Introduction Acute

malnutrition, also known as wasting, is a serious condition that results from inadequate nutrient intake and/or disease. There are two forms of acute malnutrition: Moderate Acute Malnutrition (MAM) and Severe Acute Malnutrition (SAM). There are an estimated 45 million children under five who are affected by acute malnutrition across the world, and this condition is responsible for a large proportion of illness and death in children.Addressing acute malnutrition is important for improving survival and healthy childhood development. This article will review acute malnutrition classification, diagnosis, and management strategies in a clinical or community-based context.

Classification

Acute malnutrition is classified according to anthropometric indicators:

Type Criteria

Moderate Acute Malnutrition (MAM) Weight-for-height z-score (WHZ)

between -3 and -2 SD OR mid-upper arm

circumference (MUAC) between 11.5 and 12.5 cm

Severe Acute Malnutrition (SAM) WHZ < -3 SD OR MUAC < 11.5 cm

OR bilateral pitting edema

Diagnosis

Due to the interrelated nature of malnutrition and disease, malnutrition must be diagnosed effectively and adequately. The diagnostic process includes:

• Anthropometric measurements: weight, height/length, middle-upper arm circumference (MUAC)

• Clinical examination: appetite test, checking for edema, infections, or other complications

• Laboratory investigation: if needed, to identify conditions that may underly malnutrition, e.g. anemia or infections.

Management Plan

Acute malnutrition is managed in the community or through inpatient management based on the severity and complications.

1. Management of MAM

Most children with MAM can be managed at home with support from community health workers, through:

• Supplementary Feeding Programs (SFPs): Provide fortified nutrient-dense supplementary foods, e.g. fortified blended flours or lipid-based nutrient supplements (LNS)

• Nutrition counseling and education: Encourage caregivers to optimize feeding based on locally available foods.

• Follow-up monitoring: To report changes in recovery and any deterioration.

2,Treatment of SAM Without Complication

sChildren with uncomplicated SAM can be treated at the community level through:

• Outpatient therapeutic programs (OTPs): Provision of ready-to-use therapeutic food (RUTF) like Plumpy’NutBasic

• medical treatment: General treatment with antibiotics (e.g., amoxicillin), vitamin A, deworming and anti-malarials as needed

• Close follow-up: Weekly or biweekly visits for weight gain monitoring, MUAC, or signs of complications

3. Treatment of SAM With Complications

Children with SAM and complications (e.g., severe edema, vomiting, infection) need to be treated as inpatient care:

• Stabilization phase: With therapeutic milks (F-75) and infectious disease treatments, correcting electrolyte issues, warmth and hygiene

• Transition phase: Gradually reintroducing caloric intake with F-100 or RUTF

• Rehabilitation phase: Focused on catch-up growth and discharge planning

Prevention and Long-Term Solutions

The management of acute malnutrition encompasses immediate management and longer-term strategies:

• Food Security and Poverty

• ReductionWASH (Water, sanitation, and hygiene)

• Maternal and Child Health Services

Breastfeeding Promotion and Appropriate Complementary Feeding

Conclusion

Acute malnutrition is both preventable and treatable. The successful management and long-term reduction of the burden of acute malnutrition globally requires the integration of community-based management with health system support in facilities and effective public health systems. Sustained investment in health systems, caregiver capacity and food security will be critical to breaking the cycle of under nutrition, and promoting child survival and development.