Definition and assessment of a therapeutic food for severely malnourished children in situation of humanitarian crisis

Nowadays, median case fatality rate of severely malnourished children treat ed in hospitals is 23.5 %. a rate which has not changed for the last 50 yea rs This is probably related to the use of` inappropriate or even unsafe tre atment protocols. This,work aimed at reducing case fatality rates of severe malnutrition by developing a treatment protocol and assessing its effectiv eness during humanitarian crises. A therapeutic food was designed from path ophysiologic studies and its use adapted to therapeutic feeding centres. Th is food (F100) contains 100 Kcall 100 ml, with 10 % of its energy derived f rom proteins : it has a low sodium and iron content but is fortified with v itamins and minerals. It can be prepared either at the treatment centre or at an industrial level. Industrial production, which started in 1993 reache d 1 500 MT in 1997. In refugee camps, F100 was used according to a strict p rotocol adapted to local conditions. Intakes started at 100 Kcal/kg/day and reached 200 kcal/kg/day once appetite was restored A model to assess the r isk of death according to weight, height and oedema was developed First res ults show that mortality was often below 5 %. Hence, it is possible to stan dardise and evaluate a nutritional treatment in such unfavourable condition s as a refugee camp. Standardised use of F100 can markedly reduce mortality of severely malnourished children.