Severe Acute Malnutrition

Acute form of MALNUTRITION which usually affects children, characterized by a very low weight for height (below -3z scores of the median World Health Organization standards), visible severe wasting, or occurrence of nutritional EDEMA. It can be a direct or indirect cause of fatality in children suffering from DIARRHEA and PNEUMONIA. Do not confuse with starvation, a condition in which the body is not getting enough food, usually for extended periods of time.

Also Known As:

Networked: 283 relevant articles (30 outcomes, 47 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Weight Gain
2.	Pneumonia (Pneumonitis)
3.	Diarrhea
4.	HIV Infections (HIV Infection)
5.	Shock

Experts

1.	Ahmed, Tahmeed: 16 articles (01/2022 - 02/2008)
2.	Briend, André: 15 articles (10/2021 - 01/2013)
3.	Manary, Mark J: 14 articles (01/2022 - 09/2010)
4.	Bahwere, Paluku: 13 articles (01/2021 - 07/2009)
5.	Friis, Henrik: 12 articles (10/2021 - 01/2016)
6.	Collins, Steve: 12 articles (01/2021 - 09/2006)
7.	Berkley, James A: 11 articles (01/2020 - 06/2014)
8.	Sadler, Kate: 10 articles (01/2021 - 09/2006)
9.	Trehan, Indi: 10 articles (12/2019 - 09/2010)
10.	Grais, Rebecca F: 9 articles (10/2020 - 12/2010)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Severe Acute Malnutrition:

