SEVER ACUTE MALNUTRITION
DIAGNOSIS
- Edema of both feet (+, ++) with no apparent causes
OR - Severe wasting (WFL/WFH <70% or <-3SD)
OR - Severe wasting (MUAC <11.5cm for under 5yr)
OR - Clinical signs of sever acute malnutrition like visible severe wasting of the shoulders, arms, buttocks & thighs, with visible rib outlines (specially in young infant <6 month)
COMPLICATED SEVER ACUTE MALNUTRITION
DIAGNOSIS
- ONE of the above criteria of SAM plus
° Failed appetite test
OR
° Medical complication
OR
° Marsmic-kwashiorkor
OR
° Grade +3 edema
NOTES
- No distinction has been made between the clinical conditions of kwashiorkor, marasmus, and marasmic kwashiorkor because the approach to their treatment is similar
- Classification
- Complicated SAM/Uncomplicated SAM
- Edematous SAM / Non-edematous SAM rather than saying kwashiorkor, marasmus, and marasmic kwashiorkor
- Children <60% 0R < -3SD weight-for-age may be stunted, & not severely wasted. Stunted children do not require hospital admission unless they have a serious illness
MARASMIC-KWASHIORKOR
DIAGNOSIS
- The presence of edema & Weight for age <60% ( By using harvard curve OR Calculated from actual weight ÷ ideal/expected/mean weight at 50th percentile)
OR - Edema with anthropometric evidence of sever wasting ( WFL/WFH <70% or <-3SD , & MUAC <11.5cm for under 5yr)
OR - Visible wasting of the upper extremity plus edema of both feet otherwise no apparent causes