Lay-screeners and use of WHO growth standards increase case finding of hospitalized Malawian children with severe acute malnutrition.
| Title: | Lay-screeners and use of WHO growth standards increase case finding of hospitalized Malawian children with severe acute malnutrition. |
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| Authors: | LaCourse SM; Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA 98195, USA UNC Project, Lilongwe, Malawi sylvial2@uw.edu.; Chester FM; UNC Project, Lilongwe, Malawi.; Preidis G; Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA.; McCrary LM; UNC Project, Lilongwe, Malawi University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC 27516, USA.; Maliwichi M; UNC Project, Lilongwe, Malawi.; McCollum ED; UNC Project, Lilongwe, Malawi Department of Pediatrics, Division of Pulmonology, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA.; Hosseinipour MC; UNC Project, Lilongwe, Malawi Department of Medicine, Division of Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA. |
| Source: | Journal of tropical pediatrics [J Trop Pediatr] 2015 Feb; Vol. 61 (1), pp. 44-53. Date of Electronic Publication: 2014 Dec 03. |
| Publication Type: | Case Reports; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
| Language: | English |
| Journal Info: | Publisher: Oxford University Press Country of Publication: England NLM ID: 8010948 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1465-3664 (Electronic) Linking ISSN: 01426338 NLM ISO Abbreviation: J Trop Pediatr Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: [London] Oxford University Press. |
| MeSH Terms: | World Health Organization*; Anthropometry/*methods ; Arm/*anatomy & histology ; Hospitalization/*statistics & numerical data ; Malnutrition/*diagnosis ; Mass Screening/*standards; Malnutrition/therapy ; Child ; Female ; Humans ; Infant ; Malawi ; Male ; Nutrition Surveys ; Nutritional Status ; Practice Guidelines as Topic ; Predictive Value of Tests ; Prospective Studies ; Reference Values |
| Abstract: | Objectives: Strategies to effectively identify and refer children with severe acute malnutrition (SAM) to Nutritional Rehabilitation units (NRU) can reduce morbidity and mortality.; Methods: From December 2011 to May 2012, we conducted a prospective study task-shifting inpatient malnutrition screening of Malawian children 6-60 months to lay-screeners and evaluated World Health Organization (WHO) criteria vs. the National Center for Health Statistics (NCHS) guidelines for SAM.; Results: Lay-screeners evaluated 3116 children, identifying 368 (11.8%) with SAM by WHO criteria, including 210 (6.7%) who met NCHS criteria initially missed by standard clinician NRU referrals. Overall case finding increased by 56.7%. Mid-upper arm circumference (MUAC) and bipedal edema captured 86% (181/210) NCHS/NRU-eligible children and 89% of those who died (17/19) meeting WHO criteria. Mortality of NCHS/NRU-eligible children was 10 times greater than those without SAM (odds ratio 10.5, 95% confidence interval 5.4-20.6).; Conclusions: Ward-based lay-screeners and WHO guidelines identified high-risk children with SAM missed by standard NRU referral. MUAC and edema detected the majority of NRU-eligible children.; (© The Author [2014]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.) |
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| Grant Information: | T32 HL072748 United States HL NHLBI NIH HHS; R24 TW007988 United States TW FIC NIH HHS; T32 AI07140 United States AI NIAID NIH HHS; T32 HL072748-11 United States HL NHLBI NIH HHS |
| Contributed Indexing: | Keywords: Malawi; National Center for Health Statistics (NCHS) growth reference; WHO growth standard; malnutrition screening; mid-upper arm circumference (MUAC); task-shifting |
| Entry Date(s): | Date Created: 20141206 Date Completed: 20151103 Latest Revision: 20181113 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC4375387 |
| DOI: | 10.1093/tropej/fmu065 |
| PMID: | 25477308 |
| Database: | MEDLINE |
Case Reports; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't