Effective Nutrition Intervention to Treat Children Under 5 Years Old Suffering MAM in Public Primary Health Care Services in El Salvador

Full text: Background: In El Salvador Moderate Acute Malnutrition (MAM) affects less than 1% of children under 5 years old. The importance of MAM has been neglected as a public health issue. Although moderate wasting is not a condition of medical urgency, it can easily deteriorate. If some of these undernourished children with moderate wasting do not receive adequate support, they may progress towards severe acute malnutrition (SAM), defined by the presence of severe wasting and/or bilateral pitting oedema, which is a life-threatening condition. Since 2010, a complementary feeding program for children from 6 to 59 months old was implemented at the primary health clinics for the management of moderate malnutrition. Program was implemented in 100 municipalities identified with the greatest levels of poverty at national level and it consists of a corn-soy fortified flour to be prepared at home as a poudrige given to children during the routine health controls. During the first months of program implementation, an acceptability test was conducted and it was determined that more than 85% of children had good acceptance of the product. The treatment consists of 45 grams per day of complementary food. Mothers were instructed on how to prepare the product and every month they would have to bring their children to the clinic to receive complementary food and control weight gain. If mothers did not attend the control, a health promotion worker would go visit the mother at their home and bring the complementary food to the child. Objective: Assess the results on nutritional status of children under 5 years old with MAM treated with complementary food during health controls at primary health facilities in El Salvador during January to October 2013. Methods: Transversal study. Inclusion criteria was children 6 to 59 months old attending health controls coming from prioritize municipalities, diagnose with MAM by a health professional without other disease or infections that would complies their nutritional status, children who received at least two subsequent controls after being diagnose. Data was collected from the child clinic. Results: 60 cases were identified, 35 boys, 31 lived in rural areas, mean age 20,6 months (min 6, max 52), 44 had MAM and 16 SAM, mean weight at diagnose 8,0 kilos (5 min, 11 max) and height 77,7 cm (62 min, 92 max). Children received prescription of 50,75 g per day of corn-soy flour, mean 3 subsequent health controls, average treatment duration 5,2 months. At the end of the treatment average weight 9,5 kilos (6,3 min, 12,7 max), height 80,7 cms (65 min, 102 max), 46 recovered from MAM, effectiveness of 76.7% . The other 14 children who did not recovered were classified with MAM and none of them with SAM. Conclusions: Complementary feeding is effective to treat MAM when children are follow up by health professionals and mothers receive adequate counseling. (author)