M15: Nutrition in emergencies

MALNUTRITION
Occurs when there is an imbalance between the supply and demand of nutrients for growing,
maintenance and specific functions of the body.

Children under 5 years old are the group more vulnerable.

The prevalence of acute malnutrition in children under 5 years of age is generally used as an
indicator of this condition in the entire population, since this group is more sensitive to changes
in the nutritional situation.

Anthropometric indices:

Measure: MUAC (we will use it with acute malnutrition).

Signe: Oedema

Oedema should be always bilateral. If it isn’t bilateral, there is no malnutrition. Should start at
the feets and them go up. From down to up.

Weight for height (W/H): Si el niño menor de 2 años (< 85cm), su altura se medirá acostado,
pero si mide más, será de pie.

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Bilateral pressure (Oedema) for 3 seconds with thumbs on the
upper surface of feet or the fore-limb of the leg. Classification:
 Feet = +
 Tibia = ++
 Superior limbs and eyelids = +++

KWASHIORKOR: illness in children due to a lack of nutrients.

MUAC (we will use it with acute malnutrition Weight/Height)

MAM (moderate acute malnutrition) vs SAM (severe acute malnutrition).

Thresholds for determination of nutritional status

GAM (global acute malnutrition)

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TYPES OF MALNUTRITION

Nutritional deficiencies and malnutrition:

Anaemia (deficiency of iron)

Bereberi (deficiency of Thiamine or Vit B1)

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La distención intestinal son gases y los gusanos intestinales.

Not always the face of the child is an indicator of malnutitition.

Las pestañas y las uñas tienden a crecer.

WFH (weight for height):

< - 3 Z score = SAM (severe acute malnutrition)

> - 3 - < - 2 = MAM (moderate acute malnutrition)

MUAC:

< 115mm = SAM

> 115mm - < 125mm = MAM

1) Bilateral oedema ++  desnutricion aguda (SAM)

2) SAM
3) No hay MUAC porque solo tiene 6 meses de edad.
MAM because zscore < -2 - > -3
MUAC and Oedemas are missing to diagnose malnutrition.
4) PB (perímetro branquial).
No acute malnutrition because zscore = -1
5) zscore < -3 SAM. Missing MUAC and oedemas.