The effectiveness of interventions to treat severe acute malnutrition in young children: a systematic review

Picot J, Hartwell D, Harris P, Mendes D, Clegg AJ, Takeda A
Record ID 32011000633
Authors' objectives:

It is estimated that with appropriate treatment case fatality rates for children with severe malnutrition could be as low as 5% in both the community and in health-care facilities. However, over the past 50 years, case fatality rates for children with severe malnutrition treated as inpatients have remained largely unchanged at 20% to 30% for marasmus and up to 50% to 60% for kwashiorkor. According to WHO, 'the evidence for effective prevention and treatment is incontrovertible, but it is not put into practice'. As such, it is the feasibility of implementing guidelines in the context of the resource constrained health systems of developing country that is under question. Others have questioned the likelihood of achieving case fatality rates of 5% and the evidence that underlies the strategies for managing malnutrition within different settings. It remains unclear whether the lack of progress is a reflection of the initiatives available and the guidance provided, the ease of their implementation, a consequence of the changing nature of the problem, or a combination of all these factors. It is thought that no previous systematic reviews have assessed the effectiveness of different interventions to treat severe malnutrition among different populations and settings. As a consequence, a systematic review is needed to identify and synthesise all potentially relevant studies of interventions to treat severe malnutrition in children, using rigorous and recognised methodology. This study will add to the existing research by providing an up to date assessment of the existing evidence on the effectiveness of all initiatives, including the WHO guidelines. It will allow the evidence behind recommendations on how to treat severe malnutrition in different settings and the constraints relating to implementation of guidelines to be documented.

Authors' recommendations: Study found evidence for the effectiveness of interventions to treat infants and children aged < 5 years old who have severe acute malnutrition (SAM) to be lacking or inconclusive.
Project Status: Completed
Year Published: 2012
URL for published report:
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: England, United Kingdom
MeSH Terms
  • Child
  • Child Health Services
  • Child Nutrition Disorders
  • Child, Preschool
  • Infant
  • Infant, Newborn
Organisation Name: NIHR Health Technology Assessment programme
Contact Address: NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK
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Copyright: 2012 Queen's Printer and Controller of HMSO
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.