Conference abstract

Outpatient treatment for severe acute malnutrition under 6 months: a descriptive case study from Senegal

Pan African Medical Journal - Conference Proceedings. 2018:9(7).12 Dec 2018.
doi: 10.11604/pamj-cp.2018.9.7.733

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Keywords: SAM, young infant, malnutrition, outpatient treatment

Outpatient treatment for severe acute malnutrition under 6 months: a descriptive case study from Senegal

Tabitha D. Van Immerzeel1,&, Maty D. Camara2

1Medico-Social Centre Keru Yakaar, Dakar, Senegal, 2Department of Nutrition and Alimentation, Ministry of Health, Senegal

&Corresponding author
Tabitha D. Van Immerzeel, Medico-Social Centre Keru Yakaar, Dakar, Senega


Introduction: severe acute malnutrition (SAM) is equality prevalent in infants under 6 months as in older age groups but bears more risks. Treatment is mostly done inpatient, although the 2013 World Health Organization (WHO) revised guideline gives outpatient treatment for non-complicated cases as an option. In order to study outpatient treatment for SAM under 6 months, a case clinic in Senegal is retrospectively described.

Methods: data were collected in a large urban primary care service in Dakar, Senegal. This clinic uses an outpatient approach for non-complicated SAM in infants under 6 months. WHO admission and referral criteria are followed, cup and spoon feeding is used as supplementary feeding technique, with infant formula as a milk supplement. Data on patient characteristics and treatment outcomes were collected retrospectively on all infants under 6 months with SAM treated from 1st of January 2013 to the 1st of September 2015.

Results: 60 infants under 6 months with SAM were treated in the 32 month period. 38% of patients came from outside the health district. 35% had an acute illness at admission (mostly diarrhea or respiratory infection). Remarkable was the high percentage of twins or triplets (24%) as well as infants born with low birth weight (57%). Of 16% the mother was sick or had died. Underlying (congenital) illnesses were relatively frequent (16%), for which some followed specialized treatment simultaneously. The treatment duration was long with 49 days as a mean. 39 (65%) were treated with success, 4 were transferred. The high rate of infants on supplementary feeding at discharge (79%) was concerning.

Conclusion: outpatient treatment for infants with SAM under 6 months can be done successfully. Treatment should be adapted to meet the needs of this diverse patient group in order to make treatment duration shorter and supplementary feeding given appropriately.