Management of severe acute malnutrition in children using community based therapeutic care approach: a review of three years data from southern Ethiopia.

Abstract

The objective of the study is to assess the outcome of community-based therapeutic care (CTC) for children with severe
malnutrition in Southern Ethiopia. Diagnosis of severe malnutrition was made based on anthropometric measurement and
all children received therapeutic food according to the protocol and were discharged from the feeding program when they
their weight for height was more than 80% of the reference for 2 consecutive weeks. Data on the number of admissions,
discharges, weight gain and length of stay in the program were recorded using standard formants and reports were sent to
the Regional Health Bureau monthly. The data was entered using EPI-Info proportions and means were compared using
chi-square test. This is a retrospective review of reports retained in the Bureau. A total of 12,316 patients with severe acute
malnutrition, 56.2% marasmic and 43.8% kwashiorkor cases were treated in CTC program from 2003 to 2005. The average
cure and death rates were 91% (9871) and 2.5% (217) and the average weight gain was 5.3 and 5.8 grams /kg/day and the
average length of stay was 49 and 42 days for cases of Marasmus and Kwashiorkor, respectively. Except for weight gain
and length of stay, our findings exceeded the minimum sphere standards for treatment outcome measures. In conclusion
the CTC approach has a comparable outcome to Therapeutic feeding centers and could be expanded quickly during
emergency situation. As majority of patients are treated at home, the workload for the health worker would be reduced, so it
is an alternative approach for management of severe malnutrition where human resource and space in health facilities are
limited.