Skip to main content Accessibility help
×
Hostname: page-component-5b777bbd6c-ks5gx Total loading time: 0 Render date: 2025-06-19T02:19:05.702Z Has data issue: false hasContentIssue false

Chapter 10 - Severe Acute Malnutrition in Childhood

from Section 2 - Mother and Child Health

Published online by Cambridge University Press:  18 June 2025

David Mabey
Affiliation:
London School of Hygiene and Tropical Medicine
Martin W. Weber
Affiliation:
World Health Organization
Moffat Nyirenda
Affiliation:
London School of Hygiene and Tropical Medicine
Dorothy Yeboah-Manu
Affiliation:
Noguchi Memorial Institute for Medical Research, University of Ghana
Jackson Orem
Affiliation:
Uganda Cancer Institute, Kampala
Laura Benjamin
Affiliation:
University College London
Michael Marks
Affiliation:
London School of Hygiene and Tropical Medicine
Nicholas A. Feasey
Affiliation:
Liverpool School of Tropical Medicine
Get access

Summary

Malnutrition is ‘any condition in which deficiency, excess or imbalance of energy, protein or other nutrients adversely affects body function and/or clinical outcome’ (Meier & Stratton 2008). In all its forms, undernutrition underlies around 45% of all childhood deaths (Black et al. 2013). This is because it increases susceptibility to, and severity of infectious diseases such as gastroenteritis and pneumonia. In turn, infections lead to reduced nutrient intake, and expenditure of nutrients for immune and inflammatory responses. Thus, malnutrition and infection are synergistic (Fig. 10.1).

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2025

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Book purchase

Temporarily unavailable

References

Bailey J, Opondo C, Lelijveld N et al. (2020). A simplified combined protocol versus standard treatment for acute malnutrition in children 6–59 months (ComPAS trial): a cluster-randomized controlled non-inferiority trial in Kenya and South Sudan. PLOS Medicine; https://doi.org/10.1371/journal.pmed.1003192.CrossRefGoogle Scholar
Bandsma, RHJ, Voskuijl, W, Chimwezi, E et al. (2019). A reduced-carbohydrate and lactose-free formulation for stabilization among hospitalized children with severe acute malnutrition: a double-blind, randomized controlled trial. PLoS Med; 16(2): e1002747. doi: 10.1371/journal.pmed.1002747.CrossRefGoogle ScholarPubMed
Berkley JA, Walson JL, Bahl R, Rollins N. (2024). Differentiating mortality risk of individual infants and children to improve survival: opportunity for impact. Lancet; 404: 492–4.Google Scholar
Black, RE, Victora, CG, Walker, SP, et al. (2013). Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet; 382(9890): 427–51. doi.org/10.1016/S0140-6736(13)60937-X.CrossRefGoogle ScholarPubMed
Brent, B, Obonyo, N, Akech, S et al. (2019). Assessment of myocardial function in Kenyan children with severe, acute malnutrition: The Cardiac Physiology in Malnutrition (CAPMAL) Study. JAMA Netw Open; 2: e191054.CrossRefGoogle ScholarPubMed
Childhood Acute Illness and Nutrition Network (CAINN). (2022). Childhood mortality during and after acute illness in Africa and south Asia: a prospective cohort study. Lancet Glob Health; 10: e673–84.Google Scholar
Collins, S, Dent, N, Binns, P et al. (2006). Management of severe acute malnutrition in children. Lancet; 368: 1992–2000.CrossRefGoogle ScholarPubMed
Collins, S, Sadler, K, Dent, N et al. (2006). Key issues in the success of community-based management of severe malnutrition. Food Nutr Bull; 27: S4982.10.1177/15648265060273S304CrossRefGoogle ScholarPubMed
Grantham-McGregor, SM, Fernald, LC, Kagawa, RM, et al. Effects of integrated child development and nutrition interventions on child development and nutritional status. Ann N Y Acad Sci 2014; 1308: 1132. doi: 10.1111/nyas.12284.CrossRefGoogle ScholarPubMed
Grey, K, Gonzales, GB, Abera, M, et al. (2021). Severe malnutrition or famine exposure in childhood and cardiometabolic non-communicable disease later in life: a systematic review. BMJ Global Health 6(3): e003161. doi: 10.1136/bmjgh-2020-003161.CrossRefGoogle ScholarPubMed
Heikens, GT, Bunn, J, Amadi, B et al. (2008). Case management of HIV-infected severely malnourished children: challenges in the area of highest prevalence. Lancet; 371: 1305–7.10.1016/S0140-6736(08)60565-6CrossRefGoogle ScholarPubMed
Hughes, SM, Amadi, B, Mwiya, M et al. (2009). CD4 counts decline despite nutritional recovery in HIV-infected Zambian children with severe malnutrition. Pediatrics; 123: e347–51.10.1542/peds.2008-1316CrossRefGoogle ScholarPubMed
Isanaka, S, Hanson, KE, Frison, S, et al. (2019). MUAC as the sole discharge criterion from community-based management of severe acute malnutrition in Burkina Faso. Matern Child Nutr; 15(2): e12688. doi: 10.1111/mcn.12688.CrossRefGoogle Scholar
Kerac, M, McGrath, M, Connell, N, et al. (2020). ‘Severe malnutrition’: thinking deeplyS, communicating simply. BMJ Global Health; 5(11): e003023. doi: 10.1136/bmjgh-2020-003023.CrossRefGoogle ScholarPubMed
Maitland, K, Berkley, JA, Shebbe, M et al. (2006). Children with severe malnutrition: can those at highest risk of death be identified with the WHO protocol? PLoS Med; 3: e500.CrossRefGoogle ScholarPubMed
Care Pathway., MAMI Management of small and nutritionally At-risk Infants u6 months and their Mothers. www.ennonline.net/mamicarepathway.Google Scholar
Manary, MJ, Sandige, HL (2008). Management of acute moderate and severe childhood malnutrition. Br Med J; 337: a2180.CrossRefGoogle ScholarPubMed
Meier, R, Stratton, R. (2008). Basic concepts in nutrition: Epidemiology of malnutrition. e-SPEN, the European e-Journal of Clinical Nutrition and Metabolism; 3(4): e167e170. doi.org/10.1016/j.eclnm.2008.04.002.Google Scholar
Nyeko, R, Kalyesubula, I, Mworozi, E et al. (2010). Lactose intolerance among severely malnourished children with diarrhoea admitted to the nutrition unit, Mulago hospital, Uganda. BMC Pediatr; 10: 31.10.1186/1471-2431-10-31CrossRefGoogle Scholar
Obonyo, N, Brent, B, Olupot-Olupot, P et al. (2017). Myocardial and haemodynamic responses to two fluid regimens in African children with severe malnutrition and hypovolaemic shock (AFRIM study). Critical care (London, England); 21: 103–103.10.1186/s13054-017-1679-0CrossRefGoogle ScholarPubMed
Ocal, B, Unal, S, Zorlu, P et al. (2001). Echocardiographic evaluation of cardiac functions and left ventricular mass in children with malnutrition. J Paediatr Child Health; 37: 1417.CrossRefGoogle ScholarPubMed
UNICEF (2020). Conceptual Framework for malnutrition. www.unicef.org/reports/nutrition-strategy–2020–2030.Google Scholar
Victora, CG, Bahl, R, Barros, AJD, et al. (2016). Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet; 387(10017): 475–90. doi.org/10.1016/S0140-6736(15)01024-7.CrossRefGoogle ScholarPubMed
WHO (2005). Child Reference Growth Standards. www.who.int/childgrowth/software/en/index.html.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×