Hospital management of severely malnourished children: comparison of locally adapted protocol with WHO protocol.
OBJECTIVE
To compare the effectiveness of locally adapted Institute of Child and Mother Health (ICMH) protocol with the WHO protocol for the management of severely malnourished children in Bangladesh.


METHODS
Quasi-experimental non-randomized clinical trial.


METHODS
Hospital based.


METHODS
Severely malnourished children (2-59 mo) with weight for height<70% (n=60).


METHODS
Children treated with either WHO protocol (Group I, n=30) or ICMH protocol (Group II, n=30).


METHODS
Clinical improvement, weight gain, time taken to achieve target weight gain, and mortality among the study subjects.


RESULTS
Mean (SD) weight related to gain in Group I and Group II was 11.2 (4.1) and 11.1 (3.9) g/kg/day, respectively. The weight gain was not related to the age group or type of malnutrition. The time taken for edema to subside (7.3 d vs 8 d) and for improvement of appetite (6.5 d to 7.3 d vs 6.7 d to 8.4 d) was similar between the groups. The target weight gain was achieved in 28.3 (11.5) days in Group I against 27.9 (6.2) days in Group II (P=0.88). The mortality rate was 6.7% in each group.


CONCLUSIONS
Treatment of severe malnutrition with locally adapted ICMH protocol using locally available foods is as efficacious as the WHO protocol.
Hossain
M M
MM
Faculty of Pediatrics, Institute of Child and Mother Health, Matuail, Dhaka, Bangladesh. monir91@yahoo.com
Hassan
M Q
MQ
Rahman
M H
MH
Kabir
A R M L
AR
Hannan
A H
AH
Rahman
A K M F
AK
D001459:Bangladesh / Q000453:epidemiology; D015362:Child Nutrition Disorders / Q000178:diet therapy* / Q000188:drug therapy* / Q000401:mortality; D002669:Child Welfare; D002675:Child, Preschool; D002149:Energy Intake; D005260:Female; D014943:Global Health; D006760:Hospitalization; D006801:Humans; D007223:Infant; D008297:Male; D008903:Minerals / Q000627:therapeutic use*; D009752:Nutritional Status; D013997:Time Factors; D014815:Vitamins / Q000627:therapeutic use*; D015430:Weight Gain; D014944:World Health Organization
D008903:Minerals; D014815:Vitamins