Children with SAM who meet the following criteria:
• The child is > 6 months of age and weight > 4 kg, and
• There is no pitting oedema, and
• The child is alert (not lethargic), and
• The child has a good appetite and is feeding well, and
• The child does not have any danger signs or severe classification.
All cases require careful assessment for possible TB or HIV.
Signs and symptoms
• Provide RUTF (ready to use therapeutic food regular nutritional supplements) and/or other nutritional supplements according to supplementation guidelines.
• Counsel according to IMCI guidelines.
• Regular follow-up to ensure that the child gains weight and remains well.
• Discharge with supplementation, once the following criteria are met:
o WHZ (weight-for-height z-score): > –2
o WHZ for two consecutive visits at least one month apart and/or
o MUAC: > 11.5 cm (preferable at 12 cm, if MUAC used alone).
• Follow-up patients for at least 6 months to ensure sustained growth.
- Do not repeat if child has received these during inpatient stay:
• Give an additional dose of Vitamin A:
o High dose of vitamin A (50,000 IU, 100,000 IU or 200,000 IU, depending on age) should be given to all children with SAM and eye signs of vitamin A deficiency on day 1,
o Second and a third dose on day 2 and day 15 (or at discharge from the programme), irrespective of the type of therapeutic food they are receiving;
• To all children with SAM with recent measles on day 1, with a second and a third dose on day 2 and day 15 (or at discharge from the programme), irrespective of the type of therapeutic food they are receiving
Empiric treatment for worms:
• Mebendazole, oral. Dose: Children 1–2 years: 100 mg (PO) 12 hourly for 3 days. Children > 2–5 years: 500 mg (PO) as a single dose.
20 Novemba 2020 12:19:16
- 1. STG