (London, England)
|December 5, 2006
まとめ
コミュニティベースの治療ケアは,重度の急性栄養失調 (SAM) を治療するための費用対効果の高い戦略を提供します. このアプローチは,子どもの死亡率を大幅に削減し,外科医として症例を管理することで,治療の範囲を拡大します.
科学分野:
- 小児科は小児科です.
- 公衆衛生は公衆衛生である.
- 栄養科学 栄養学 栄養科学は,栄養学が,栄養学が,栄養学が,栄養学が,栄養学が,栄養学が,栄養学が,栄養学が,栄養学が,栄養学が,栄養学は,栄養学が,栄養学は,栄養学は,栄養学は,栄養学は,栄養学は,栄養学は,栄養学は,栄養学は,栄養学は,栄養学は
背景:
- 重度の急性栄養失調 (SAM) は,5歳未満の1千3百万人の子供に影響を与え,年間1~200万人の予防可能な死亡を引き起こしています.
- その影響にもかかわらず,SAMはしばしば子供の生存プログラムによって見過ごされ,WHOによって認められていない.
- 現在のSAMの入院治療は資源が集約され,高症例死亡率 (20-30%) と低カバー率 (<10%) を有しています.
研究 の 目的:
- 深刻な急性栄養失調の治療のためのコミュニティベースの治療ケア (CTC) プログラムの有効性を評価する.
- CTCがSAMの生存率を向上させ,治療アクセシビリティを向上させる方法を示す.
- 伝統的な入院SAM治療の実行可能で費用対効果の高い代替手段としてCTCを強調する.
主な方法:
- SAM管理のためのコミュニティベースの治療ケア (CTC) プログラムの実施.
- 合併症のないSAM症例の診察室での治療のために,使用済みの治療用食品 (RUTF) を利用する.
- サービスへのアクセスを拡大し,コストを削減し,早期の提出と遵守を奨励することに焦点を当てています.
主要な成果:
- CTCプログラムは,重度の急性栄養失調による死亡率を大幅に削減します.
- CTCは,入院のみのアプローチと比較して,治療対象率を大幅に増加させます.
- 合併症のないSAMの門診管理は,効果を証明し,回復率を増大します.
結論:
- コミュニティベースの治療ケアは,重度の急性栄養失調の治療のための成功的で費用対効果の高い戦略です.
- CTCプログラムは,適時かつ適切な治療へのアクセスを拡大することによって,子供の生存率を改善します.
- このアプローチは,入院医療の限界に対処し,高負荷領域にスケーラブルなソリューションを提供しています.
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