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Standardized treatment protocol reduces deaths from malnutrition by 47%

Below are highlights of a paper published in the June 5th issue of the Lancet (353:9/68 1919-1922)

Malnutrition is responsible, at least in part, for nearly 6 million deaths in children under five each year. Severely malnourished children have high mortality rates from a variety of diseases (up to 50%), and usually die in the first 48 hours after hospital admission. The Centre for Health and Population Research (ICDDR,B) in Dhaka, Bangladesh treats well over 110,000 children each year and has an overall mortality rate of 0.45%. However, since deaths in severely malnourished children at the ICDDR,B remain at 15%, additional methods are needed to manage illness in these patients.

In collaboration with colleagues from the Louisiana State Medical School in New Orleans, ICDDR,B researchers have outlined a standardized protocol to treat severely malnourished children. The new proto-col includes:

  • Slow rehydration with an emphasis on oral rehydration;
  • Immediate feeding with a diet of locally available, inexpensive foods;
  • Routine micronutrient supplementation, and
  • Broad spectrum antibiotic therapy

When compared with non-protocol management at the same hospital, the malnourished children given the standardized treatment regimen had fewer episodes of hypoglycemia, less need for intravenous fluids, and a 47% reduction in mortality.

Dr. George Fuchs of the ICDDR,B says: "the lives of many children were saved at our hospital through the use of the standardized treatment regimen. It should be considered for use in all severely malnourished children."


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Contact: Laura M. Kelley
lkelley@jhsph.edu
410-614-5439
Child Health Research Project
4-Jun-1999


Page: 1

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