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The MSF nutritional program is located in the districts of Guidan Roumjdi and Madarounfa - epicentre of the nutritional crisis in 2005. In addition to the two hospitalisation centres (CRENI), our teams work in eleven ambulatory/outpatient nutritional centres which are integrated in public health centres.
The first five months of operation show that acute malnutrition is still raging this year in Niger. Children under three in the poorest families are still without access to food adapted - both in quality and quantity - to their nutritional needs.
In 2006, we decided to treat moderate malnutrition using the same mode of operation that had proved so efficient the previous year in treating the severely malnourished children.
As recently as a few years ago, severely malnourished people were being hospitalised and given a therapeutic milk, whereas the moderately malnourished were receiving food rations. This mode of operation was cumbersome for families and medical staff, and certain results proved unsatisfactory.
At present, the difference in treatment is no longer based on the nutritional status of the child but on the need for hospitalisation. The large majority of malnourished children can follow treatment at home under weekly medical supervision. On the other hand, children who have no appetite or who suffer from severe medical complications (severe malaria, severe anaemia, pneumonia, meningitis, etc.) require hospitalisation and intensive nutritional and medical treatment.
This year, non-complicated cases of acute malnutrition - be it a child whose weight is below at least 20% (moderate level) or 30% (severe level) in relation to the median level - are treated in ambulatory/outpatient clinics. Children suffering from complicated acute malnutrition, on the other hand, are admitted to the CRENI.
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This mode of operation is made possible owing to a new therapeutic product in the form a peanut butter. Manufactured in individual doses (sachet or jar), its complex composition is rich in micronutrients that allow the child to make a rapid recovery.
Despite the obvious advantages of these ready-to-use therapeutic products, they have been only used on a minimal basis and exclusively in the treatment of severe malnutrition. A better response, however, can be introduced in the treatment of moderate malnutrition - a serious acute childhood pathology.
The preliminary results have been very encouraging in moderately malnourished children treated exclusively in ambulatory/outpatient clinics. The average length of time children spend is 28 days (calculated on the basis of 702 cured on departure). On departure the height to weight ratio is 85% that of the median. The weight gain is 4.5g/kg/day (with two Plumpy'nut © a day), in other words, a weight gain of 12.7%. These results are considerably higher than those obtained using enriched flour.
In the first six months of 2006, nine out of ten children admitted in our programs were suffering from moderate acute malnutrition. Our objective is to reduce the annual death rate, particularly during the hunger season. Although a child suffering form severe acute malnutrition is more at risk of dying, the sheer number of those suffering from acute moderate malnutrition means they account for a large percentage of the total number of deaths linked to malnutrition. To limit the number of children dying, we now provide this efficient treatment before the onset of the severe stage of malnutrition .
» For more information, please go to the malnutrition dossier on our web site www.msf.fr or contact Anne Yzèbe on 00 33 1 40 21 28 43 (anne.yzebe@paris.msf.org).
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