[Definition and evaluation of therapeutic food for severely malnourished children in situations of humanitarian emergencies].
Nowadays, median case fatality rate of severely malnourished children treated in hospitals is 23.5%, a rate which has not changed for the last 50 years. This is probably related to the use of inappropriate or even unsafe treatment protocols. This work aimed at reducing case fatality rates of severe malnutrition by developing a treatment protocol and assessing its effectiveness during humanitarian crises. A therapeutic food was designed from pathophysiologic studies and its use adapted to therapeutic feeding centres. This food (F100) contains 100 Kcal/100 ml, with 10% of its energy derived from proteins; it has a low sodium and iron content but is fortified with vitamins and minerals. It can be prepared either at the treatment centre or at an industrial level. Industrial production, which started in 1993 reached 1,500 MT in 1997. In refugee camps, F100 was used according to a strict protocol adapted to local conditions. Intakes started at 100 Kcal/kg/day and reached 200 kcal/kg/day once appetite was restored. A model to assess the risk of death according to weight, height and oedema was developed. First results show that mortality was often below 5%. Hence, it is possible to standardise and evaluate a nutritional treatment in such unfavourable conditions as a refugee camp. Standardised use of F100 can markedly reduce mortality of severely malnourished children.
Desjeux
J F
JF
Académie nationale de Médecine, Chaire de Biologie, Conservatoire National des Arts et Métiers, Paris. desjeux@cnam.fr
Briend
A
A
Prudhon
C
C
Greletty
Y
Y
Golden
M H
MH
D002648:Child; D015362:Child Nutrition Disorders / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D003906:Developing Countries; D004630:Emergencies; D005069:Evaluation Studies as Topic; D005526:Food, Formulated; D005527:Food, Fortified; D006801:Humans; D016015:Logistic Models; D012372:ROC Curve; D012036:Refugees; D012720:Severity of Illness Index