The objectives of this study was to determine 1- the prevalence of severe acute malnutrition (SAM) and severe chronic malnutrition (SCM), and 2- the extent of overlap between SAM and SCM among children aged 6–59 months seeking medical care from the two Médecins Sans Frontières-supported primary health centres in Bangladesh. In a retrospective record review, data were analysed from out-patient registers on age, sex, height, weight and mid-upper arm circumference (MUAC) of children attending for medical care from April to September 2011. SAM was defined as weight for height less than −3 Z scores of the median and/or MUAC more than 115 mm. SCM was defined as height for age less than −3 Z scores of the median. World Health Organization growth standards were used as reference. Data were complete in the records of 7318 (98%) children, of whom 322 (4%) had SAM and 1698 (23%) had SCM. Among the 322 children with SAM, 162 (50%) also had SCM. It was concluded that in an urban Bangladesh slum, SAM and SCM co-exist, with a predominance of SCM. The current national guidelines for severe malnutrition, which focus on identification and management only for SAM, urgently need to be expanded to include SCM if substantial childhood morbidity and mortality are to be reduced.
Shams, Z.; Zachariah, R.; Enarson, D.A.; Satyanarayana, S.; Van den Bergh, R.; Ali, E.; Alders, P.; Manzi, M.; Allaouna, M.; Draguez, B.; Delchevalerie, P.; Vernaeve, L.; Harries, A.D. Severe malnutrition in children presenting to health facilities in an urban slum in Bangladesh. Public Health Action (2012) 2 (4) 107-111.