1.	Therapeutic UsesIBA 01/01/2019 - "Is Indigenously Prepared Ready-to-use Therapeutic Food Effective in Severe Acute Malnutrition?" 06/01/2015 - "Ready-to-use therapeutic food (RUTF) has been found effective in treating severe acute malnutrition. " 01/01/2023 - "Previously, a novel oat ready-to-use therapeutic food (o-RUTF) resulted in improved recovery from severe acute malnutrition (SAM) when compared to a standard RUTF (s-RUTF). " 03/01/2017 - "Acceptability and Efficacy of Locally Produced Ready-to-Use Therapeutic Food Nutreal in the Management of Severe Acute Malnutrition in Comparison With Defined Food: A Randomized Control Trial." 11/01/2017 - "The development of ready-to-use therapeutic food (RUTF) for the treatment of uncomplicated cases of severe acute malnutrition in young children from 6 months to 5 years old has greatly improved survival through the ability to treat large numbers of malnourished children in the community setting rather than at health facilities during emergencies. "
2.	Amoxicillin (Wymox)FDA LinkGeneric 11/01/2023 - "Amoxicillin treatment led to acute but not sustained increases in antimicrobial resistance genes and improved gut microbiome maturation 2 years after severe acute malnutrition treatment. " 01/01/2017 - "Meta-analysis on efficacy of amoxicillin in uncomplicated severe acute malnutrition." 11/01/2023 - "We conducted a secondary analysis of a randomised, double-blinded, placebo-controlled trial (NCT01613547) of amoxicillin in children (aged 6-59 months) with severe acute malnutrition treated as outpatients in Madarounfa, Niger. " 11/01/2023 - "Effect of amoxicillin on the gut microbiome of children with severe acute malnutrition in Madarounfa, Niger: a retrospective metagenomic analysis of a placebo-controlled trial." 02/04/2016 - "In a double-blind, placebo-controlled trial in Niger, we randomly assigned children who were 6 to 59 months of age and had uncomplicated severe acute malnutrition to receive amoxicillin or placebo for 7 days. "
3.	Anti-Bacterial Agents (Antibiotics)IBA 01/01/2016 - "The addition of antibiotics to therapeutic regimens for uncomplicated severe acute malnutrition was associated with a significant improvement in recovery and mortality rates. " 01/31/2013 - "The addition of antibiotics to therapeutic regimens for uncomplicated severe acute malnutrition was associated with a significant improvement in recovery and mortality rates. " 10/01/2022 - "A narrative review of efficacy of antibiotics in treatment of children with severe acute malnutrition in community based out-patient treatment." 11/01/2023 - "Children with severe acute malnutrition are treated with antibiotics as outpatients. " 11/01/2023 - "Antibiotics are routinely used as part of the management of severe acute malnutrition and are known to reduce gut microbial diversity in non-malnourished children. "
4.	Azithromycin (Zithromax)FDA LinkGeneric 04/20/2021 - "Azithromycin for uncomplicated severe acute malnutrition: study protocol for a pilot randomized controlled trial." 10/01/2022 - "Comparing Azithromycin to Amoxicillin in the Management of Uncomplicated Severe Acute Malnutrition in Burkina Faso: A Pilot Randomized Trial." 11/01/2023 - "Three hundred one children aged 6 to 59 months with uncomplicated severe acute malnutrition (mid-upper arm circumference < 11.5 cm and/or weight-for-height Z-score < -3 without clinical complications) were enrolled in a 1:1 RCT of single-dose azithromycin versus a 7-day course of amoxicillin (standard of care). " 11/01/2023 - "We evaluated gut microbiomes in children participating in a randomized controlled trial (RCT) of azithromycin versus amoxicillin for severe acute malnutrition. " 11/01/2023 - "Gut Microbiome among Children with Uncomplicated Severe Acute Malnutrition in a Randomized Controlled Trial of Azithromycin versus Amoxicillin."
5.	PrebioticsIBA 04/26/2023 - "Double-Blind Parallel Treatment Randomized Controlled Trial of Prebiotics' Efficacy for Children Experiencing Severe Acute Malnutrition in Southern Punjab, Pakistan." 07/11/2009 - "Our aim was to assess the clinical and nutritional efficacy of a probiotic and prebiotic functional food for the treatment of severe acute malnutrition in a HIV-prevalent setting. " 07/11/2009 - "Probiotics and prebiotics for severe acute malnutrition (PRONUT study): a double-blind efficacy randomised controlled trial in Malawi."
6.	Vitamin A (Retinol)FDA LinkGeneric 01/01/2012 - "Efficacy of high-dose vitamin A (VA) in children suffering from severe acute malnutrition (SAM) has recently been questioned. " 01/01/2012 - "Efficacy of a high-dose in addition to daily low-dose vitamin A in children suffering from severe acute malnutrition with other illnesses." 09/12/2013 - "Review of the safety and efficacy of vitamin A supplementation in the treatment of children with severe acute malnutrition." 01/01/2017 - "In addition, only 19.9% of children 12-59 months received two doses of vitamin A supplementation in a calendar year, and 32.5% of children 6-59 months with severe acute malnutrition were admitted for treatment at health facilities. " 09/12/2013 - "World Health Organization (WHO) guidelines recommend for children with severe acute malnutrition (SAM), high-dose vitamin A (VA) supplements be given on day 1 of admission, and on days 2 and 14 in the case of clinical signs of vitamin A deficiency (VAD). "
7.	ORALIT (ORS)IBA 01/01/2021 - "More research is required to modify ORS further to make it safe and effective in neonates, severe acute malnutrition, renal failure, cardiac and other co-morbidities. " 12/01/2015 - "Safety and Efficacy of Low-osmolarity ORS vs. Modified Rehydration Solution for Malnourished Children for Treatment of Children with Severe Acute Malnutrition and Diarrhea: A Randomized Controlled Trial." 04/01/2023 - "As per the World Health Organization (WHO) guidelines, rehydration therapy for children with severe acute malnutrition (SAM) is different from other children including the fluid used for bolus, i.e., RL and oral rehydration solution (ORS), i.e., rehydration solution for malnourished (ReSoMal). "
8.	Amino AcidsFDA Link 06/01/2023 - "Here, we describe a patient, a case of GA-1 on medical food, presenting with severe acute malnutrition, who improved with a combination of medical and home-made foods along with lysine-free, tryptophan-reduced amino acid supplements." 01/01/2018 - "Amino-acid-enriched cereals ready-to-use therapeutic foods (RUTF) are as effective as milk-based RUTF in recovering essential amino acid during the treatment of severe acute malnutrition in children: An individually randomized control trial in Malawi." 10/01/2017 - "Soya, maize, and sorghum-based ready-to-use therapeutic food with amino acid is as efficacious as the standard milk and peanut paste-based formulation for the treatment of severe acute malnutrition in children: a noninferiority individually randomized controlled efficacy clinical trial in Malawi." 07/01/2017 - "Here, we discuss a rare case of a 13-month-old female, having Severe Acute Malnutrition (SAM) and failure to thrive, with serial high plasma ammonia, normal plasma lactate with high arginine and glutamine levels on Amino Acid Assay (AAA) which was performed on 1220 Agilent HPLC. "
9.	Proteins (Proteins, Gene)FDA Link 01/01/2021 - "Severe acute malnutrition (SAM), due to poor energy and/or protein intake, is associated with poor growth, depressed immune function, and long-term impacts on metabolic function. " 06/01/2013 - "Protein source and quality in therapeutic foods affect the immune response and outcome in severe acute malnutrition." 01/01/2020 - "For RUTF, the protein requirement recommended was 2.82 g · kg-1 · d-1, to achieve a catch-up weight gain of 10 g · kg-1 · d-1 in children recovering from severe acute malnutrition. " 08/01/2017 - "We studied children in Lusaka, Zambia, with severe acute malnutrition (SAM) and persistent diarrhea using endoscopy, biopsy and analysis of markers and protective proteins in blood and intestinal secretions. " 10/01/2006 - "In the dietary management of severe acute malnutrition in children, there is evidence to support the WHO Manual's protocol of cautious feeding of a low energy and protein formula with small frequent feeds in the initial phase of treatment, particularly in kwashiorkor. "
10.	Lumefantrine Drug Combination Artemether (Coartem)FDA Link 10/24/2016 - "Efficacy of artemether-lumefantrine in relation to drug exposure in children with and without severe acute malnutrition: an open comparative intervention study in Mali and Niger." 06/12/2015 - "The main objective of this study is to assess whether artemether-lumefantrine is less efficacious in children suffering from severe acute malnutrition (SAM) compared to non-SAM children, and if so, to what extent this can be attributed to a sub-optimal pharmacokinetic profile. " 06/12/2015 - "A multi-center, open-label trial to compare the efficacy and pharmacokinetics of Artemether-Lumefantrine in children with severe acute malnutrition versus children without severe acute malnutrition: study protocol for the MAL-NUT study." 12/01/2019 - "Severe Acute Malnutrition Results in Lower Lumefantrine Exposure in Children Treated With Artemether-Lumefantrine for Uncomplicated Malaria."

