Hospital Management of Severely Malnourished Children: Comparison of Locally Adapted Protocol with WHO Protocol
MM Hossain, MQ Hassan, MH Rahman, A KABIR, AH Hannan AND AKMF Rahman
In Bangladesh, Treatment of severe malnutrition with locally adapted ICMH protocol using locally available foods is as efficacious as the WHO protocol.
This study compared 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 in a non-randomised clinical trial. In all, 60 severely malnourished children in a hospital were involved. The children were treated with either WHO protocol (Group I, n=30) or ICMH protocol (Group II, n=30).
The results showed that the 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.
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