Dr. Andy

Reflections on medicine and biology among other things

Wednesday, February 15, 2006


When I think of technology improving lives, I'm not sure treatment of malnutrition is what comes to mind. But that is exactly what it is doing. In the past, refeeding of malnourished children was problematic. In poor countries you simply couldn't admit every child to the hospital as there weren't enough beds or resources. And admitting the sickest child in a family potentially hurt other children as a parent (usually the mother) was away from home, staying at the hospital. Finally, having a bunch of sick, malnourished (and therefore immunocompromised) kids staying in tight quarters could lead to outbreaks of infections

But it was equally hard to send kids home. Formulas and other nutritional supplements usually required remixing with local water, which could cause the same sort of gastrointestinal infections that contributed to the malnutrition in the first place.

Solution: Plumpy'nut
Unlike fortified powdered milk formulas, Plumpy'nut does not require mixing with clean water, which can be difficult to come by in some war-torn and famine-stricken areas. Plumpy'nut is a ready-to-eat mixture of peanut paste, sugar, fats, minerals, and vitamins. One pouch of Plumpy'nut alone packs 500 calories and costs as little as $0.35 cents a packet. Malnourished children will consume as many as three packets a day at nine feeding session
You won't often hear an allergist say anything good about peanuts, but this sounds fantastic. According to this article (free full text) in a recent New England Journal of Medicine, the feasability of outpatient treatment of malnutrition in making a big difference in Niger, allowing doctors and hospitals to concentrate on the worst cases:
Children who do not eat what they are fed at a nutritional rehabilitation center usually have serious infectious or metabolic disorders that necessitate hospitalization. But for most other children, and for children whose condition has been stabilized in an inpatient setting, weekly medical consultation is sufficient for health care providers to diagnose and treat the common, non–life-threatening complications and infections associated with severe malnutrition. Most children in outpatient programs for severe malnutrition who are treated with the new solid therapeutic foods are cured in four weeks, without having to be hospitalized.
Outpatient treatment also avoids taking the parents out of the process of treatment.


At 1:12 PM, Blogger PaedsRN said...

That sounds quite exciting! Although as you say, the mention of the word 'peanut' gives one pause. Still, I assume the percentage of malnourished children with severe peanut allergy would be sufficiently low to make a cheap alternative worthwhile.

'Cheap'? At 35 cents a pack it sounds do-able, but of course it's not for most impoverished families. So long as this is a state-funded (or internationally funded) solution it should work great.

But how do you get them to eat it instead of taking a bottle? :)

At 10:52 PM, Blogger ollie said...

George Washington Carver would be proud!

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