Therapies and Procedures

1.	Therapeutics 01/01/2017 - "This study found that recovery rate of 6-59 months old children treated for severe acute malnutrition in therapeutics units was in acceptable range based on the WHO recommendation. " 01/01/2023 - "Rate, risk factors and estimations of time to develop severe acute malnutrition after children receiving antiretroviral therapy at selected health facilities in northwest Ethiopia." 01/01/2021 - "Severe acute malnutrition (SAM) may alter the pharmacokinetics (PK), efficacy, and safety of antiretroviral therapy. " 01/01/2020 - "However, determinants of severe acute malnutrition among HIV-positive children receiving care and treatment in antiretroviral therapy clinics in Ethiopia are not abundantly investigated. " 01/01/2020 - "Treatment outcome of Severe Acute Malnutrition and associated factors among under-five children in outpatient therapeutics unit in Gubalafto Wereda, North Wollo Zone, Ethiopia, 2019."
2.	Blood Transfusion (Blood Transfusions) 12/01/2023 - "To date, no study has evaluated systematically the effects of inotrope or vasopressor or blood transfusion in children with dehydrating diarrhoea (eg, in cholera) and severe acute malnutrition (SAM) or severe underweight who are in shock and unresponsive to WHO-recommended fluid therapy. " 12/15/2021 - "Children with hemoglobinopathies, autoimmune diseases, previous blood transfusion, severe acute malnutrition, hemophagocytic lymphohistiocytosis and chronic hepatitis were excluded. " 01/01/2019 - "The diagnoses associated with the order for blood transfusion were sickle cell disease (129, 43.0%), active bleeding (58, 19.3%), malaria (50, 16.7%), visceral leishmaniasis (25, 8.3%), severe acute malnutrition (16, 5.30%), snake bite (11, 3.7%), sepsis (5, 1.7%), and others. " 12/01/2023 - "Efficacy of dopamine, epinephrine and blood transfusion for treatment of fluid refractory shock in children with severe acute malnutrition or severe underweight and cholera or other dehydrating diarrhoeas: protocol for a randomised controlled clinical trial."
3.	Nutrition Therapy (Medical Nutrition Therapy) 04/01/2021 - "In India, Nutrition Rehabilitation Centers (NRCs) established at public health facilities provide residential medical nutrition therapy for severe acute malnutrition (SAM) children with complications. " 01/01/2019 - "To compare efficacy of indigenous Ready-to-use Therapeutic Food (Medical Nutrition Therapy) with Standard Nutrition Therapy in children with Severe acute malnutrition. " 01/01/2019 - "Indigenous Ready-to-use Therapeutic Food (Medical Nutrition Therapy) appeared to be superior to Standard Nutrition Therapy in promoting weight gain in children with Severe Acute Malnutrition."
4.	Aftercare (After-Treatment) 01/01/2018 - "Recovery and relapse from severe acute malnutrition after treatment: a prospective, observational cohort trial in Pakistan." 01/01/2014 - "Follow-up of post-discharge growth and mortality after treatment for severe acute malnutrition (FuSAM study): a prospective cohort study." 11/01/2023 - "Growth and Body Composition 5 y After Treatment for Severe Acute Malnutrition: A 5-y Prospective Matched Cohort Study in Ethiopian Children." 10/01/2021 - "Linear catch-up growth after treatment of severe acute malnutrition (SAM) is low, and little is known about the association between ponderal and subsequent linear growth. " 01/01/2021 - "Children with severe acute malnutrition (SAM) remain vulnerable after treatment at nutritional rehabilitation units (NRUs). "
5.	Fluid Therapy (Oral Rehydration Therapy) 02/18/2021 - "All prescriptions were silent about the severe acute malnutrition status of the children before administering fluid therapy. " 01/01/2021 - "Gastroenteritis Rehydration Of children with Severe Acute Malnutrition (GASTROSAM): A Phase II Randomised Controlled trial: Trial Protocol." 01/01/2017 - "Background: Rehydration strategies in children with severe acute malnutrition (SAM) and severe dehydration are extremely cautious. " 12/01/2023 - "To date, no study has evaluated systematically the effects of inotrope or vasopressor or blood transfusion in children with dehydrating diarrhoea (eg, in cholera) and severe acute malnutrition (SAM) or severe underweight who are in shock and unresponsive to WHO-recommended fluid therapy. " 04/01/2023 - "As per the World Health Organization (WHO) guidelines, rehydration therapy for children with severe acute malnutrition (SAM) is different from other children including the fluid used for bolus, i.e., RL and oral rehydration solution (ORS), i.e., rehydration solution for malnourished (ReSoMal). "