Severe childhood malnutrition
Top Cited Papers
- 21 September 2017
- journal article
- review article
- Published by Springer Nature in Nature Reviews Disease Primers
- Vol. 3 (1), 1-18
- https://doi.org/10.1038/nrdp.2017.67
Abstract
The main forms of childhood malnutrition occur predominantly in children <5 years of age living in low-income and middle-income countries and include stunting, wasting and kwashiorkor, of which severe wasting and kwashiorkor are commonly referred to as severe acute malnutrition. Here, we use the term ‘severe malnutrition’ to describe these conditions to better reflect the contributions of chronic poverty, poor living conditions with pervasive deficits in sanitation and hygiene, a high prevalence of infectious diseases and environmental insults, food insecurity, poor maternal and fetal nutritional status and suboptimal nutritional intake in infancy and early childhood. Children with severe malnutrition have an increased risk of serious illness and death, primarily from acute infectious diseases. International growth standards are used for the diagnosis of severe malnutrition and provide therapeutic end points. The early detection of severe wasting and kwashiorkor and outpatient therapy for these conditions using ready-to-use therapeutic foods form the cornerstone of modern therapy, and only a small percentage of children require inpatient care. However, the normalization of physiological and metabolic functions in children with malnutrition is challenging, and children remain at high risk of relapse and death. Further research is urgently needed to improve our understanding of the pathophysiology of severe malnutrition, especially the mechanisms causing kwashiorkor, and to develop new interventions for prevention and treatment.Keywords
This publication has 211 references indexed in Scilit:
- Mortality risk in preterm and small-for-gestational-age infants in low-income and middle-income countries: a pooled country analysisThe Lancet, 2013
- Risk and causes of paediatric hospital-acquired bacteraemia in Kilifi District Hospital, Kenya: a prospective cohort studyThe Lancet, 2011
- Mortality after Fluid Bolus in African Children with Severe InfectionNew England Journal of Medicine, 2011
- Prevalence of wasting among under 6-month-old infants in developing countries and implications of new case definitions using WHO growth standards: a secondary data analysisArchives of Disease in Childhood, 2011
- Mitochondrial Dysfunction and Resuscitation in SepsisCritical Care Clinics, 2010
- Lactose intolerance among severely malnourished children with diarrhoea admitted to the nutrition unit, Mulago hospital, UgandaBMC Pediatrics, 2010
- Overlooking undernutrition? Using a composite index of anthropometric failure to assess how underweight misses and misleads the assessment of undernutrition in young childrenSocial Science & Medicine, 2008
- What's new? Investigating risk factors for severe childhood malnutrition in a high HIV prevalence South African setting1Scandinavian Journal of Public Health, 2007
- Developmental potential in the first 5 years for children in developing countriesThe Lancet, 2007
- Effects of psychosocial stimulation and dietary supplementation in early childhood on psychosocial functioning in late adolescence: follow-up of randomised controlled trialBMJ, 2006